Texas Pharmacy Today - Texas Pharmacy Association

The results of these elections do not change the party breakdown in either the Texas House or Senate, and will have no effect on the Republicans’ majority control of both chambers of the Legislature.

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Key Groups Endorse Anti-Drug Abuse Bill: Newly introduced bipartisan legislation intended to reduce prescription drug abuse was endorsed recently by NCPA, NACDS, APhA and HDMA. The Ensuring Patient Access and Effective Drug Enforcement Act of 2015 (H.R. 471) was introduced by Reps. Marsha Blackburn (R-Tenn.), Judy Chu (D-Calif.), Tom Marino (R-Pa.) and Peter Welch (D-Vt.). In addition, a group of 19 patient and health professional groups also wrote in support of the legislation. The bill seeks to clarify key terminology in the Controlled Substances Act to give registrants a better understanding of their responsibilities under the law. This bill will also allow DEA-registered companies to submit corrective action plans to address any agency concerns as well as require a report to Congress that will encourage dialogue to identify how collaboration between agencies and stakeholders can benefit patients and help prevent the diversion and abuse of controlled substances.

NCPA Comments to CMS Regarding Medicare Part D DIR and Pharmacy Price Concessions Reporting: NCPA’s comments were in response to draft guidance for Part D sponsors on reporting direct and indirect remuneration (DIR) data for pharmacy price concessions for contract year 2016 and beyond. This is the second set of comments NCPA has submitted related to this topic and our message to CMS is that Medicare must standardize how Part D plan sponsors report prices because it will help make better apples-to-apples comparisons among prescription drug plans. Some Part D plan sponsors have manipulated how and when to report certain price concessions received from or incentive payments made to pharmacies. Such manipulation has resulted in an un-level playing field as the price of a drug out-the-door from a given pharmacy to a beneficiary can appear higher or lower on the Medicare Plan Finder depending on how and when certain payments and discounts are accounted for by Medicare Part D plans. PBMs receive undisclosed revenue streams from pharmacies (labeled "network access fees", "DIR fees", "credentialing fees", etc.). Conversely, PBMs may make conditional, incentive payments to certain pharmacies. Without uniform reporting standards, neither of these payments, which can certainly be determined at the point of sale, may be reflected in the "negotiated price" and appropriately reported by Part D plans. NCPA's comments noted CMS has more than sufficient statutory authority to implement this change.

CMS Updates Medicare Part B Coverage of Pneumococcal Vaccinations: As a reminder, CMS has recently updated the Medicare coverage requirements of the pneumococcal vaccine to more closely align with the updated Advisory Committee on Immunization Practices (ACIP) recommendations. Prior to 2015, pneumococcal vaccine was only covered once in a beneficiary’s lifetime, with revaccinations covered for those at highest risk if 5 years have passed since the last vaccination or if the beneficiary’s vaccination history was unknown. The ACIP updated its guidelines in the fall of 2014 and now recommends administration of two different pneumococcal vaccinations. Therefore, an initial pneumococcal vaccine may be administered to all Medicare beneficiaries who have never received one. In keeping with the ACIP recommendations, CMS has modified its coverage policy so that now a different, second pneumococcal vaccine may be administered 1 year after the first vaccine was administered. Pharmacists should familiarize themselves with these updates, and notify billing staff as appropriate. Additional information on this coverage change, set to be implemented February 2, can be found in this article: MLN Matters^® Article #MM9051.

HHS Releases Aggressive Plans to Tie Medicare FFS Payments to Quality: On January 26 HHS Secretary Sylvia M. Burwell announced measurable goals and a timeline to move the Medicare program, and the health care system at large, toward paying providers based on the quality, rather than the quantity of care they give patients. The goals set forth by HHS include:

This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments. Secretary Burwell also announced the creation of a Health Care Payment Learning and Action Network.

The Health Mart Senior Savings Tour stopped by Las Colinas in Irving, TX on January 7, 2015 to let their community know how Medicare Part D patients can save on their prescriptions by switching to a Health Mart pharmacy and avoiding the changes that took effect on January 1, 2015. The pharmacy staffed posed in front of the Health Mart-branded vehicle with props representing savings.

Health Mart Senior Savings Tour stopped at 27 independent pharmacies throughout Texas during the month of January 2015 to help raise awareness around the co-pay changes impacting most Medicare Part D patients as of January 1, 2015.

