The Official Publication Of The Florida Pharmacy Association FEB. 2018
CONNECTING HEALTH CARE: MARIJUANA DISPENSARIES
florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint
VOL. 81 | NO. 12 FEBRUARY 2018 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION
Features
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CONNECTING HEALTH CARE: Regulating Medical Marijuana Dispensaries Spills into Pharmacy Space
7 Executive Insight 24 Buyer’s Guide
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NCPA Survey: Pharmacy DIR Fees Plague Both Community Pharmacies and Their Patients Opinion: Remote Dispensing Pharmacy Legislation Enabling Technology for the Wrong Purpose
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Mission Statements:
FPA Calendar 2018
MARCH
of the Florida Pharmacy Today Journal MAY
16-19 APhA Annual Meeting Nashville, TN
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NASPA National Leadership Retreat Kansas City, Mo.
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FPA Board of Directors Meeting
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Good Friday - FPA Office Closed
Deadline for the submission of House of Delegates Resolutions
APRIL 3-4
Florida Board of Pharmacy Meeting Tallahassee
11-12 NCPA Fly-In Washington, D.C. 21-22 FPA Clinical Conference Tampa
19-20 FPA CE Conference Jacksonville 28
Memorial Day - FPA office closed JUNE
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Deadline for the submission of items of new business for the House of Delegates
12-13 Florida Board of Pharmacy Meeting Howey-in-the-Hills, Florida
For a complete calendar of events go to www.pharmview.com Events calendar subject to change CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours’ LIVE Continuing Education as part of the required 30 hours’ general education needed every license renewal period. There is a new 2 hour CE requirement for pharmacists on the dispensing of controlled substances effective this biennial renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2019 or prior to licensure renewal. Consultant pharmacists and technicians will need to renew their licenses and registrations by December 31, 2018. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office. For more information on CE programs or events, please contact the Florida Pharmacy Association at (850) 222-2400 or visit our website at www.pharmview.com
The Florida Pharmacy Today Journal is a peer-reviewed journal which serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.
of the Florida Pharmacy Today Board of Directors
The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Association members to secure appropriate advertising to assist the Journal in its goal of self-support.
Advertisers EPIC PHARMACY NETWORK......................... 2 PQC........................................................................ 9 KAHAN & ASSOCIATES................................. 11 NASPA................................................................. 13 PHARMACISTS MUTUAL.............................. 21
CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Tamekia Bennett (850) 906-9333 UF — Kristin Weitzel (352) 273-5114 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association is engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use. 4 |
FLORIDA PHARMACY TODAY
E-MAIL YOUR SUGGESTIONS/IDEAS TO dave@fiorecommunications.com
The President’s Viewpoint SUZY WISE, PHARMD/MBA CPH
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Let Your Voice Be Heard!
s the legislative session is wrapping up in Tallahassee, now is the time to start our advocacy efforts for the next legislative session. As we watch the session unfold each year that we attend the FPA Legislative Days, we call and email our elected officials, and some pharmacists test i f ied i n t he com m it tees on pharmacy issues. These are extremely important ways we can have the voices of pharmacists and patients heard on the issues. Many times we forget about how important advocating during the rest of the year is as well. Our elected representatives and senators have a wide variet y of professional backgrounds and are tasked with making laws that affect all professions and aspects of everyday life. It would be impossible to expect them to be experts in health care or pharmacy. This is our most important role as health care professionals. It is our responsibility to ensure our voices and the voices of our patients are heard. As we discuss important issues in Tallahassee, such as the safety and necessity of remote dispensing pharmacies in Florida or the impact of controlled substance regulations on patient care and the health care system, we must be the voice of pharmacy. How can you use your voice? Start today. Whether your elected official is still in Tallahassee or has returned to your home district, the time is now to get to know them and talk about the profession. Set up a meeting with them in their home office to introduce yourself and talk about what you do in your practice. Many people we encounter every
day are not aware of the education pharmacists receive or the services we provide to our patients. This is a great place to start. As we speak to the committees in Tallahassee, the qualifications and training of a pharmacist is always discussed, and we hear a lot of misconceptions. You can change this by simply having these conversations with your elected officials. Talk about the services you provide to patients and how it benefits their health outcomes. Invite them to the pharmacy. Having your elected officials in the pharmacy to show them what pharmacists are doing and the services provided is a fantastic way for them to learn more about the practice of pharmacy. Invite them to attend local health fairs and other community health care events. They love to see how you are helping the residents of the community who are their constituents. It also allows them to see the impact pharmacists have on patients firsthand. Become a resource. Stay in communication with your representative and senator throughout the year. Even if it is just a quick phone call or email, keep them informed on what is happening with patients and in the profession. As they are faced with a variety of different issues that will come up and be heard during the legislative session, they typically reach out to experts in the related fields for more information. By making and maintaining a connection with your representatives, you can be this resource for them.
