CMS outlines recommendations to smooth Obamacare transition
ARLINGTON, Va. — The Centers for Medicare and Medicaid Services is encouraging health plans to cover patients’ existing non-formulary drugs as though they were formulary drugs for the first 30 days after the Jan. 1 rollout of the insurance coverage provided under the Patient Protection and Affordable Care Act.
CMS also is recommending that plans treat out-of-network providers as in-network providers during the initial months of enrollment to address situations in which out-of-network providers were listed as in-network at the time of enrollment or are providing treatments for acute episodes of care at the start of the year.
The recommendations have drawn support from the National Association of Chain Drug Stores, a trade group of retail pharmacy chains, which is hoping that CMS includes pharmacies as part of the recommendations.
"We welcome the additional millions of Americans who will have new insurance coverage," a letter from the NACDS to the CMS read. "We are committed to working with all parties to address challenges and to maximize the experience of patients, similar to the efforts of community pharmacy that were noted as vital to smoothing the transition during the rollout of Medicare Part D."
The group also is recommending that CMS "empower patients with information" so that they can maximize their experience with healthcare reform.
"We are concerned that the initial enrollment deadline extensions may result in some newly insured patients not having the information necessary to process pharmacy claims for them in January," the NACDS’ letter read. "We are also concerned that some patients who enroll in a plan and take the opportunity to pay January premiums later in January may not be aware that they must pay for their health care and prescription drug services out-of-pocket pending payment of their insurance premium. In light of our concerns, NACDS urges CMS and insurers to engage in consumer education and outreach to address and mitigate these scenarios, offer ample support for pharmacies via call centers throughout the holidays and use techniques that helped to ease the transition for the initial enrollment in Medicare Part D."
United Therapeutics PAH drug wins approval
SILVER SPRING, Md. — The Food and Drug Administration has approved a new drug made by United Therapeutics for treating pulmonary arterial hypertension, the company said Monday.
The FDA approved Orenitram (treprostinil) extended-release tablets for treating certain PAH patients to improve exercise capacity. PAH is a disease in which abnormally high blood pressure in the arteries of the lungs causes the right side of the heart to work harder than normal, according to the National Library of Medicine.
"This approval marks the first time that the FDA has approved an orally administered prostacyclin analogue for any disease, and our fifth approval from the FDA for treatment of PAH, supporting our mission of providing a wider choice of PAH therapies for physicians and patients," United Therapeutics president and COO Roger Jeffs said. "We are grateful for the FDA’s thorough review and will continue to build clinical support for the use of Orenitram."
Tracey Rossi named Kinney Drugs’ 2013 Favorite Pharmacist of the Year
GOUVERNEUR, N.Y. — A Barre, Vt., pharmacist has been named Kinney Drugs’ top pharmacist, the regional chain announced Monday.
Kinney, which operates 99 stores in central and northern New York and adjacent areas of Vermont, named Tracey Rossi as its 2013 Favorite Pharmacist of the Year, based on customer votes from all of the chain’s stores.
"Tracey is a kind, caring, compassionate individual," Kinney Drugs stores president Jim Spencer said. "The relationship she has with her patients and the care she provides for them are her highest priorities. We truly appreciate Tracey’s nearly 30 years of service as a healthcare professional at Kinney Drugs."
Rossi will be honored at a reception later this month, while the company will donate $1,000 in her name to a charity of her choice.
"Tracey is a spectacular pharmacist who is revered by our customers," Barre, Vt., Kinney Drugs store manager Norm Robinson said. "She knows her patients by name and works hard to go beyond the everyday counseling to deliver outstanding customer service. Over the years, Tracey has truly become woven into the fabric of our community."