Pallone Introduces Long-Awaited Breakthrough Pharmacy Bill

In welcome news to pharmacists everywhere, Rep. Frank Pallone (D-N.J.) has introduced his eagerly anticipated "Safe Medications for the Elderly Act" (SMEA), breakthrough legislation that would, if approved, lay the foundation for a broad Medicare outpatient pharmacy benefit.

Rep. Frank Pallone (D-N.J.)

"This legislation [will take] pharmaceutical care into the 21st century" by providing Medicare Part B reimbursement for a variety of "targeted" pharmacist interventions, according to a statement from Rep. Pallone's office. These services include:

• Physician consultations resulting in a drug regimen change, a change in drug dosage or dosage form, discontinuation of an "unnecessary or harmful" medication, or initiation of drug therapy
• Patient consultations that result in improved compliance with drug therapy for diseases including asthma and COPD, depression, diabetes, congestive heart failure, hyperlipidemia, and stroke
• Administration of influenza, pneumococcal, and hepatitis vaccines

With regard to reimbursement, the legislation would direct the Secretary of Health and Human Services "to create a fee schedule for these services, based on time required for services, level of risk of particular drugs, and differences in health status of individuals receiving services." Pharmacist-provided services would be reimbursed "only if they achieve results."

Rep. Pallone first put forth the SMEA concept last fall but deferred formal introduction of the bill to build solid bipartisan support. At press time, SMEA cosponsors included Reps. Gary Ackerman (D-N.Y.), Bill Brewster (D-Okla.), Corrine Brown (D-Fla.), Robert Cramer (D-Ala.), Ron Dellums (D-Calif.), Jon Fox (R-Pa.), Victor Frazer (I-Vt.), Martin Frost (D-Tex.), Eliot Engel (D-N.Y.), William Lipinski (D-Ill.), Nita Lowey (D-N.Y.), Bennie Thompson (D-Mo.), and Robert Torricelli (D-N.J.).

Long-Term Care Insurance: An Idea Whose Time Has Come

Virtually unheard of just 10 years ago, long-term care insurance now appears to be catching on fast. The Health Insurance Association of America reports that sales of such policies increased an average of 25 percent each year from 1987 to 1994, with close to 4 million new policies sold.

Typical policy premiums range from about $400 at age 50, to slightly over $1,000 at age 65, to about $4,500 at age 79.

Individuals still account for most policy sales, but more employers are getting involved: At the end of 1994, more than 1,000 employers offered such policies, compared to only seven in 1988, HIAA says.