Due to preferred networks, some Medicare Part D patients will be forced to pay higher co-pays, however, Health Mart pharmacies are in the preferred network so if people being impacted by this change are looking to save they may want to consider switching from a chain to a local community pharmacy, like Health Mart.

The Senior Savings Tour includes 4 fun, green & white, Health Mart branded armored trucks (a metaphor for "savings”) going around the country talking about how seniors can save. Participants were encouraged to take photos and post them online using hashtag #SeniorSavingsTour.

Pharmacies visited include: Preston Road in Dallas, Las Colinas Health Mart Pharmacy in Irving, Flower Mound Pharmacy in Flower Mound, Grapevine Drug Mart in Grapevine, Randoll Mill Pharmacy in Arlington, Ben Franklin Pharmacy in Duncanville, Red Oak Drug in Red Oak, Circle Drug Pharmacy in Waco, People’s Pharmacy in Austin, 10 Minute Pharmacy in New Braunfels, Comal Drug Health Mart in New Braunfels, Laurel Heights Pharmacy in San Antonio, Rite-Away Health Mart Pharmacy in San Antonio, Mohrmann’s Pharmacy in Gonzales, City Drug Store in Yoakum, Deliverit Pharmacy in Sugarland, Southside Pharmacy in Houston, Uptown Pharmacy in Houston, Tomball Health Mart Pharmacy in Tomball, Cleveland Pharmacy in Cleveland and Livingston Pharmacy in Livingston.

Texas Register Highlights
The Texas Medical Board adopted a rule on an emergency basis, effective Jan. 16, concerning violation guidelines. Based on court action which interpreted that a June 2011 letter from the General Counsel of the Board to a physician, stating that a business model of providing medical services, including prescribing

medications/drugs without establishing a physician-patient relationship through a face-to-face visit, did indeed constitute improper rulemaking and was invalid. After the ruling, the Board convened an emergency meeting and adopted a rule which insures patient safety by setting forth specific parameters and requirements for a practitioner to establish a defined physician-patient relationship prior to prescribing drugs The rule will protect patient health and safety by requiring the use of acceptable medical practices that comply with state law and medical board rules, while still providing ample access to medical treatment. (Feb. 6)

National News
Community Pharmacy Foundation (CPF) Appoints New Executive Director
Pharmacist and current grants administrator, Anne Marie (Sesti) Kondic, PharmD from Chicago, IL (pictured at right) will succeed her father, Louis Sesti, and has been

appointed executive director of the Foundation effective January 1, 2015. In this capacity Kondic will manage the Foundation’s operations and administer its policies and procedures as established by the Board of Directors.

Anne Marie completed her BS at Ferris State University and PharmD at the University of Cincinnati. She finished an outcomes research fellowship at the University of South Carolina and Janssen Pharmaceuticals. Anne Marie has diverse practice experience in community and hospital pharmacy as well as pharmaceutical and healthcare data industries. She gained academic education and national organization experience working for the Accreditation Council for Pharmacy Education prior to establishing a consulting business for the past 5 years. Anne Marie has been integral to CPF operations serving as the grants administrator since 2004.

Lou is a pharmacist and served the Foundation since 2002 bringing organizational and professional skills from 28 years as executive director of the Michigan Pharmacists Association and 6 years as Vice President of Professional Relations with Advance PCS (now CVS Caremark). Through his leadership, CPF established an online grant award process and has approved 150 grants and numerous projects contributing to over 6 million dollars in funds committed to assist community pharmacy practitioners in advancing patient care. Lou has been appointed Executive Director Emeritus as a tribute to his years of service and countless contributions to CPF and the pharmacy profession.

CPF President, Phil Burgess, RPh of Chicago (formerly a Walgreens executive and currently a national consultant), said, "This is an excellent transition for the Foundation which has been an outstanding resource to advance community pharmacy through the grants it awards, primarily to colleges of pharmacy working with state associations and community pharmacists across America. Lou will pursue new professional projects to advance pharmacy leadership while Anne Marie continues working with the Board to advance the mission and bring the work of the Foundation to a growing segment of community pharmacy practitioners." Burgess urged pharmacists to review the published work of the Foundation in the "Completed Grants" section of the website at communitypharmacyfoundation.org.

