| Government Affairs & Advocacy Find out what’s happening across the country, and how it could affect you and your patients. Learn ASCP's stand on key issues. Make your voice heard. ASCP Members - Are you reading ASCP Insider? Read ASCP Insider to catch the latest exclusive updates on legislative developments, ASCP's advocacy work, and other issues affecting pharmacsts! Archives available here (members only). All ASCP members are eligible to receive the weekly Insider e-newsletter free! Recent News (click here for archive of past news items) June 26, 2009 LTC and Post-Acute Providers File Joint Statement on "Meaningful Use" ASCP joined nine other associations representing long-term and post-acute providers and professionals to draft and file comments to the National Coordinator for Health Information Technology (ONC) on the Health Information Technology (HIT) Policy Committee draft recommendations for the term "meaningful use" of electronic health records (EHRS) as required by the American Recovery and Reinvestment Act (ARRA). ARRA, the new stimulus bill that was passed, has allocated $19 billion to improve HIT infrastructure in the U.S., and has incentives for healthcare providers to start using electronic health records (EHRs) and electronic medical records (EMRs). The incentive program, as implemented by the Secretary of the Health and Human Services, will pay providers that implement EHRs and EMRs that have a "meaningful use". The issue has now become defining "meaningful use" and the HIT Policy Committee invited comments to be submitted for consideration. The long term care and post-acute care (LTPAC) collaborative's comments urge ONC to define "meaningful use" to include the electronic exchange of meaningful clinical information over the entire continuum of care. That continuum is not limited to physician practices and hospitals but spans all providers of care including LTPAC. Noting that LTPAC is currently ineligible for financial incentives, the collaborative also urged ONC to identify other funding opportunities and incentives to encourage HIT adoption and HIE among LTCPAC. June 25, 2009 AGS Endorses Independence at Home Act In a letter to Senator Wyden (D-OR) and Congressman Markey (D-MA 7th), the American Geriatrics Society (AGS) has endorsed the Independence at Home Act. While praising the bill for filling a significant gap in traditional Medicare coverage by covering comprehensive geriatric assessment and care coordination services for high-cost Medicare beneficiaries with multiple chronic conditions, AGS raises concerns that there may not be enough certified geriatric specialists to meet the program's staffing requirements. Specifically, AGS raises two concerns: 1) that experienced home care physicians who are not board-certified geriatricians would not be able to pass the AAHCP certification test in time to staff the pilot programs; and 2) the workforce may be more limited outside of large urban areas. Accordingly, AGS makes two recommendations: 1) AGS would like to request that prior to launching the pilot program, the investigators ensure that there is adequate local workforce availability in each selected pilot region to meet the needs of older adults within this program. 2) with respect to the geriatric pharmacy component, AGS states that they would like to see eligibility expanded so that pharmacists who have completed a geriatric residency or fellowship are also eligible to participate. Specifically, AGS asks that the following language be incorporated into the bill: Care coordination services consisting of monitoring and management of medications by a pharmacist who is certified in geriatric pharmacy by the Commission for Certification in Geriatric Pharmacy or possesses other comparable TRAINING (E.G., RESIDENCY OR FELLOWSHIP), knowledge and expertise in geriatric pharmacotherapy. June 15, 2009 ASCP Submits Comments on Electronic Health Records to ONCHIT This past week ASCP submitted brief comments to the Office of the National Coordinator for Health Information Technology (ONCHIT) regarding electronic health records (EHRs). The "Health Information Technology for Economic and Clinical Health Act'' or the HITECH Act, a section of the American Recovery and Reinvestment Act of 2009, includes provisions to promote the adoption of interoperable health information technology. In order for providers to qualify for incentive payments for HIT implementation as outlined by the HITECH Act, providers will have to meet certain criteria...including meeting the definition of a "meaningful user" of EHRs. There has been much discussion about the definition of "meaningful use." ASCP wants to be sure that any entity using an EHR to e-prescribe can effectively communicate orders to and from long-term care facilities, so comments were submitted to ONCHIT on this topic. In the comments, ASCP suggests that providers' EHR systems should accommodate electronic prescribing in all settings, including long-term care and post acute care, in order for them to qualify as "meaningful users" and receive incentive payments. June 10, 2009 Health Care Reform Legislation Would Expand Access to Pharmacist Patient Care Services Legislation released June 9 by Health, Education, Labor and Pensions (HELP) Committee Chairman Edward Kennedy (D-MA) would