As election nears finale, legislative goals remain
WASHINGTON As the 2008 presidential election nears its dramatic finale, pharmacy advocates are still pushing for passage in the waning days of the 110th Congress of key legislation to advance their interests, or awaiting a signature from President Bush on bills that have already reached his desk.
Retail pharmacy’s signature victory in 2008 was the enactment in July—over the President’s veto—of the Medicare Improvements for Patients and Providers Act of 2008, or H.R. 6331, which delayed implementation of Medicaid prescription reimbursement cuts, ensured prompt payment of Medicare prescription claims, postponed adoption of burdensome competitive bidding procedures for durable medical equipment under Medicare Part B, and promoted faster adoption of electronic prescribing. But in recent weeks, lawmakers have handed pharmacy a series of smaller victories and opened the door on new, pharmacy-friendly legislation.
One key win was Senate passage late last month of the House-Senate negotiated version of S. 3001, the National Defense Authorization Act for fiscal year 2009. The bill—which at press time was awaiting White House approval—includes an important provision to preserve pharmacy choice for TRICARE beneficiaries.
If signed into law, the bill would preserve the right of U.S. military members and their families to choose where they have their prescriptions filled with passage of a newly revised military spending bill.
The provision would extend the current freeze on increases to retail pharmacy co-payments, thus maintaining a level playing field for retail pharmacies vis-a-vis mail-order pharmacies. Chain and independent pharmacy advocates fought a long struggle to have that provision included in last year’s military spending bill and were buoyed by its inclusion in this year’s proposal.
Retail pharmacy groups also praised the Senate for its passage Sept. 30 of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008. The bill, also expected to be signed by the president, would clamp down on the illegal sale, abuse and trafficking of prescription drugs over the Internet.
Passed in the House of Representatives Sept. 23, the online pharmacy bill would require a valid prescription for the purchase or distribution of any prescription drug over the Internet, issued by a prescribing physician or other qualified professional who has personally examined the patient. However, it would exempt remote-site pharmacies that operate under approved “tele-medicine” procedures.
“This landmark piece of legislation will bring rogue pharmacy operators out of the shadows by establishing a clear standard for legitimate online pharmaceutical sales,” said Michele Leonhart, acting administrator of the Drug Enforcement Administration. The new law, she said, “will allow customers to know they are doing business with a trusted, legitimate pharmacy and give law enforcement the tools we need to identify illegitimate online pharmacies.”
Added Stephen Giroux, president of the National Community Pharmacists Association and an independent pharmacy owner in upstate New York, “There are just some services that should not be available online. This legislation to clamp down on illegal online operators is the first step in the right direction.”
With pharmacy’s support, the Senate also passed another bill last month to strengthen DEA oversight of illegal pharmaceutical activity. If signed into law, S. 1276, the Methamphetamine Production Prevention Act, would spur the adoption of methamphetamine precursor electronic logbook systems, thus providing law enforcement with easier access to information and streamlining record-keeping requirements for pharmacies.
The National Association of Chain Drug Stores praised passage of the bill. “Senate passage of this legislation sends an important message that preventing the illegal production and abuse of methamphetamine is imperative to our nation’s well-being,” said NACDS president and chief executive officer Steven Anderson. “S. 1276 will help law enforcement efforts while also allowing increased efficiency in logging meth precursor sales. We encourage the House to join the Senate in passing this legislation so that it can be enacted into law.”
Another bill on independent pharmacy’s wish list is H.R. 6582, the Small Business Cooperative for Health Care Options to Improve Coverage for Employees [CHOICE] Act of 2008. The bill, introduced by U.S. House Small Business Committee chair Nydia Velazquez, D-N.Y., with support from both parties, is aimed at keeping smaller employers from falling prey to steadily rising health care and insurance costs.
The CHOICE bill has drawn vocal support from the National Community Pharmacists Association. It would set up private, voluntary purchasing cooperatives established under state insurance laws to provide excess claims insurance coverage to participating small businesses. The bill allows those employers to pool health risks over a larger number of insured plan participants, thus reducing costs and, ultimately, premiums.
H.R. 6582 also provides a refundable tax credit to small employers who purchase health insurance for their employees through the cooperative.
Retail pharmacy leaders are also lobbying heavily in favor of legislation to curb the alarming rise of organized retail crime, which drains $30 billion a year from retail businesses, according to NACDS. Congress is currently mulling at least three bills that would combat the problem: H.R. 6713, the “E-fencing Enforcement Act of 2008;” H.R. 6491, the “Organized Retail Crime Act of 2008;” and S. 3434, the “Combating Organized Retail Crime Act of 2008.”
Addressing the U.S. House Judiciary Subcommittee on Crime, Terrorism, and Homeland Security Sept. 22, Walgreens security expert Frank Muscato discussed the growing problem of organized retail theft and its impact on chain drugstores. “ORC is an extremely sophisticated and coordinated crime,” Muscato told the House panel. “It involves highly structured organizations and gangs that hire and control teams of thieves to steal merchandise in large quantities.
“The legislation currently being considered would make ORC a federal criminal offense, which would be extremely helpful in prosecuting more of these large, multi-jurisdictional cases,” Muscato added. “ORC is not garden variety shoplifting. It is organized crime and should be treated as such with stronger penalties and enforcement.”
Medicare patients not getting cancer screenings often enough
ROCKVILLE, Md. A study by researchers at the University of North Carolina shows that screening rates for certain types of cancer among older Medicaid patients lag behind national objectives.
The study, published in the Oct. 13 issue of the Archives of Internal Medicine and based on documented evidence, analyzed 1,951 Medicaid recipients in North Carolina aged 50 and older and found that physicians recommended screening for colorectal, breast and cervical cancer to 52.7 percent, 60.4 percent and 51.5 percent of patients, respectively.
Respective rates of adequate screening for the three cancers were 28.2 percent, 31.7 percent and 31.6 percent.
Report shows Philadelphia has high rate of those treated for diabetes type 2
PHILADELPHIA Percentages of people in Philadelphia who receive services to treat type 2 diabetes are higher than national averages. At the same time, the percentage of working-age people with the disease is higher in the city than the national average.
These are some of the results in the Greater Philadelphia Type 2 Diabetes Report for 2008, released Wednesday by the Greater Philadelphia Diabetes Coalition, which analyzed the demographics, costs and quality of care for people in the city with type 2 diabetes. The report included data from around the city’s metropolitan area, as well as western Pennsylvania and Atlantic City, N.J.
“GPDC helped develop the Greater Philadelphia Type 2 Diabetes Report to serve as a useful resource for employers, illustrating the seirous negative impact diabetes has on the Greater Philadelphia area,” GPDC chairman Dr. Ronald Brooks said. “This report points out the need to prevent diabetes through exercise and prudent nutrition as well as the importance that people with diabetes receive optimal care, based on evidence-based guidelines.”
The report also shows that 57 percent of Philadelphia residents in 2007 were between 18 and 64 years old, higher than the national average of 52.3 percent. In Atlantic City, the rate was 59.4 percent.
It also shows that costs for care of people with Type 2 diabetes are higher in Philadelphia than in the other five markets profiled. In 2007, the average hospital inpatient charges for treating Type 2 diabetics was $95,813, almost twice as high as the national average of $49,870. Hospital outpatient charges were $6,168, while the national average was $4,673.