Suzy Wise, Pharm.D./MBA CPh 2017-2018 FPA President
Turn your patients into advocates. The easiest way to have your patients as advocates is to ensure they are aware of all the services you offer. Do your patients rely on your expertise to manage their diabetes, hypertension, immune disorders or keep their family up to date on vaccinations? When pat ient s rely on t hei r pharmacist for valuable health services, they are willing to be advocates in keeping those services. Share with your patients what is happening with the practice of pharmacy in the state and nationally. Informed patients can make the greatest advocates for health care. Patients can be the greatest untapped resource for advocacy efforts as they are the constituents our elected officials represent. It is important to share important issues with our patients so they can let their voices be heard on issues that affect their access to quality health services.
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2017-18 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work diligently all year long on behalf of our members.
Scott Tomerlin....................................................................................................Board Chair Suzanne Wise...............................................................................................FPA President Ashley Huff.................................................................................................... FPA Treasurer Angela Garcia............................................................................................President-Elect David Mackarey........................................................................Speaker of the House Jeanette Connelly.......................................................Vice Speaker of the House Charzetta James.................................................................................. FSHP President Joyanna Wright................................................................................... Region 1 Director Neil Barnett............................................................................................Region 2 Director Dean Pedalino.......................................................................................Region 3 Director Linda Lazuka.........................................................................................Region 4 Director Melissa Ruble........................................................................................Region 5 Director Luther Laite IV.....................................................................................Region 6 Director Paul Delisser.......................................................................................... Region 7 Director Humberto Martinez..........................................................................Region 8 Director Mitchell Fingerhut.............................................................................Region 9 Director
Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair....................................................Cristina Medina, cmmedina@cvs.com Treasurer...............................Don Bergemann, don.bergemann@verizon.net Secretary................................................................... Stuart Ulrich, stuarx@aol.com Member.............................. Rebecca Poston, Rebecca.Poston@flhealth.gov Member.................................................Patricia Nguebo, notablep@hotmail.com Member................................................................Norman Tomaka, FLRX9@aol.com Member............................................Greta Pelegrin, gretapelegrin@yahoo.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com Journal Reviewer....................... Dr. Melissa Ruble, mruble@health.usf.edu Journal Reviewer....................................Dr. Angela Hill, ahill2@health.usf.edu
Connect with other health care professionals. Even within the health care system, many other health professionals are unsure of all the services offered by their pharmacists. This is a great opportunity to showcase the practice of pharmacy. Invite them to your pharmacy, invite t hem to healt h screenings and events, meet with them in their offices and discuss how you can help improve outcomes for your mutual patients. Many times, opposition in health care legislation comes from other health care providers based on different understandings of the role each profession plays in improving patient outcomes. You can be a part of the solution by integrating yourself with other health professionals. Get someone else involved. While having a few pharmacist voices in Tallahassee is wonderful and can make a difference, the future of the profession depends on more involvement. As you are beginning or continuing your advocacy efforts, invite another pharmacist, student pharmacist or technician to join you. A united voice of pharmacists, patients and other health care professionals across the state is a very powerful voice in advocating for quality health care. Start advocating for the next legislative session now. The advocacy that happens every day is extremely powerful. Plan to attend the 2019 Legislative Days now. Join us in coordinating our advocacy efforts as we prepare for the next session by contacting us at PharmacyAdvocacyOutreach@gmail. com I challenge you to become a voice of the profession. If not you‌ then who? n
SCAN HERE TO JOIN TODAY
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FLORIDA PHARMACY TODAY
Executive Insight BY MICHAEL JACKSON, RPH MICHAEL JACKSON, BPHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION
Why Do Florida Pharmacies Have to Subsidize Health Care Costs?
