texaspharmacy.org  Friday, January 24, 2020 View Archive
Association News

Board of Directors Holds First 2020 Meeting

TPA logo iconThe Texas Pharmacy Association’s Board of Directors held its first meeting of 2020 via conference call Wednesday morning. The Board discussed the solid financial footing of the Association and plans for growth. In addition, the Board heard that membership has increased significantly since this time last year, although a number of members have yet to renew for 2020. Please encourage your colleagues to renew their memberships or join TPA! The Board will meet in Austin February 11–12, with meetings of the Association Affairs, Financial Affairs, and Public Policy Councils scheduled for February 12. American Pharmacists Association President Brad Tice will be the guest speaker at a joint meeting of the Board and councils.

The Texas Pharmacy Foundation's Board of Trustees will meet today, January 24, to plan the year's activities.

House Candidate Douglas Visits with TPA

Texas House candidate Will Douglas with TPA CEO Debbie Garza
Texas House candidate Will Douglas meets with TPA CEO Debbie Garza.

Pharmacist and TPA Member Will Douglas, a candidate for the Texas House of Representatives, visited the Texas Pharmacy Association office Wednesday to discuss pharmacy's support of his campaign. Douglas, his campaign staff, and TPA CEO Debbie Garza talked about the importance of having a pharmacist in the Texas House and ideas for TPA and its members to engage in this effort. Garza connected Douglas with the Texas Business Roundtable, of which TPA is the only pharmacy member, where he spoke Wednesday afternoon. Douglas is running as a Republican in House District 113, which encompasses the eastern edge of Dallas County. The seat is currently held by Rep. Rhetta Andrews Bowers (D-Rowlett), who was elected in 2018 with 53.5% of the vote. Learn more about his campaign online at willdouglasfortexas.com.

Vendor Drug Program Holds Quarterly Pharmacy Stakeholder Meeting

Texas HHS logoTexas Pharmacy Association CEO Debbie Garza attended the Medicaid Vendor Drug Program’s (VDP) quarterly pharmacy stakeholder meeting Wednesday, where VDP staff shared updates on their legislative requirements from the 2019 legislative session and project updates including status of pharmacist reimbursable services. Key issues include:

Legislative Update: Several bills and riders were discussed, including HB 2174 that exempts opioid prescriptions for initial treatment of acute pain from counting toward fee-for-service clients' three-prescription limit. VDP submitted its State Plan Amendment (SPA) to CMS in December and is awaiting approval to implement. Additionally, HB 2174 removes PDL prior authorizations from medication-assisted treatment drugs to treat opioid- and substance-use disorders. These drugs will remain on the PDL, but all products for this purpose will be preferred. HB 1584, which creates an exception for use of non-preferred drugs associated with stage-four cancer, will require a manual process. The VDP has no way to automate the prior authorization, so the doctor will have to call the help desk for a manual request. Lastly, implementation of SB 1096, which provides children enrolled in STAR Kids to have access to any prescribed drug regardless of whether it is on the VDP formulary, is awaiting direction from CMS.

Project Updates: Rider 30 report: VDP staff is still deciding what to include in the report Rider 30 requires to evaluate strategies to achieve cost savings for Medicaid prescription drugs, including direct dispensing of prescription drugs by physicians. Report findings and recommendations are due by Sept. 1, 2020. The VDP staff is reviewing comments received from stakeholders, including those submitted from TPA, and will determine which suggestions they will include in their report based on what they can actually do as an agency.

Pharmacist Reimbursable Services: VDP submitted its SPA to CMS in December to allow reimbursement of pharmacies in both fee-for-service and Medicaid managed care through the pharmacy benefit for long-acting injectable antipsychotics, Vivitrol, and naloxone for the ingredient cost, dispensing fee, and administration fee; along with flu vaccines reimbursement for the ingredient cost and administration fee. This was initially planned to be effective September 1, 2019, but will now be delayed until spring/summer 2020 awaiting CMS approval and VDP implementation time.

