Legislative Update February 5, 2008
Author: Kathy Lynch
Legislative Update
By Kathy Lynch, Vice President of Government Affairs
February 4, 2008
The Senate Committee on Budget and Fiscal Review met today to hear from the Administration and affected parties, regarding the Governor's proposed budget cuts. After the Administration made its presentations, a series of individuals and groups testified in opposition to the proposed actions.
I attended the hearing and testified on behalf of CPhA. CPhA, along with other pharmacy representatives, detailed what the impact of these proposed cuts would mean to pharmacies and the patients they serve everyday. I further explained the various other state and federal actions that threaten the viability of independent pharmacies. All the comments pertaining to pharmacies were well-received by the Committee. The Committee took no action, but is expected to do so within the next few weeks. Please stay tuned for further information.
If you have any questions or comments, please contact me at klynch@cpha.com or (916) 779-1400.
Thank you very much for your continued support!
Kathy
Update on Bills Heard Last Week
ABx1 1 (Nunez) Health Care Reform
CPhA Position: Watch
ABx 1 1 did not pass out of the Senate Health Committee.
To read the full text of this bill click or cut and paste:
http://www.legislature.ca.gov/cgi-bin/port-postquery?bill_number=abx1_1&sess=CUR&house=B&author=nunez
SB 349 (Perata) Health Care Electronic Billing
CPhA Position: Watch
SB 349 was read and held in Senate Appropriations.
To read the full text of this bill click or cut and paste:
http://www.legislature.ca.gov/cgi-bin/port-postquery?bill_number=sb_349&sess=CUR&house=B&author=perata
AB 2 (Dymally) Health Care Coverage
CPhA Position: Watch
AB 2 was sent to the Senate inactive file by the author.
To read the full text of this bill click or cut and paste:
http://www.legislature.ca.gov/cgi-bin/port-postquery?bill_number=ab_2&sess=CUR&house=B&author=dymally
Update on the Board of Pharmacy Meeting
On January 24th, the Board of Pharmacy held a hearing on the proposed compounding regulations. The Board voted to provide the revised compounding regulations for a 15-day comment period and to take up the regulations for a vote at the next Board meeting. The revised regulations have not yet been released for further comment but we anticipate receiving them in the next few weeks.
Tamper Resistant Prescriptions
The Centers for Medicare and Medicaid Services (CMS) have reviewed our policy with respect to tamper-resistant prescriptions and are providing two updates to that policy. All other guidance included in the State Medicaid Directors Letter and the Frequently Asked Questions continues to be in effect. For more information on the tamper resistant prescription pad policy, please visit www.cms.hhs.gov/DeficitReductionAct/30_GovtInfo.asp. This notification will be posted to the website early next week.
Provider Additions to Otherwise Non-Tamper-Resistant Paper
Several States have had specific questions about whether a provider can add a feature to a prescription to make it compliant with the requirements. States have proposed various features, including particular kinds of ink to write the prescription (gel or indelible); writing out the drug quantities rather than just the number (i.e. “thirty” vs. “30”); and embossed logos. The statute states that all written prescriptions must be “executed on a tamper-resistant pad.” As a result, features added to the prescription after they are printed do not meet the requirement of the statute. Features that would make the prescription tamper-resistant include certain types of paper as well as certain items that can be pre-printed on the paper.
The National Council for Prescription Drug Programs (NCPDP) has convened a focus group to identify consensus best practices and make a recommendation to State Medicaid programs on a standard approach to this requirement. Representatives from provider groups, pharmacy groups, prescription pad vendors, the National Governors Association, the National Association of State Medicaid Directors, the National Conference of State Legislators and several State Medicaid programs are participating. This group is developing a document for State Medicaid programs that identifies a minimum set of features that satisfy the requirements for April 1, 2008 and October 1, 2008. CMS will share the clarification provided above with the NCPDP group so that no recommendations are included in the document that conflict with the requirement.
Computer Generated Prescriptions
CMS is also clarifying that during the period between April 1, 2008 and October 1, 2008, computer generated prescriptions printed by a provider on plain paper, including Electronic Medical Record (EMR) computer generated prescriptions, may meet CMS guidance by containing one or more industry-recognized features designed either to prevent the erasure or modification of information contained on the prescription, or to prevent the use of counterfeit prescription forms.
However, based on its understanding of current prescription security technology, CMS does not believe that computer generated prescriptions printed by a prescriber on plain paper will be able to meet the first baseline requirement that prescriptions contain one or more industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form. In other words, prescriptions printed on plain paper will not be able to meet all three baseline characteristics outlined by CMS. Therefore, beginning October 1, computer generated prescriptions must be printed on paper that meets that requirement. The NCPDP focus group has developed a list of examples of industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form which include, but are not limited to: watermarks, micro-printing, and paper on which the word “void” appears when copied.