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here are several issues that pharmacies and pharmacists are struggling with in today’s managed care marketplace. Pharmacies are reimbursed based upon an agreedto contract that allows for payments for pharmacy services. These agreements may include payments based on the pharmacy’s usual and customary charge to the general public, a standard reimbursement formula that is known as a maximum allowable cost list. That list is generated through a nontransparent process that compels a pharmacy that is caring for a patient to accept a payment that the pharmacy benefits manager has determined to be the lowest cost for a prescription drug. Our members are telling us that these maximum allowable cost lists are unreasonable and do not reflect what the true costs of the drugs may be that a pharmacy must purchase from their supplier. Some of our members have claimed that these maximum allowable cost lists, which are proprietary tools used by the PBM industry, are not being updated to reflect the current supplier market here in Florida. There was legislation filed (SB 1494 and HB 351) that was the first attempt to get some of the many issues with these lists corrected by requiring them to be updated at least every seven days. They would also require PBMs to register with the Office of Insurance Regulation. Laws were passed several years ago that put these requirements within the Board of Pharmacy, but the Legislature failed to include any enforcement options that the Board could take. There currently is no regulatory framework around PBMs, even though they are a
major player in the provision of health care services for Florida consumers. Also in SB 1494 and HB 351 is language that prohibits health insurers and health maintenance organizations from allowing PBMs to include in their contracts with pharmacies any clauses or contract language that limit a pharmacist’s ability to interchange a
What this bill does is open a very small doorway in prescription drug price transparency to assist the patient and control the cost of their medications. generically equivalent drug that would save the patient on their prescription costs. Such options that a pharmacist may provide to a patient may include offering to charge for the pharmacy’s cash price rather than filing a claim with their insurance provider. The insurance claim could be higher than the pharmacy’s cash price in some cases. Our members have been concerned that disclosing options like this may be in violation of their provider
Michael Jackson, B.Pharm
agreements, and this language in the bill is designed to provide some protection. What this bill does is open a very small doorway in prescription drug price transparenc y to assist t he patient and control the cost of their medications. It is the first step of many that needs to be looked at within the PBM marketplace. We are not convinced that those who purchase prescription drug benefits know what their true costs are. How could an employer group know what their prescription drug costs are if the maximum allowable cost lists are so secretive that not even pharmacy providers who purchase medications are allowed to know where the pricing lists come from or what method is used to generate these lists? This issue is not unique to Florida, FEBRUARY 2018 |
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FPA STAFF Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200
Director of Continuing Education Tian Merren-Owens, ext. 120
Educational Services Office Assistant Stacey Brooks, ext. 210 Coordinator of Membership Christopher Heil, ext. 110 Accounting Coordinator Ashley Gandy ext. 211
FLORIDA PHARMACY TODAY BOARD Chair..................................... Carol Motycka, St. Augustine Vice Chair................................Cristina Medina, Hollywood Treasurer...................Don Bergemann, Tarpon Springs Secretary.........................Stuart Ulrich, Boynton Beach Member..............................Rebecca Poston, Tallahassee Member.............................................. Patricia Nguebo, Ocala Member................................. Norman Tomaka, Melbourne Member..............................................Greta Pelegrin, Hialeah Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee
This is a peer-reviewed publication. ©2018 FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today. The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board. FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax. FLORIDA PHARMACY ASSOCIATION
610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 8Web | Address: F L O R I D http://www.pharmview.com A PHARMACY TODAY
You are welcome to call us here at the FPA office on underwater prescription claims that are driving down reimbursement, but the real conversation needs to be with your state senator and state representative. They have the ability to crack open this nut and fix the problem. and if there is going to be a fix the Florida Legislature and Congress have to take action. You are welcome to call us here at the FPA office on underwater prescription claims that are driving down reimbursement, but the real conversation needs to be with your state senator and state representative. They have the ability to crack open this nut and fix the problem. If they don’t act,
then pharmacies will continue to be unfavorably reimbursed, thus shielding the government and the private health care marketplace of what the real costs are. When that bubble breaks, those who purchase health care may be in for a surprise. n
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“I’M ALWAYS WATCHING OUT FOR MY PATIENTS, BUT WHO’S WATCHING OUT FOR ME?”