Usual and Customary (U&C) Price: VDP guidance is awaiting sign-off from HHSC leadership. While U&C pricing is defined by rule, guidance has been requested regarding inclusion of discount cards for U&C pricing determination.

Outstanding Balances: Some pharmacies have received “demand packets” indicating they owe the state/Medicaid money for overpayment in fee-for-service Medicaid when the Medicaid beneficiary was switched to Medicaid Managed Care. More than 500 pharmacies, once rolled up by chains, are to be sent these letters. Nearly half of the pharmacies have been contacted covering the bulk of the dollars outstanding. Others may still receive letters as completion of this project is estimated for Fall 2020. These claims date back as far as 2009 to as recent as present time.

Specialty Drug List (SDL): VDP is looking to change the update of the SDL to twice a year instead of quarterly as current practice. They will consider lengthening the window for review from the current 10-day allowance.

Enrollment Revalidation: As required at least every five years, pharmacies will start to be notified in early 2020 regarding their need to be revalidated for the Medicaid program. Unfortunately, the process will again be manual and must be completed by December 31, 2021. Pharmacies not revalidated will be disenrolled from the Medicaid program and will not receive reimbursement.  Approximately 4,600 pharmacies will need to be revalidated..

Read TPA's 2019 Annual Report

2019 TPA Annual Report

“Together Pharmacy Advances” is the motto adopted by the Texas Pharmacy Association in 2017. Indeed, two years later, Texas pharmacy advanced in numerous ways thanks to TPA’s 2019 activities. TPA's 2019 Annual Report explains how our members' voice was vital, innovation was impactful, and participation was powerful! Read the report online or in the Winter 2020 issue of Texas Pharmacy magazine for more details.

In the State

Provider Management and Enrollment System Update

The Texas Health and Human Services Commission (HHSC) has terminated its contract and ended its vendor’s involvement in the Provider Management and Enrollment System (PMES) modernization project. HHSC will continue to streamline and simplify the Texas Medicaid provider application. The agency will take a phased approach to implement enhancements to the provider enrollment and screening processes, including adding pharmacy, long-term care, and long-term services and supports provider types.

Texas Health and Human Services Commission (January 23, 2020)

Texas A&M Student May Have Coronavirus

A Texas A&M student who may have contracted novel coronavirus after traveling to China has entered into voluntary isolation and is showing signs of improvement, a Brazos County health official said Thursday. The student went to a local emergency room Wednesday night after exhibiting “very mild” upper respiratory infection symptoms.

The Bryan Eagle (January 24, 2020) Barber, Katy

Center Pharmacy Receives Texas Treasure Business Award

Center Pharmacy in Pleasanton, Texas, owned by TPA Member Myron Repka, is joining the ranks of well-established Texas businesses honored with the Texas Treasure Business Award from the Texas Historical Commission. The program recognizes the accomplishments of Texas businesses that have provided employment opportunities and support to the state’s economy for at least 50 years. Center Pharmacy has been in the retail pharmacy business, at the same location, for 57 years.

Pleasanton Express (January 22, 2020) Luna, Lisa

National News

National Groups Urge CMS to Leverage Pharmacy via Executive Order

NACDS has told the Centers for Medicare & Medicaid Services (CMS) that the President's Executive Order to protect and improve Medicare can only succeed if beneficiaries have access across the care continuum, including community pharmacies. NCPA urged CMS to enhance coverage of pharmacist-provided care services and reevaluate supervision requirements as well as coverage policies for incident-to services. TPA signed onto a similar joint letter last week.

National Association of Chain Drug Stores (January 22, 2020)

National Community Pharmacists Association (January 21, 2020)

First Travel-related Case of 2019 Novel Coronavirus Detected in United States

The CDC on Tuesday confirmed the first case of 2019 Novel Coronavirus in the United States in the state of Washington. The patient recently returned from Wuhan, China. Originally thought to be spreading from animal-to-person, there are growing indications that limited person-to-person spread is happening, but it's unclear how easily.