expand access to pharmacist-delivered medication therapy management (MTM) services for patients suffering from chronic diseases. The Affordable Health Choices Act – not yet introduced in the Senate – would provide grants that expand opportunities for pharmacists to deliver MTM services through local community-based, multi-disciplinary health teams (such as medical homes) to patients who suffer from chronic diseases such as heart disease, cancer, and diabetes. The bill also contains several ASCP-promoted provisions from the “Retooling the Healthcare Workforce for An Aging America Act of 2009” (S. 245/H.R. 468). Specifically, under the Workforce sections of the Affordable Health Choices Act, pharmacy schools are among institutions eligible for funds to administer fellowships in geriatrics, long-term care, and chronic care management. In addition pharmacists and pharmacy students will be eligible to receive Geriatric Career Incentive Awards provided they teach or practice in the field of geriatrics, long-term care, or chronic care management for a minimum of five years. Also included in the bill is a requirement that Geriatric Education Centers include instruction or materials on the appropriate, safe, and effective use of medications for older adults in their family caregiver training programs. June 5, 2009 Government Accountability Office Reports on Enrollee Cost Sharing for Specialty Prescription Drugs A report on the Federal Employees Health Benefits Program: Enrollee Cost Sharing for Selected Specialty Prescription Drugs has been made available on the GAO website. The GAO writes in the report, "Specialty prescription drugs are typically used to treat chronic or life-threatening conditions, such as multiple sclerosis and cancer, for which few other treatment options exist. The drugs typically have few competitors or generic alternatives and may require frequent dosage adjustment, special storage, patient education, or special methods of administration, such as by injection. Costs for specialty prescription drugs are usually high, typically ranging from $1,200 to $40,000 for a 30-day supply." The GAO also found that in order to cover these high costs, "Enrollees may be required to pay a portion of specialty drug costs through a copayment--a flat dollar amount--or coinsurance--a percentage share of the drug's actual costs. To manage the high and rising costs of these drugs, some health plans have begun to require enrollees to contribute a greater share of their costs, such as by increasing the use of coinsurance." June 2, 2009 Elder-Care Workforce Alliance Sends Letter to Members of House of Representatives Urging Support of Retooling the Health Care Workforce for an Aging America Act This past week the Elder-Care Workforce Alliance, a group of 28 national organizations representing older adults and the healthcare professionals, direct-care workers, and family caregivers who care for them, sent a letter of endorsement for H.R 468 to members of the House of Representatives. The letter details the need for training to increase the number of geriatric health professionals to care for the fastest growing segment of the population. ASCP succeeded in getting language into the bill that ensure that pharmacists are eligible to participate in grant programs and focusing training requirements on medications problems in the elderly. To read a copy of the letter, click here. June 1, 2009 Health Care Industry Releases Savings Plan Details On June 1, representatives of the health care industry released a 28-page letter to the White House outlining a plan to increase health care savings. The letter suggests significant savings in health care spending could come from adopting proposals such as standardization of insurance processing, reduction of hospital infections, and reduced prescribing of unnecessary medications. In addition, the letter states that over the next 10 years, the proposals could save $180 billion by improving how health care is delivered, over $850 billion by improving care of chronically ill patients, and $700 billion by improving administrative functions. June 1, 2009 Senate Health, Education, Labor, and Pensions (HELP) Committee Releases Briefing Paper on Health Care Reform Bill The Senate Health, Education, Labor, and Pensions (HELP) Committee has just released a briefing paper entitled, "A New Vision for American Health Care: Strengthening What Works and Fixing What Doesn't." The document provides a blueprint for the Senate HELP committee's comprehensive health care reform package legislation to improve the nation's health care system. Pharmacists are mentioned in a portion of the paper dealing with new mandated hospital discharge plans that feature a discharge advocate working together with a pharmacist and others to coordinate hospital discharge, patient education, and medication reconciliation to reduce follow-up emergency visits and rehospitalizations. The need for geriatric health professionals is also noted as follows: "The bill creates new grant programs to specially train health professionals in geriatric care to address special needs of a booming aging population." May 25, 2009 Sen. Wyden Introduces "Independence at Home" Act With Provisions for Certified Geriatric Pharmacists On May 25, 2009, US Senator Ron Wyden (D-OR) of the Senate Special Committee on Aging and the Senate Finance Committee and US Representative Ed Markey (D-MA), co-chairman of the Bi-Partisan Congressional Task Force on Alzheimer's disease and senior member ofthe Energy and Commerce Committee, introduced the "Independence at Home Act" (IAH) (S. 1131, H.R. 2560). The Act would establish a new Medicare pilot program in 26 states to provide certain high cost Medicare beneficiaries suffering from multiple chronic conditions with access to coordinated, primary care medical services in lower cost treatment settings, such as their residences, under a plan of care developed by at eam of qualified and experienced health care professionals. ASCP worked to ensure that pharmacists were included in this groundbreaking bill. As a result, chronically ill Medicare beneficiaries who enroll in an "IAH" Program will be eligible to receive medication monitoring and management by "a pharmacist who is board certified in geriatric pharmacy by the Commission for Certification in Geriatric Pharmacy or possesses other comparable board certification demonstrating knowledge and expertise in geriatric pharmacotherapy." IAH has attracted bipartisan support in both the House and Senate, including: Senators Richard Burr (R-NC), Ben Cardin (D-MD), and Sheldon Whitehouse (D-RI), and Representative Chris Smith (R-NJ) and efforts are underway to include the IAH in broader health care reform legislation. This week,we must convince members of the Senate Finance and HELP Committees to co-sponsor and support inclusion of IAH in the health care reformpackage. It's easy -- just click on the link below to access ASCP's Legislative Alert and write to your officials. You can also call the US Capitol Switchboard at 202-224-3121 and ask to be connected to your Senator's office.
May 20, 2009 ASCP urges Senator Lincoln to Strengthen S.1004, The Reaching Elders with Assessment and Chronic Care Management and Coordinate Act ("RE-Aligning Care Act") On May 20, ASCP's President, Judith Beizer, PharmD, CGP, FASCP sent a letter to Senator Blanche Lincoln (D-AR) urging her to strengthen the RE-aligning Care Act by ensuring that pharmacists, particularly those with training and specialized expertise in geriatrics, are included as members of the assessment and care coordination teams established by the RE-Aligning Care Act. May 13, 2009 ASCP Submits Comments to the Senate Finance Committee on "Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs" Today ASCP submitted comments to the Senate Finance Committee regarding proposals to improve quality and reduce health care costs. ASCP's comments focused on the impact of the Senate proposals on older adults. In particular, ASCP discussed the need to incorporate a systemic response to the epidemic of medication-related problems in the elderly that pervade the U.S. HealthCare System. ASCP also commented on specific proposals including proposed improvements to the physician quality reporting initiative, Medicare Reimbursement for Transitional Care Activities, a proposal to create a Chronic Care Management Innovation Center, Accountable Care organizations, Health Information Technology, quality measures, Comparative Effectiveness Research and Workforce issues. May 11, 2009 Senators Call Upon DEA to Allow E-prescribing of Controlled Drugs A bipartisan group of U.S. Senators have sent a letter to Secretary of Health and Human Services Kathleen Sebelius and Attorney General Eric Holder to quickly put federal regulations in place that would allow electronic prescribing for controlled substances. The Senators signing the letter include: Sheldon Whitehouse (D-RI), Tim Johnson (D-SD), Tom Coburn (R-OK), Jay Rockefeller (D-WV), Edward Kennedy (D-MA), Debbie Stabenow (D-MI), Sherrod Brown (D-OH), Lindsey Graham (R-SC), John Kerry (D-MA), John Thune (R-SD), and Richard Burr (R-NC). May 4, 2009 Senate Finance Committee Releases Health Care Reform Proposals - Your Comments are Needed by May 10, 2009 On April 29, 2009, the Senate Finance Committee released a White Paper entitled, "Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs." ASCP is in the process of analyzing the proposals and will be submitting comments to the Finance Committee by May 15, 2009. However, we need your input no later than May 10, 2009. Many of the proposals focus on payment reforms and increasing reliance on pay-for-performance. For home health agencies and skilled nursing facilities, the Committee proposes completing the Medicare value-based purchasing implementation plans by 2011 and 2012 respectively. Among other recommendations, the Committee also proposes: (1) paying for integrated, transitional care management for chronically-ill patients who experience hospitalization by reimbursing providers for targeted interventions that have proven successful in the Medicare Coordinated Care Demonstration, the Medical Home and other care management models; (2) establishing at CMS a Chronic Care Management Innovation Center for the purpose of testing and disseminating payment innovations that foster patient-centered care coordination for high-cost, chronically-ill Medicare beneficiaries; (3) paying hospitals a bundled payment for all acute in-patient and post-acute services (including home health, skilled nursing