WE ARE. We are the Alliance for Patient Medication Safety (APMS), a federally listed Patient Safety Organization. Our Pharmacy Quality Commitment (PQC) program: • • • •
Helps you implement and maintain a continuous quality improvement program Offers federal protection for your patient safety data and your quality improvement work Assists with quality assurance requirements found in network contracts, Medicare Part D, and state regulations Provides tools, training and support to keep your pharmacy running efficiently and your patients safe
Call toll free (866) 365-7472 or visit www.pqc.net PQC IS BROUGHT TO YOU BY YOUR STATE PHARMACY ASSOCIATION FEBRUARY 2018
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CONNECTING HEALTH CARE: Regulating Medical Marijuana Dispensaries Spills into Pharmacy Space
By FPA Legal Counsel T.J. Morton
CITIES AND MUNICIPALITIES
have the ability to consider and adopt policy surrounding a number of issues such as how land and property are used in their communities. That authority is granted under certain provisions of the Florida Constitution as well as laws enacted by the Legislature and signed by the governor. For example, a community can determine whether utilities must be installed underground or how high signs and billboards are allowed to be for advertising businesses. The Florida Pharmacy Association has learned that the city of Wellington has filed ordinance number 2017-21 attempting to regulate medical marijuana dispensing organization facilities. The city is stating in its plan that it has been granted authority under Florida Statutes 163 and 166 and is driven by the passage of Amendment 2 during the November 8, 2016, election. The city is also looking at Senate Bill 8A that was adopted during the 2017 fall special session as part of its guiding principles. In the ordinance, the city defined a medical marijuana dispensing organization as an organization approved by the Florida Department of Health to cultivate, process and dispense low-THC cannabis or medical cannabis pursuant to the provisions of Chapter 2017-232, Laws of Florida
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and Chapter 64-4 “Compassionate Use� of the Florida Administrative Code. The city also defined a medical marijuana treatment center as an entity that acquires, cultivates, possesses, processes (including development of related products such as food, tinctures, aerosols, oils or ointments), transfers, sells, distributes, dispenses or administers marijuana, products containing marijuana, related supplies or educational materials to qualifying patients or their professional caregivers and is registered by the Florida Department of Health. Clearly, many of the things that are described in the definition of a medical marijuana treatment center are the things pharmacies are capable of doing – with one exception. Medical marijuana is a Class I drug and is not a substance that should be found in a pharmacy. So why is the FPA sharing this information with the membership? The origins of this issue, and how it may impact pharmacies in certain communities, go back to the signing of SB 8A last year. SB 8A prohibits a city from enacting ordinances for permitting or determining the location of a medical marijuana dispensing facility that are more restrictive than its ordinances for pharmacies. My guess is the city commission wanted to prohibit
medical marijuana dispensing facilities in Wellington but, perhaps for political reasons, the commission did not want to outright ban them. (SB 8A authorizes cities to ban dispensing facilities.) Instead, the commission passed this ordinance that purports to allow dispensing facilities but, in reality, effectively prohibits them. Because of the provision in SB 8A that requires cities to treat pharmacies and dispensing facilities the same, the commission had to impose the same requirements on pharmacies. Essentially, the ordinance that passed requires medical marijuana treatment facilities AND retail pharmacies to be at least 10,000 square feet of floor space and not be less than 1,000 feet from any public or private school. There are exceptions for pharmacies and medical marijuana facilities on US 441. It is possible that this ordinance could cause harm to some small family-owned pharmacy businesses that wish to expand into other areas of the city of Wellington. We do not agree with the city’s attempt to justify the pharmacy restrictions as being necessary to protect the public. We believe that it is a backdoor attempt to prohibit dispensing facilities, and there is a legitimate argument that it is not valid. The test for determining whether an ordinance is valid is whether the ordinance is reasonable and not arbitrary. Bal Harbour Village v. Welsh, 879 So. 2d 1265 (Fla. 3d DCA 2004). If, in fact, the only reason these restrictions have been imposed on pharmacies is to prohibit dispensing facilities, we
A Pharmacist And A Lawyer Licensure Disciplinary Proceedings Insurance Company/PBM Audits and Appeals Purchase & Sales of Pharmacies Regulatory Compliance Consultants Business Operations Consultants KAHAN & ASSOCIATES, PLLC
Pharmacist Attorney Brian A. Kahan, R.Ph., J.D. Licensed Florida Pharmacist and Attorney
believe a court could find that the ordinance is arbitrary as it relates to pharmacies. Any individual pharmacy that is affected by the ordinance can challenge it. The FPA or any association can challenge an ordinance on behalf of its members if a substantial number of its members are substantially affected by the ordinance, and that the activity regulated by the ordinance is within the association’s general scope of interest and activity, and the relief requested is of the type appropriate for a trade association to receive on behalf of its members. Florida Home Builders Assoc., Inc. v. City of Tallahassee, 15 So. 3d 612 (Fla. 1st DCA 2009). This would require a showing by the association that several of its members are directly impacted by the city’s ordinance. If there is an existing proceeding challenging the ordinance, the association could seek to intervene in that proceeding. Otherwise the association would need to initiate a new proceeding by filing a complaint for declaratory relief challenging the ordinance. Such action would require consideration by the FPA Board of Directors. It is possible that other municipalities in Florida may be considering changes to their regulatory codes that could have an impact on small businesses. Members are encouraged to contact their legislators if you see proposals like this being considered in your city or county community meetings. T.J. Morton is a partner with the Lockwood Law Firm and serves and legal counsel for the Florida Pharmacy Association.
