Friday, April 18, 2014

2016 1/2 Kanawha Boulevard E. Charleston, WV  25311-2204 Phone: (304) 344-5302 Fax: (304) 344-5316


 

 

Your Membership Matters
 
 
Dear Colleague: 

The resources WVPA invests in making sure your voice is heard and your interests represented are significant. Advocacy for your profession requires an ongoing commitment and stakeholder investment.
 
Advocacy is the major responsibility of WVPA.   If you ask yourself whether or not what you are doing is at risk for obsolescence...then you need advocacy. If someone attempts to control what professional services you provide and what you are permitted to do with your profession and business practice...then you need advocacy. If you cannot identify 100 consumers of your services willing to go to the wall to ensure that you remain their provider...then you need advocacy. If your perception of quality services and positive outcomes is considered overrated by others...then you need advocacy. If you do not know who your state legislators or U. S. Congressman are...then you need advocacy. If you are just beginning your professional career...then you need advocacy. 
 
WVPA staff and elected officers attend to their advocacy responsibilities with the interest of your profession foremost. The resource fueling WVPA’s advocacy efforts is dependent upon membership. 
 
WVPA needs your membership to help assure continue advocacy for your profession. While our efforts are not always successful, WVPA has made – and will continue to make with your membership – tremendous strides and accomplishments in being pharmacy’s advocate. WVPA secured legislative authority allowing pharmacists to expand their scope of practice by administering certain immunizations. This expansion offers an opportunity to you to provider more health care services to your patients. 
 
As late as the 2012 Legislature, WVPA issued a “call to action” to pharmacists/members to defeat legislation that would have allowed insurance companies and PBMs to dispense 90-day supplies of medication from out-of-state mail order operations. Similar advocacy action was taken to prohibit insurance companies to require mail order of chronic medications. 
 
Earlier this year WVPA influenced the Legislature to “modernize” our Pharmacy Practice Act allowing you to provide health care services with the skills you attained through from your education and training. 
 
This accomplishment did not come easy as we had opponents to our legislative efforts. But wit the help of our members who contacted Senators and Delegates, we were successful.
 
A major provision in the new Act advancing our profession is medication therapy management (MTM). This is a professional services you can provide Medicare beneficiaries to improve their health and be paid by Part D plans I am very excited about this new opportunity for our profession, as I’m sure you are. The provisions of this new law are contained in House Bill 2577. 
 
We trust you can conclude from the above that your membership matters. Your being a member is imperative to WVPA continuing to advocate for our profession. Please continue your membership...or become a member if you currently are not one... and participate in our advocacy efforts. 
 
Your membership matters!
 
Thank you,

Jason Turner, Pharm.D.
President
 
 
 
News & Updates
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Guidance on Part D Coverage of Hospice Drugs:

CMS has issued a final memo providing guidance for Part D sponsors and hospices as it relates to payment for drugs for hospice beneficiaries in 2014.  The effective date of this policy clarification will be May 1, 2014 and will be applied prospectively.  When a beneficiary (or authorized representative) has elected the hospice benefit, the hospice is responsible for covering all drugs or biologicals for the palliation and management of the terminal and related conditions. Drugs and biologics covered under the Medicare Part A per-diem payment to a hospice program, therefore, are excluded from coverage under Part D.  

For prescription drugs to be covered under Part D when the enrollee has elected hospice, the drug must be for treatment of a condition that is completely unrelated to the terminal illness or related conditions.  CMS expects drugs covered under Part D for hospice beneficiaries will be unusual and exceptional circumstances. Therefore, the sponsor should place beneficiary-level prior authorization (PA) requirements on all drugs for beneficiaries who have elected hospice to determine whether the drugs are coverable under Part D.  CMS expects Part D sponsors should implement processes to handle payment resolution directly with hospice providers and beneficiaries without requiring the pharmacy reverse and rebill the original claim in the retail setting. However, whenever the network pharmacy involved is also the hospice pharmacy, as is often the case with long-term care pharmacies, reverse and rebill may be the most appropriate approach.

 

Update on Federal Provider Status Efforts

On March 11, 2014, HR 4190 was introduced in the US House of Representatives to recognize pharmacists as providers under Medicare Part B.

The current legislation, introduced by Representatives Brett Guthrie (R-KY), G.K. Butterfield (D-NC), and Todd Young (R-IN), will enable patient access to, and reimbursement for, Medicare Part B services by state-licensed pharmacists in medically underserved communities. Pharmacists, as the most accessible health care professionals, are uniquely positioned to provide patients in medically underserved communities access to health care services that are already within their scope of practice. By providing for a payment mechanism under Medicare Part B, the bill will allow pharmacists to help fill the gaps in care that have been created by shortages of health care professionals and increases in the number of Americans who are now eligible to gain health insurance under the Patient Protection and Affordable Care Act.

Although provider status has been a profession-wide goal for many years, activity began picking up in early 2013 and have come to a head with the formation of the Patient Access to Pharmacists’ Care Coalition (PAPCC). The coalition currently represents over 20 organizations and is continuing to grow. Members include organizations representing patients, pharmacists, pharmacies, and other interested stakeholders.

This coalition is focused on developing and helping to enact a federal policy proposal that will enable patient access to, and payment for, Medicare Part B services by state-licensed pharmacists in medically underserved communities. Their primary goal is to expand medically underserved patients’ access to pharmacist services consistent with state scope of practice law.

 

Getting HR 4190 passed may be a long term effort (possibly even multiple years) that will require grassroots advocacy from all pharmacists. Get ready for action alerts asking you to send letters and emails and make phone calls to your legislators!   WV Pharmacists Association will continue to work with our national partners to make sure that you are kept up to date on the progress of HR 4190 and PAPCC. To read the press release from PAPCC, click here: http://bit.ly/1ix4RQQ

 
More news here

 

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