PHARMACY

NCPA endorses latest prescription transparency legislation

BY Michael Johnsen

WASHINGTON — Reps. Doug Collins, R-Ga., and Dave Loebsack, D-Iowa, on Thursday introduced H.R. 1316, the Prescription Drug Price Transparency Act, to protect taxpayers and the community pharmacists who serve them by requiring greater transparency from pharmacy benefit managers.

“I’m introducing a bipartisan bill to ensure that PBMs update their MAC lists for Medicare Part D, TRICARE, and FEHBP every seven days to protect competitive pricing and to preserve pharmacy access and choice for patients," Collins stated. "The Prescription Drug Price Transparency Act provides essential oversight to prevent waste, fraud, and the abuse of taxpayer funds and better protects patient privacy.”

Support for this legislation extends across the aisle, Collins noted. Rep. Loebsack is the bill’s lead Democratic co-sponsor. Other original co-sponsors for H.R. 1316 include Reps. Brian Babin, R-Texas, Rod Blum, R-Iowa, Buddy Carter, R-Ga., John Duncan, Jr., R-Tenn., Cathy McMorris Rodgers, R-Wash., and John Sarbanes. D-Md.

“Whether it is in large cities, or small towns, pharmacists across the country serve as the first line of health care services for many patients. I appreciate all of their hard work to serve our communities and to provide quality, affordable and personal care,” Loebsack said. "However, I also recognize how challenging it can be for some small pharmacists to compete with bigger companies. One pressing challenge facing many community pharmacists is the ambiguity and uncertainty surrounding the reimbursement of generic drugs. To help address this problem, I am proud to join my colleague Rep. Collins to reintroduce the Prescription Drug Price Transparency Act, which also helps ensure federal health plan reimbursements to pharmacies to keep pace with generic drug prices.”

The National Community Pharmacists Association on Thursday announced its strong support for the legislation.  

According to the association, H.R. 1316, the Prescription Drug Price Transparency Act would:

  • Require pharmacy benefit managers which serve TRICARE and the Federal Employee Health Benefits programs, to provide the same updates and disclosures to pharmacies for the maximum allowable costs lists that are currently provided to pharmacies in Medicare Part D. These “MAC” lists determine generic reimbursements for pharmacies;
  • Set a standard for how frequently those lists are updated;
  • Prohibit sharing patient information with PBM-owned pharmacies (mail order and/or retail) unless a patient has chosen to fill that prescription there; and;
  • Forbid PBMs from mandating patients use their affiliated pharmacies.

“Taxpayer-funded federal health programs should operate in a fair, efficient and cost-effective manner, but we are falling short of those objectives when it comes to the dispensing and reimbursement system for generic prescription drugs,” stated Douglas Hoey, NCPA CEO.  “Building off of the Centers for Medicare & Medicaid Services transparency requirements for PBMs’ Medicare Part D plans, Reps. Doug Collins and Dave Loebsack have introduced [a] common-sense bill [that] extends many of those disclosure and privacy protections to federal employees and the military health programs.”

The bill would bolster patient access to the pharmacies of their choosing and ensure pharmacies that sign contracts with PBMs are no longer ‘flying blind’ when it comes to understanding the criteria for generic drug reimbursements, Hoey added. In addition, the bill will create more accountability for how these federal health programs deliver prescription drug services.

 

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PHARMACY

MD Labs names $1K scholarship recipient

BY Brian Berk

WOONSOCKET, R.I. — Kim Nguyen of La Puente, Calif., was named a recipient of a $1,000 MD Labs/Rxight Scholarship Supporting Excellence in Pharmacy Studies.

MD Labs awards its semi-annual pharmacy scholarships through its various programs, including scholarships geared specifically for Pharmacy graduate students and current college students who are planning a career in pharmacy. Nguyen completed her undergraduate studies from the University of California, Los Angeles, with a bachelor of science in Biochemistry and is currently enrolled in Keck Graduate Institute School of Pharmacy to earn a Doctor of Pharmacology degree. Her areas of research interest are oncology and pharmacogenomics. One of Nguyen’s research projects will focus on the implementation of pharmacogenetics testing in a community pharmacy.

 “We are pleased to reward Kim for her contributions to school and community,” said Chuck Dushman, director of corporate giving with MDLabs/Rxight. “In addition, we were very impressed with her future plans and passion for implementing and testing pharmacogenomics in a community pharmacy.”

Scholarship candidates must have a minimum 3.5 cumulative GPA, be a U.S. citizen or legal permanent resident, be pursuing or plan to pursue their first undergraduate or graduate degree in Pharmacy, and plan to enroll as a part-time or full-time student at an accredited U.S. postsecondary institution in the upcoming academic year.

“It is an honor to have received The MD Labs Rxight Scholarship Supporting Excellence in Pharmacy Studies,” said Nguyen. “My love for pharmacogenetics/pharmacogenomics solidified during my enrollment in a graduate level genetics course and I will use my research to advance the pharmacy profession.”

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Zero tolerance for disruption and security breaches

BY Jim Smith
Savvy business owners understand the difference between investments that are nice to have and those that are necessary. For retail pharmacies, electronic claims processing moved into the necessity category long ago. However, many locations continue to operate with outmoded networking solutions that can leave them vulnerable to connection failures or security breaches.
 
Any pharmacy location that hasn’t had a connectivity upgrade in some time – and those for whom upgrades may have been less than optimal – may be missing out on cost-effective solutions that can ensure rock-solid connectivity. When that’s the case, a simple fix is readily at hand.
 
Reliable Connectivity: Heightened Expectations
A fault-tolerant connection is a must-have for thoroughly reliable electronic claims processing. “Fault tolerance” refers to a connection’s ability to continue uninterrupted at all times, even when a primary connection fails. For example, if a retail pharmacy communications with a claims processor over the internet, and the internet service provider (ISP) has a temporary outage, connectivity immediately rolls over to a backup network connection. In this scenario, communication with the claims processor continues seamlessly, as if nothing happened.
Because protected health information (PHI) is routinely shared with claims processors, the second must-have for a connection is data protection. At minimum, transmissions should be encrypted, so that any intercepted transmissions will be unintelligible to unauthorized recipients.
 
Meeting these requirements requires zero in-house technical expertise. A few inquiries of appropriate vendors will reveal immediately if a claims-processing connection is all it should be.
 
Assessing Infrastructures and Improving System Reliability
Taking the following three simple steps will ensure that claims-processing connections are both fault-tolerant and secure:
 
  1. Contact the pharmacy software vendor, and ask what capabilities the software includes for fault tolerance and security in communications. Does it guard against downtime, and how is data protected when in transit? Electronic claims flowing over the internet should be encrypted using TLS 1.2 encryption at a minimum.
  2. Contact the facility’s ISP or private-line supplier and ask the same questions. What happens if the primary connection goes down?
  3. Finally, contact the claims processor with the same questions – how does it ensure that data is always flowing and always secure?
If the answers indicate a shortcoming in fault tolerance or security, it’s time to pursue options. Even if all is well today or if connections are upgraded, be sure to periodically check in with vendors to see if newer capabilities exist that need to be considered for even greater protection.
The reason for periodically checking in is that network technology continually advances, and vendors often deliver new solutions that perform even better, and at lower cost, than the solutions they replace.
 
Today’s networking solutions are inevitably yesterday’s, and nobody wants to unintentionally end up with a solution that’s no longer supported. With just a bit of inquiry from time to time, retail pharmacy operators can rest assured that their claims-processing connections are available at all times, with full protection of their customers’ sensitive information.
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