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NCPA General Meeting

NCPA General Meeting October 29 th , 2007 HLS G04 NCPA Exec Officers Dustin Rewinkel - President DustinRewinkel@creighton.edu Andy Kampfe - VP AndyKampfe@creighton.edu Julia Rhodes - Secretary JuliaRhodes@creighton.edu Andy Bath - Treasurer AndrewBath@creighton.edu

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NCPA General Meeting

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  1. NCPA General Meeting October 29th, 2007 HLS G04

  2. NCPA Exec Officers • Dustin Rewinkel - President • DustinRewinkel@creighton.edu • Andy Kampfe - VP • AndyKampfe@creighton.edu • Julia Rhodes - Secretary • JuliaRhodes@creighton.edu • Andy Bath - Treasurer • AndrewBath@creighton.edu • Stephanie Morgan – PHPSG Rep • StephanieMorgan@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

  7. Stacey and Stephanie

  8. View from 3rd floor of Annual Convention Center

  9. 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

  10. 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

  11. 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@creighton.edu

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

  15. 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

  16. 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

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

  18. 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

  19. 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

  20. 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

  22. 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”

  23. 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

  24. 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

  25. 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?

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

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