Centers for Disease Control and Prevention (January 21, 2020)

FDA to Launch Drug Risk Management Board this Month

FDA will launch its Drug Risk Management Board later this month. The board is expected to improve coordination of safety issues and improve communication. The DRMB is a center-level body that will also rapidly analyze and resolve drug safety issues by facilitating decision-making on major clinical and quality-related safety issues.

Regulatory Focus (January 21, 2020) Brennan, Zachary

DEA Criticized for Failure to Implement Telehealth Prescription Program

Sen. Mark Warner, D-Va., called out the DEA for failing to launch a program that would allow providers to prescribe controlled substances via telehealth, even though Congress requested it be implemented by October 2019. As a result, many patients suffering from substance use disorders remain unable to access treatment via telehealth,

mHealth Intelligence (January 20, 2020) Wicklund, Eric

Medicare’s Part D Doughnut Hole Has Closed! Mostly. Sorta.

With the new decade comes this long-awaited milestone: the Medicare Part D doughnut hole has closed. Two cheers. More than 61 million Americans are Medicare beneficiaries, and about 46 million of those are enrolled in Part D. The doughnut hole, more formally called the coverage gap, has been one of Part D’s more detested features since the drug benefit took effect in 2006.

New York Times (January 17, 2020) Span, Paula

CDC Maps America's High Levels of Inactivity

New state maps of adult physical inactivity prevalence reveal that all states and territories had more than 15% of adults who were physically inactive. The highest prevalence of physical inactivity was in the South. Being physically active helps people sleep better and reduce the risk of obesity, heart disease, type 2 diabetes, and some cancers.

Centers for Disease Control and Prevention (January 16, 2020)

Republican FTC Commissioner Says She Supports Medicare Negotiating Drug Prices

A Republican member of the Federal Trade Commission (FTC) expressed support for Medicare negotiating drug prices, an idea typically more supported by Democrats. “The federal government, which accounts for I think a third of pharmaceutical spending, is essentially a price-taker, and that seems like a problem to me,” she added.

The Hill (January 16, 2020) Sullivan, Peter

Panel Identifies Need for Improved Implementation of Preventive Services, Reduced Disparities

More research is needed to evaluate and address disparities in access to health care and use of preventive clinical services, according to an independent panel convened by NIH. The six-member panel called on scientists to examine interventions with multiple components and to engage stakeholders both in and outside of the health care system.

National Institutes of Health (January 15, 2020)

NCPA CEO Shares 2020 Pharmacy Forecast

Changing the pharmacy payment model—from the creation of innovative medications to helping patients optimize its benefit—has been NCPA’s bold statement throughout all of 2019. More and more policy makers are digging into where prescription drug spending is going, and they are taking actions when they don’t like what they see.

Chain Drug Review (January 14, 2020) Hoey, B. Douglas

Trending News

PBMs Handle Complex Interactions to Keep Spending Low

Some have proposed reducing the role of intermediaries in the pharmaceutical supply chain, namely the pharmacy benefit managers (PBMs). Pharmacy benefit managers effectively handle complex interactions between health insurers, unions and other payers, drugmakers, pharmacies and patients to optimize benefits and reduce spending.

The Hill (January 18, 2020) Schlecht, Eric

Patient Benefits of Audiology, Pharmacy Collaboration

To decrease the likelihood of drugs causing harm to the auditory system, pharmacists and audiologists should collaborate and provide clinical interventions. Drug classes identified as ototoxic include aminoglycosides, cisplatin, loop diuretics, and salicylates. Pharmacists should be trained to identify when an audiologist is required for workup.

The Hearing Journal (January 2020) Qureshi, Imran and Qureshi, Arifa

How Technology Is Helping Improve the Prescription Journey

E-prescribing has changed the way prescribers, pharmacists and patients interact with regard to medication therapy. It has improved efficiencies and patient safety. Are the prescribing and dispensing processes as efficient and painless as possible? Thanks to new tools and technologies that are emerging almost daily, they’re getting there.