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STATEWIDE REPRESENTATION 561-392-9000 bkahan@kahanlaw.com 7000 West Palmetto Park Road, Suite 210 Boca Raton, FL 33433 The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience.
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NCPA Survey: Pharmacy DIR Fees Plague Both Community Pharmacies and Their Patients
T N E I T A P S
N O I T A R E U REMUN
S E C C A
S E FE
According to a survey from the National Community Pharmacists Association, an overwhelming majority of independent community pharmacy owners say retroactive pharmacy direct and indirect remuneration fees undermine patient access to prescription drugs and hinder owners’ ability to manage their businesses. “Our members say fixing retroactive pharmacy DIR fees should be NCPA’s priority for 2018,” said NCPA CEO B. Douglas Hoey, Pharmacist, MBA. “The results of this recent survey will help us make the case to CMS and members of Congress that a fix is needed, and it’s needed now. “For example, 84 percent of independent community pharmacy owners say they never know what their final reimbursement will be at the point of sale, and 77 percent say it takes four to 12 months before they learn what the final reimbursement figure will be. The only realistic solution is to end the retroactive nature of DIR fees – whether through S. 413 / H.R. 1038, the Improving Transparency and Accuracy in Medicare Part D Drug Spending Act, or by the Centers for Medicare & Medicaid Services flexing their regulatory muscles in a similar manner.” Among other findings reported by survey respondents: ■■ 84 percent said DIR fees hinder their ability to plan for the future of their business. ■■ 78 percent said DIR fees make cash flow unpredictable. ■■ 75 percent said DIR fees make it hard to predict operating revenue. ■■ 87 percent said DIR fees push patients into the Part D coverage gap more quickly, where patients have much higher out-of-pocket costs. 12
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69 percent said DIR fees inflate patient cost-sharing levels, which increases their patients’ true out-of-pocket totals.
In addition, 35 percent of respondents said DIR fees are never itemized to a specific claim. While pharmacy benefit managers claim pharmacy DIR fees are linked to patient health outcomes, 82 percent of respondents said they never receive any information about how the fees are linked to quality measures. NCPA attached the survey results to comments it submitted in response to CMS’ proposed rule for 2019 Medicare Part D plans, which included a request for information on a potential proposal to include DIR fees at the point of sale.
THE ONLY REALISTIC SOLUTION IS TO END THE RETROACTIVE NATURE OF DIR FEES – WHETHER THROUGH S. 413 / H.R. 1038, THE IMPROVING TRANSPARENCY AND ACCURACY IN MEDICARE PART D DRUG SPENDING ACT, OR BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES FLEXING THEIR REGULATORY MUSCLES IN A SIMILAR MANNER.”
