NCPA General Meeting

1
NCPA General Meeting

• October 29th, 2007
• HLS G04

2
NCPA Exec Officers

• Dustin Rewinkel - President
• DustinRewinkel_at_creighton.edu
• Andy Kampfe - VP
• AndyKampfe_at_creighton.edu
• Julia Rhodes - Secretary
• JuliaRhodes_at_creighton.edu
• Andy Bath - Treasurer
• AndrewBath_at_creighton.edu
• Stephanie Morgan PHPSG Rep
• StephanieMorgan_at_creighton.edu

3
NCPA Annual ConventionOctober 13-17, 2007
4
Stephanie in front of the Anaheim Convention
Center
5
Waiting for Robert Novak and Mark Shields
Political Discussion
6
Dustin and Dr. Barr
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Stacey and Stephanie
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View from 3rd floor of Annual Convention Center
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List of Sessions

• Get DME Accredited and Bid
• ROI Convenient Care Clinics
• Snapshot of Profitable Niches
• Foot Care Program
• Pain Management
• Travel Immunizations
• Nutrition
• Obesity
• Veterinary Compounding
• Durable Medical Equipment
• MTM
• Pharmacy Valuations and Exit Strategies

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List of Sessions

• Models of Ownership
• Medication Therapy Management
• Issues that Affect the Pharmacy Profession
• Opportunities in Medicare Part D
• Embracing Pharmacy Professional Services for
  Business Survival
• Survival Spanish for Pharmacists

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Growing Strawberries in October???
12
T-shirt Sales

• 12/t-shirt
• 11/shirt if 3 or more ordered
• Available in gray, royal blue or navy

13
PHPSG Update

• Dress code passed
• No pajama or sweat pants
• No hats or caps
• All visible tattoos must be covered
• All visible body piercings other than ears are
  not permitted during classroom hours
• Waiting for faculty approval
• Those consistently noncompliant may face
  Professional Behavior Citation
• PHPSG Rep Stephanie Morgan
• stephaniemorgan_at_creighton.edu

14
Current Legislation

• Medicaid defining AMP
• Medicare Part D prompt payment and co-branding
• PBMs contain their assault on Community Pharmacy

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Medicaid

• AMP is the new baseline for generic drugs
  reimbursements in Medicaid
• GAO report stated that pharmacies would be
  reimbursed 36 below their average retail
  pharmacy acquisition cost
• AMP-based FUL is below pharmacy acquisition cost
  for 19 of the 25 most prescribed generics

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Medicaid

• AMP must reflect community pharmacies actual
  acquisition cost
• AMP must exclude discounts not available to
  retail pharmacy, such as mail order discounts and
  PBM redates
• AMP must be reported frequently, with oversight
  and review

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AMP Legislation

• H.R. 3140, Saving Our Community Pharmacies Act of
  2007
• S. 1951, Fair Medicaid Drug Payment Act of 2007
  (H.R. 3700)

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H.R. 3140

• The new benchmark would be Retail Acquisition
  Cost (RAC)
• RAC is the median price for each drug based on a
  quarterly survey of actual invoices subject to
  audit from a 5 representative sample of
  pharmacies nationwide
• A FUL based on RAC will allow states to pay
  pharmacies accurately and preserve patient access
• Require states to increase their use of
  cost-effective generic drugs by 1-3 each year

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S. 1951

• Retains AMP as the benchmark but would use the
  weighted average price (rather than lowest)
  available to retail pharmacy
• Excludes special prices extended to mail order
  pharmacies
• Increases payment rate from 250 of AMP to 300
• Requires prior auth for coverage of a
  more-expensive brand name drug when a cheaper
  generic is available

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Medicare Part D Prompt Pay

• Slow reimbursement
• Low reimbursement
• No electronic direct deposit
• No definition of clean claim

21
Medicare Part D Legislation

• H.R. 1474, the Fair and Speedy Treatment (FAST)
  of Medicare Prescription Drug Claims Act
• S. 1954, the Pharmacy Access Improvement Act

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H.R. 1474 S. 1954

• Requires PDPs to pay within 14 days by electronic
  transfer
• Addresses co-branding in a more thorough manner
  than CMS does
• Spells out terms for clean claims

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PBMs

• Take it or Leave it Contracts
• Shrinking and shifting formularies
• Pre-authorizations and formulary-restricted
  prescriptions
• 90-day prescriptions only through PBM mail order

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H.R. 971

• Allows independent pharmacies, defined as
  pharmacies not owned or operated by a publicly
  traded company, the same leverage that much
  larger chains enjoy when negotiating their
  Medicare Part D and other third-party contracts

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Next Meeting

• Congressman Lee Terry (NE-3rd)
• How to get to know your congressman
• Which form of contact is the most effective
  (letter, visit, email, phone call)?
• What is the best way to petition your
  congressman?

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Websites

• Chapter Website
• pharmacy.creighton.edu/ncpa
• National Website
• www.ncpanet.org