Chain Drug Review (January 20, 2020) Whittemore, Ken

Study Sees More Benefits from Insulin Infusion vs. Insulin Pump

A study showed patients with type 1 diabetes who used subcutaneous insulin infusion had fewer severe hypoglycemic events and hospital days and lower A1C, diabetic ketoacidosis risk and microalbuminuria, than those who used insulin injections. However, insulin injection therapy users were less likely to suffer from neuropathy and depression.

Healio/Endocrine Today (January 20, 2020) Grammes, J

What is the Current Status of Bioingestible Sensors for Medication Adherence?

Leveraging technology to track and intervene on patients' medication adherence has been the subject of numerous studies. Sensors that can be attached to insulin pens, smart auto-injectors for patients with MS, sensors for inhalers, smart pill bottles, and bioingestible sensors are evolving technologies. However, there has not yet been a blockbuster.

Pharmacy Times (January 18, 2020) Aungust, Timothy

A Placebo for Pain Relief—Even When You Know It’s Not Real

Some patients with chronic pain can get relief from a placebo even when they know it isn’t an active medication, a growing body of evidence shows. More researchers are looking at the idea of placebos as an alternative to traditional pain medications. Placebos might have particular potential for difficult-to-treat conditions like chronic back pain.

Wall Street Journal (January 20, 2020) Reddy, Sumathi

How Swallowing a Star Might Keep You from Missing a Dose of Medicine

After a patient takes Lyndra Therapeutics' capsule, its six-armed "star" opens inside the stomach and releases ingredients over the course of a week, and eventually leaves the body similar to undigested food. Lyndra is initially focusing on developing a system that provides a weekly dose of risperidone, used to treat schizophrenia.

Boston Globe (January 16, 2020) Saltzman, Jonathan

Study: Few Docs Write Too Many Antibiotic Scripts for Kids

Researchers found fewer than 2% of outpatient health care providers accounted for nearly a quarter of prescriptions for broad-spectrum antibiotics in youths younger than 20. The findings also showed that pediatricians who completed medical school before 2000 and female pediatricians were more likely to be high prescribers of antibiotics.

MedPage Today (January 15, 2020) Walker, Molly

An Update on Pharmacists’ Vaccination Authority

When it comes to state vaccination laws, pharmacists are gaining increasing authority to administer immunizations, but association experts say there’s still work that needs to be done. One of the largest challenges remains expanding pharmacists’ authority to administer vaccines to those patients 17 years of age and younger.

Drug Topics (January 15, 2020) Sederstrom, Jill

Naloxone via Nasal Spray is Best for Use by Untrained Individuals

The most effective way for untrained community members to administer naloxone for an opioid overdose is through nasal spray, according to a study published in the journal Pharmacotherapy. Untrained study participants administered the drug more efficiently and faster than injectable or auto-injector, the other FDA approved forms of naloxone.

Drug Topics (January 13, 2020)

Prescription for Food: What Pharmacists Should Know about Nutrition

All pharmacists know that for many conditions, medication isn’t enough. As trusted and accessible providers, pharmacists can help their patients make healthy food choices and changes. Kristi L. King, senior pediatric dietitian at Texas Children's Hospital in Houston and a clinical instructor at Baylor College of Medicine, explains how.

Pharmacy Today (January 15, 2020) Balick, Rachel

What's NEXT for your pharmacy?

Pharmacy Technician Certification Board

Free Member CE: Collaborative Practice: How to Begin

Texas Pharmacy Today
Editor: Brian Sparks, Division Director, Communications and Marketing
(512) 615-9140 • bsparks@texaspharmacy.org

Texas Pharmacy Association

Debbie Garza, R.Ph., Chief Executive Officer • (512) 615-9170

Disclaimer: Texas Pharmacy Today is a weekly e-newsletter for members of the Texas Pharmacy Association, 3200 Steck Avenue, Suite 370, Austin, TX 78757. According to Texas Government Code 305.027, portions of this material may be considered "legislative advertising." Authorization for its publication is made by Debbie Garza, CEO, Texas Pharmacy Association.
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