CEO Message March 28, 2008
Author: Lynn Rolston
Dear Member,
Today, the Department of Health Care Services released the long overdue Myers & Stauffer study from last year on pharmacy dispensing and acquisition costs. As expected, the study concluded that the current Medi-Cal dispensing fee is well below the average cost of dispensing, finding that the statewide average (mean) cost of dispensing, weighted by Medi-Cal volume, was $10.81 per prescription. This result does not include any allowance for a reasonable profit for the pharmacy. Based on Myers & Stauffer report, the dispensing fee would need to be increased by almost 50% to cover actual dispensing costs. However, the report also concluded that pharmacies were still making adequate margin on the “spread” between what Medi-Cal pays for covered drugs and the pharmacies’ actual drug costs to more than compensate for the shortfall. The study did not, however, take into consideration in its analysis the impact of the shift to AMP-based reimbursement for all prescription drugs that was included in last year’s State Budget. That change will largely negate the margins Myers & Stauffer found related to drug product acquisition. CPhA will continue to analyze the entire report and will provide more information as it becomes available. You can view the report by clicking here.
E-Pedigree Extension
On Tuesday, Kathy Lynch attended the Board of Pharmacy meeting in San Diego. The sole focus of the meeting was to discuss the e-Pedigree law and the ability of the supply chain to implement the law on 1/1/09. Kathy has testified at various Board of Pharmacy meetings in addition to their Enforcement Committee meetings on the subject matter. CPhA also submitted written testimony to the Board. I am happy to report that our efforts have paid off and the Board of Pharmacy agreed to extend the deadline to January 1, 2011 (you can read the Board’s statement here) (you can read CPhA’s statement here). We are very concerned about the safety of medications for patients. We believe more time was needed to ensure that all members of the supply chain are ready, and that pharmacies would have ample time to come up-to-speed on the required equipment and necessary software to accurately read the pedigree. Thank you to Kathy and our partners (NACDS and CRA) for tirelessly working with the Board and others on this issue.
Alliance for Patient Care Meeting with SF Mayor Gavin Newsom
On Tuesday, San Francisco Mayor Gavin Newsom hosted a meeting with the Alliance for Patient Care (APC) at the Sacramento Sheraton Grand Hotel. APC members such as CPhA and other health care stakeholders were provided with an opportunity to discuss what the Medi-Cal cuts will mean for access to care for Medi-Cal enrollees, and the devastating effects the cuts will have on the health care infrastructure. There was also discussion on strengthening efforts to fight the cuts. Mayor Newsom was concerned that his new universal health plan in San Francisco would not be able to pick up the additional patient load if the Medi-Cal program falters as a result of the proposed 10 percent cuts. Mayor Newsom and CMA are working together on a lawsuit to help stop these cuts (CPhA is also looking at taking legal action and is working with CMA and Mayor Newsom as well). Statements from the many provider representatives and patient advocates were heartbreaking and frightening. It was announced that California’s Medicaid program places last in terms of funding. An additional 10 percent reduction would literally decimate the program in every way. This group will continue to actively fight Medi-Cal cuts.
PR Support to Fight 10 Percent Medi-Cal Cuts
A number of providers and advocates have expressed concern that there has been very little press regarding the 10 percent cuts to Medi-Cal. Education and other sectors affected have gotten off to a stronger start. CPhA, NACDS and CRA will be kicking off a PR campaign within the next couple of weeks. However, in advance of that, one of our members, Ira Freeman, took it upon himself to express his grave concerns over this issue by instituting a 15 day hunger strike. CPhA sent out a news release regarding Ira’s plight. Ira has received considerable news coverage (see news section below) and will be featured this Sunday night on KNBC Ch. 4 Extra in Los Angeles at 11 p.m. Ira reports that patients are calling up saying, “thank you for what you’re doing and that people are even trying to feed me out of concern for my blood sugar levels.”
Tamper-Resistant Prescription Pads Deadline
With April 1st rapidly approaching, I want to remind you that all written prescriptions for Medi-Cal beneficiaries must be on a tamper-resistant prescription pad with at least one of three tamper-resistant features. Keep in mind that the pads must contain all three tamper-resistant features by October 1, 2008. CMS has provided baseline characteristics for the tamper-proof pads, but each state has defined their features and, thus, you are cautioned to view California’s Medi-Cal website to ensure compliance. To read more about California’s tamper-resistant Rx pads, please click here. If you have questions about this law, please contact Paige Talley at ext. 346 or by e-mail at ptalley@cpha.com.
Executive/Audit and Finance Committee Meeting
On Wednesday, the CPhA Executive/Audit and Finance Committee met for their regularly scheduled meeting. It was a packed agenda that revolved, in large part, around CPhA activities in blocking the 10 percent Medi-Cal cuts. It was agreed by all that these cuts would be devastating to California pharmacy and their patients in all practice settings where Medi-Cal is taken. This committee provides oversight for activities in this effort, from the selection of contractors to budgetary issues. While CPhA has committed significant funding, more is needed. Again, we urge you to make your contribution to the Pharmacy Defense Fund of California by clicking here or to CPh PAC by clicking here.
AB 1947 Meeting
On Monday, I attended a meeting in Assembly member Emmerson’s office. Jim Gross, our contract lobbyist, and CSHP’s contract lobbyist, Bryce Docherty, and Philip Swanger, CSHP Director of Government Affairs were also in attendance. Emmerson is the author of CSHP’s sponsored bill AB 1947, which requires that technicians take a test like the PTCB or equivalent and obtain 20 hours of continuing education per two-year licensing cycle. The intent of this bill is to contribute to quality of care and patient safety. It was agreed by all that there are potentially more items to consider for this bill and that convening a larger number of stakeholders over the coming months could provide valuable input. As such, the Assembly member agreed to pull AB 1947 for 2008, but remained very supportive of this CSHP initiated effort. We look forward to working with CSHP and other stakeholders on this bill.