facility, rehabilitation and long term care hospital services) occurring within 30 days of discharge from a hospital to increase care coordination and reduce hospital readmissions; and (4) increasing transparency of information about SNF and nursing homes, enforcement of SNF and nursing home standards and rules staff training. Notably, neither pharmacists nor medications are mentioned in the 48 page document. Please send your comments no later than May 10, 2009 to govaff@ascp.com! April 9, 2009 FDA Reverses Decision On Morphine 20mg/ml Manufacture In a telephone conference call with stakeholders today, Douglas Throckmorton, MD, Deputy Director, Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), announced that FDA has notified manufacturers of morphine sulfate 20mg/ml oral concentrate that they will be permitted to continue to manufacture the product. The decision effectively reverses warning letters sent on March 31, 2009 advising the manufacturers that they must stop production and distribution within 90 days. In reversing FDA's earlier decision, Dr. Throckmorton was remarkably candid, stating that FDA had not fully understood the needs of the palliative care community when it made the initial decision to send warning letters to manufacturers. Once the needs of the palliative care community became clear, FDA determined it was necessary to make achange. Dr. Throckmorton made clear that while morphine 20 mg/ml remains an unapproved drug, it is medically necessary, and he stated,"We have no alternatives." FDA's decision comes one day after ASCP sent a letter to FDA Acting Commissioner Joshua Sharfstein alerting the FDAto severe shortages of appropriate narcotics for hospice and long-term care patients. April 8, 2009 ASCP Sends Comments on Narcotic Drug Shortages to FDA Acting Chairman Today, ASCP continued its rapid response to the nationwide narcotics shortages by sending a letter to FDA Acting Chairman Joshua Sharfstein. April 8, 2009 Nationwide Shortages of Narcotics for Long-Term Care and Hospice Patients -- Helpful Resources and Survey Pharmacies serving long-term care and hospice patients throughout the United States are experiencing severe shortages of narcotic pain medications. ASCP has notified the FDA and is monitoring the situation. This notice is designed to provide you with basic information about the shortages,which products are approved and which are unapproved, what ASCP is doing to address the issue, and some recommendations for how to cope with some of the challenges that pharmacists face as a result. For patients who will need to be switched, we have developed some template letters that you can customize and send to prescribers. Links to each of these documents can be found at our FDA resources page by clicking this link. April 6, 2009 ASCP Policy & Advocacy Proposes Edits to Independence at Home Act The Independence at Home Act proposes a demonstration project to provide comprehensive health care services including medication management to certain high cost Medicare beneficiaries who have multiple chronic conditions who cannot be served in traditional clinic settings. Independence at Home is modeled in part on the VA Home-based Primary Care program that uses multi-disciplinary teams to provide care to certain chronically ill veterans in their homes. In the VA program, pharmacists are an integral part of the ID team - but the Independence at Home Act makes no mention of pharmacists. Senator Wyden is currently in the process of reviewing the bill and preparing to reintroduce it in the 111th Congress. ASCP provided the Senator's staff with draft language to amend the legislation. To see ASCP's recommended changes to the Independence at Home Act, please click below. April 3, 2009 ASCP Provides Comments to AHRQ National Advisory Council on Comparative Effectiveness Research Today ASCP Director of Clinical Affairs, Tom Clark, RPh, MHS, CPG, gave public comments to the AHRQ National Advisory Council of Comparative Effectiveness Research.
Federal Issues Use these resources to learn more about how current federal issues may directly impact consultant and senior care pharmacy. more >> State Issues Here you will find the latest state legislation and regulations that directly affect consultant and senior care pharmacy. more >> Briefing Rooms Your complete source for information and resources on various issues, including Patient Safety, Repackaging of Medications, HIPAA, etc. more >> Medicare Drug Benefit Resources and links to assist pharmacists and other stakeholders with the Medicare Part D drug benefit program. more >> CMS Resources Centers for Medicare & Medicaid Services (CMS) regulations, guidance documents, links and announcements. more >> ASCP Advocacy Center Take Action! Learn how to communicate your views to decision-makers directly and make a difference for the profession. more >> ASCP-PAC Promote the legislative goals and express the concerns of consultant and senior care pharmacy to members of Congress. (Members Only) more >> Coalitions Listing of various groups and coalitions of which ASCP is a member. more >> Support the ASCP Advocacy/Campaign 2011 Fund ASCP’s legislative war chest, will increase the ASCP Policy and Advocacy Department’s ability to advance advocacy efforts at the state and federal levels. more >> |