2017 Recipients of the “Bowl of Hygeia” Award
Larry Presley Alabama
John McGilvray Alaska
Alan Barreuther Arizona
Sue Frank Arkansas
Pierre Del Prato California
Mary Petruzzi Connecticut
Noel Rosas Delaware
Goar Alvarez Florida
Hewitt Ted Matthews Georgia
Ed Cohen Illinois
Ahmed Abdelmageed Indiana
Tim Becker Iowa
Merlin McFarland Kansas
Melody Ryan Kentucky
Gregory Poret Louisiana
Greg Cameron Maine
Cynthia Boyle Maryland
Anita Young Massachusetts
Dennis Princing Michigan
Denise Frank Minnesota
David French Mississippi
David Farris Missouri
Matthew Bowman Montana
Gary Rihanek Nebraska
Mark Decerbo Nevada
Hubert Hein New Hampshire
Thomas F.X. Bender, Jr. New Jersey
David Lansford New Mexico
John T. McDonald III New York
Steve Caiola North Carolina
Tim Weippert North Dakota
Debra Parker Ohio
Ben Allison Oklahoma
Mercy Chipman Oregon
Jerry Musheno Pennsylvania
Marisa Carrasquillo Puerto Rico
Gary Kishfy Rhode Island
Terry Blackmon South Carolina
Tim Tucker Tennessee
Chris Alvarado Texas
Kurt Price Utah
Pat Resto Virginia
The “Bowl of Hygeia”
In Memoriam: Rob Loe South Dakota Keith Campbell Washington Daneka Lucas Washington DC
Kevin Yingling West Virginia
Thad Schumacher Wisconsin
Joe Steiner Wyoming
The Bowl of Hygeia award program was originally developed by the A. H. Robins Company to recognize pharmacists across the nation for outstanding service to their communities. Selected through their respective professional pharmacy associations, each of these dedicated individuals has made uniquely personal contributions to a strong, healthy community. We offer our congratulations and thanks for their high example. The American Pharmacists Association Foundation, the National Alliance of State Pharmacy Associations and the state pharmacy associations have assumed responsibility for continuing this prestigious recognition program. All former recipients are encouraged to maintain their linkage to the Bowl of Hygeia by emailing current contact information to awards@naspa.us. The Bowl of Hygeia is on display in the APhA History Hall located in Washington, DC. Boehringer Ingelheim is proud to be the Premier Supporter of the Bowl of Hygeia program. FEBRUARY 2018
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OPINION: Remote Dispensing Pharmacy Legislation Enabling Technology for the Wrong Purpose By Michael Jackson, BPharm, CPh Executive Vice President / CEO, Florida Pharmacy Association The Florida Legislature is supporting a change in the Pharmacy Practice Act that would allow for a facility to be operated by pharmacy technicians and remotely supervised by a Florida licensed pharmacist offsite. SB 848 and HB 679, filed respectively in the House and Senate, would: ■■ Create a new pharmacy permit for remote dispensing; ■■ Define remote dispensing as a location where prescription drugs are compounded or dispensed by a registered technician who is supervised electronically by an offsite pharmacist; ■■ Allow for a remote dispensing pharmacy to operate without a pharmacist being present; ■■ Allow a registered pharmacy technician to compound and dispense medicinal drugs if supervised electronically; ■■ Remove violations and penalties for anyone who operates a remote dispensing pharmacy without a pharmacist being present; and ■■ Remove violations and penalties for anyone who is working as a registered technician in a remote dispensing pharmacy without a pharmacist being present.
Significant Change to Pharmacy Regulations Pharmacists are regulated under Florida Statutes 465, which includes comprehensive legal guidance on what their duties and responsibilities are. In addition to the provision of patient consultation services, these bills also allow for the preparation of and the presentation to the patient of prescription medications that have not been physically examined in person by a pharmacist. However, they will be remotely validated using application software. The operation of the pharmacy
itsel f would on ly be subjec t to occasional inspections by a prescription department manager that may schedule visits to the remote pharmacy. These proposals are a dramatic revision to the Pharmacy Practice Act. They create two distinct regulatory standards in which some pharmacies in Florida require the physical presence of a pharmacist by law and others don’t. We argue that the pharmacist supervising remotely d i sp en s ed pre sc r ipt ion s i s sued to patients is just as likely to have dispensing and processing failures as a pharmacist working side by side with pharmacy technicians.