Leader Pharmacy Dinner
On Wednesday evening, Paul Lofholm, Lynn Rolston, Kathy Lynch and Veronica Van Orman attended the Leader Pharmacy Meeting in Sacramento. Paul, Kathy and Lynn updated the audience on the 10% budget cuts looming over Independents and provided updates on AMP and e-Pedigree. Paul encouraged attendees to contact their Legislators. He quoted David Wilcox from his message broadcast earlier in the week, “if your legislator doesn’t hear from you, then he or she can only assume that you either don’t care or you can absorb these cuts.” Veronica encouraged all attendees to get involved by donating to the PAC and the Pharmacy Defense Fund. A total of $8,700 was raised from the Leader group who were in attendance. GO LEADER! Cardinal Health’s Jimmy Neil and David Gonzales closed the meeting with information on Medicare Part B Accreditation and provided a legislative update from the wholesaler’s perspective. This was an outstanding meeting with very dedicated pharmacy professionals.
A Healthy You News Conference
Yesterday, I participated in a news conference at the Capitol to help launch a new resource booklet called A Healthy You! – America’s Guide to Healthy Living. This free, pocket-sized book provides useful tips and resources to help Americans lead healthier lives and prevent chronic diseases such as heart disease, cancer and diabetes. The contents of the book can be found online at www.lillyforbetterhealth.com. Following the news conference, CPhA participated in a health fair with approximately 20 other health care professionals and organizations. We applaud Eli Lilly for taking this step to educate patients throughout country.
Sad News
It is with regret that I announce that pharmacist-attorney John Berger, Past President of CPhA, past member of the California State Board of Pharmacy and longtime pharmacy law professor at USC, died of a heart attack late last month. In recent years, John was a strong advocate for employee pharmacists and most recently served on the CPhA Board of Trustees as Trustee for the Academy of Employee Pharmacists. He was also a Past President of the American Society for Pharmacy Law, a national organization of pharmacy attorneys. John will be deeply missed by his friends, family and colleagues. This is sad news indeed.
This is Your Last Chance to Complete Evaluations and Claim CE Credit for Outlook 2008!
If you attended CE sessions at Outlook 2008, you have until Monday, March 31st to use the on-line process to complete program evaluations and print Statements of Credit. Before you visit www.pharmacyfoundation.org/OutlookCE, make sure you have the specific "voucher codes" for the sessions attended and then click here for step-by-step instructions that will guide you through the entire process. If you have questions or need help, please contact Shannon Presidio at spresidio@pharmacyfoundation.org. Evaluations submitted after March 31, 2008 may not be valid for CE credit.
Call for Outlook 2009 CE Presentation Proposals
The Pharmacy Foundation of California (PFC) invites university professors, informal educators, pharmacy practitioners and other members of the “community of pharmacy” to share their experience and expertise with other pharmacy professionals by submitting a proposal to present an educational lecture and/or workshop at Outlook 2009 (scheduled for February 19 – 22 in Anaheim, CA). If you are interested in having your CE program considered for Outlook 2009, click here to review the proposal submission guidelines and to complete the proposal form. Proposal forms must be submitted by April 14, 2008, to receive full consideration. If you have any questions, please contact Shannon Presidio at spresidio@pharmacyfoundation.org.
Pharmacy Technician CE
Tech Lectures, a pharmacy technician organization that offers CE for little or no cost, recently provided CPhA with their Tech Lecture Update- currently offering 26 Pharmacy Technician specific CE lectures. Four new lectures have been added this month. See current list of lectures. In the coming weeks, Tech Lectures will be posting new CE offerings, so mark the web page for future visits. Click here to view the most recent program on Diabetes Mellitus.
In the News
Ira Freeman, CPhA member, has gone on a 15 day hunger strike in protest of the Governor’s proposed Medi-Cal cuts. His story was picked up by KCAL TV, KFWB, KPFK, KNBC and the San Fernando Business Times. You can read the SFBT article by clicking here. You can watch KCAL video here or listen to the KFWB radio piece here.
Paul Lofholm and John Cronin were both interviewed for a Sacramento Bee story regarding delays in Medi-Cal treatment approvals. To read the story, click here.
CPhA member Dave Wilcox was interviewed for a story in the Central Valley Business Times regarding the Board of Pharmacy’s decision to extend the e-Pedigree deadline. To view the article, click here.
John Cronin and Chris Woo were both interviewed for a San Diego Union Tribune article regarding the California Board of Pharmacy’s decision to extend the deadline for e-Pedigree. To read the article, click here.
San Francisco Mayor Gavin Newson in Sacramento regarding 10 percent Medi-Cal cuts. You can watch the NBC 11 news story here.
Question of the Week
Dear Lynn,
Can you get this information out to CPhA members? There have been some important changes to the Medicare Part B DME accreditation and bidding process. The most important change is that the deadline for accreditation has changed from August 31, 2008 to May 14, 2008.
David Breslow
CPhA member, UPNI
Answer
Dear David,
Certainly! I know how important that the Part B DME provider status is for our members. As we mentioned earlier in this message, Cardinal Health can provide that to our members and they should contact Cardinal Health directly. I also know that UPNI has an entire program built around helping accredited providers through the complicated bidding process and that you have a web site going up today at www.accreditedprovidernetwork.com. Our members should also visit the CMS web site at www.cms.hhs.gov for more rules, regulations and process information.
Thank you for this important reminder.
Sincerely,
Lynn Rolston
Chief Executive Officer
California Pharmacists Association