Pharmacy Night with the Houston Rockets
Friday, March 27th 2015 • 7:00pm @ Toyota Center

Come support the Texas Pharmacy Foundation as you enjoy the Houston Rockets game as they take on the Minnesota Timberwolves. A portion of the ticket prices will benefit the Foundation!

"When I was growing up in Texarkana, my sister, who is six years older than me, was studying journalism. I remember my dad, reading an article in the Wall Street Journal, and telling us that there would be a shortage of pharmacists. She changed her major, and I followed suit—I always liked science.”

At that time (the late 70’s) there were only a few pharmacy schools in Texas. Bogue attended Stephen F Austin University, where she took two years of pre-pharmacy, and then went on to the University of Texas College of Pharmacy in Austin, and earned her BPharm in 1979.

"I loved the program- I had some excellent professors,” says Bogue. "I stayed in my own little world of studying—I loved gaining the new knowledge and I really enjoyed pharmacy school.”

Since 1982, Bogue has lived in Lufkin, south of Nacogdoches. She currently works at two different jobs.

Bogue started out as a pharmacist at an old-fashioned retail store called Thompson’s Pharmacy. "They had the lunch counter with hamburgers and milkshakes,” she says. "And the owners always worked with me so I could take care of all the things a mom has to do.”

Currently Bogue has a part-time schedule at Timberland Discount Pharmacy, where she’s worked for 20 years.

"I love it because I get to see the same customers I’ve always seen,” says Bogue.

Although there are quite a few pharmacy options in the Lufkin area, Bogue notices that people like the one-on-one customer service of a small-town pharmacy. For example, she always gives her cell phone number to customers, in case of emergencies.

"People like to come to our store,” says Bogue. "I remember one family whose daughter was being treated for cancer. They’d come home after going to MD Anderson in Houston with a prescription that no one else could fill right away. So I’d do the research to get it for her. Or I might get a call on my cell while I’m in church from someone who’s about to take a trip, and they need me to get their prescriptions filled. I’ll go down to the store, unlock the closed door, and fill it for them.”

Timberland Discount Pharmacy fills around 200 prescriptions a day, but, says Bogue, "Times are changing. The way insurance coverage works, it’s hard for small-town pharmacies to make it. I have loved pharmacy forever. It’s more than a job, and always has been. You have to have compassion and empathy for people—it’s a mission, not a job. My career in pharmacy has been a blessing.”

Bogue’s other job is at East Texas Behavioral Health Network, and couldn’t be more different.

"It’s essentially a mental health organization—those are the type of prescriptions we fill,” says Bogue.
"It’s a very busy operation. We mainly fill prescriptions for indigents. It’s not a typical walk-in pharmacy. Clinics from around 70-80 counties send their prescriptions here and we fill them and send them out by UPS.”

According to Bogue, it’s mostly mail order, though she may do some phone counseling—patients can call in and she’ll help them out if they have any questions.

"It’s much different from retail, but it’s referred to as a Class A pharmacy,” she says.

In Memoriam
TPA was saddened to learn that Shirley P. McKee passed away on February 3rd, 2015 at the age of 80.

Shirley was a pharmacist before many women actually entered in to the pharmacy profession. She spent many years on both the State and National Pharmaceutical boards as well as Texas Southern and the University of Houston advisory boards.

She spent several years as a lay chaplain at St Luke's Hospital and served faithfully at Palmer Memorial Church on the Alter Guild and their cooking team.

Shirley served many years on the Insurance Board of Trustees and the Texas Pharmacy Foundation Board of Trustees. Per Shirley’s wishes, a portion of her life insurance policy is going to the Texas Pharmacy Foundation.

Texas Pharmacy Law: Myths, Misconceptions and Common Compliance Issues • Live Webinar March 3, 1:00 p.m.
Did you know that new Texas State Board of Pharmacy Rules require all

pharmacists and technicians to obtain one contact hour of continuing education related to Texas pharmacy laws or rules for all license and registration renewals starting January 2015? A general law CE program or program based only on federal law will not meet this requirement as the course must be specific to Texas laws and rules. This one hour webinar will meet this new requirement and provide the participant with information on some of the most misunderstood laws and rules related to pharmacy practice in Texas. The course will also cover some of the more common areas of non-compliance found in Texas pharmacies. Visit here to sign up!

February CE - Free to TPA Members

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