WE ARGUE THAT THE PHARMACIST SUPERVISING REMOTELY DISPENSED PRESCRIPTIONS ISSUED TO PATIENTS IS JUST AS LIKELY TO HAVE DISPENSING AND PROCESSING FAILURES AS A PHARMACIST WORKING SIDE BY SIDE WITH PHARMACY TECHNICIANS. 14
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Not Endorsed by Pharmacy These ideas are not a recommendation of the profession and we question the real purpose and intent of HB 679 and SB 848. There is a question of patient safety, particularly when our industry is working so hard to build systems and procedures to minimize medication errors. Indeed, the number of cases before the Board of Pharmacy has declined over the years through the implementation of quality improvement programs and team-based interventions with hands-on, face-to-face monitoring and management of pharmacy services. Disconnecting Pharmacist and Patient Care Services Our leadership theme for this year is connecting health care, however, this proposal is actually disconnecting h e a lt h c a r e by s e pa rat i ng t h e pharmacist from pharmacy services. We see t h is as frag ment ing t he relationship between the pharmacist, patient and physician and utilizing registered technicians as the frontline caregiver. This is a task for which their academic training and apprenticeship development has not prepared them. Our state’s technicians are a very important part of the health care team that works best when working together in proximity. To physically disconnect the pharmacist from the technician and extend to them the authority to compound and dispense dangerous life-sustaining medications is being unfair to the technician and to the pharmacist who must overcome the limits of offsite supervision. It is most unfair to the patient who is depending upon coordinated pharmacist care services. Telepharmacy and Remote Dispensing are not Interchangable The proposed legislation being introduced includes terms such as remote dispensing, telehealth and telepharmacy. These terms are not interchangeable and have entirely different meanings and different purposes. Telepharmacy is the delivery
of medication and health management via telecommunications to patients in locations where they may not have direct contact with a pharmacist. This is a direct encounter between the pharmacist and patient. Remote dispensing is when medications are provided to a patient that have been prepared by a pharmacy technician with a Florida licensed pharmacist monitoring from somewhere else in Florida (or perhaps the U.S.). Telepharmacy has a Purpose, This is Not It We agree that there is a need, pur pose a nd medical i ntent for telepharmacy services. This includes the direct consultation with patients by a pharmacist on health issues, direct consultation with other health care practitioners and the consultation of pharmacists with other colleagues who have special expertise in certain clinical areas to resolve unique problems. The use of telepharmacy technology to manage a fully operational pharmacy is inappropriate. O u r st at e i s not i m mu ne to communication disruptions that this technology must heavily rely upon. This may include natural or manmade disruptions. This is particularly challenging in remote areas of Florida where the availability of a viable and stable internet service provider or other digital connectivity may be spotty at best. When a communication network becomes disabled, a pharmacist remotely super v i si ng t he ta sk s performed by a pharmacy technician becomes impossible. The Real Problem with Access There is a perception that locating pharmacies in medically underserved areas will resolve the problem of remote access, but the real issue cannot be solved with the solution suggested by SB 848 and HB 679. Over 93 percent of Florida citizens are within five miles of a community pharmacy. The real question that Florida needs to examine is what happened to t he pharmac y providers t hat were in some of these underserved communities? We believe they had to
WE ALSO BELIEVE THAT PATIENTS IN RURAL OR UNDERSERVED AREAS ARE ENTITLED TO HAVE ONSITE PHARMACIST SERVICES JUST LIKE ALL OTHER COMMUNITIES IN THIS STATE. close their businesses due to the lack of policies that would end restricted networks, unfair maximum allowable cost reimbursement programs and mandatory mail order. Creating a regulatory framework of removing a pharmacist from a pharmacy is not going to help at all with access. Safety First Each pharmacist licensed in Florida publically declares that he or she will consider the welfare of humanity and relief of suffering their primary concerns. This includes having full confidence in the services provided by our profession to be one of the utmost important tasks that we perform. This includes the opposition of concepts that we believe introduce a level of doubt in the delivery of quality health care. To that end, we are unable to find support or endorse any proposal that seeks to separate pharmacists and patients. We also believe that patients in rural or underserved areas are entitled to have onsite pharmacist services just like all other communities in this state. This includes the provision of immunizations and face-to-face consultation. Pharmacists in this state are not fearful of new technology and indeed have been pioneers in the use of data-processing systems, claims processing and other advanced patientcare tools. We see the application of this tool as inconstant with the value of direct customized patient-care services that our state’s pharmacists have faithfully provided to our citizens over the years.
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CALL FOR RESOLUTIONS TO THE 2018 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in May 2018 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is May 11, 2018! PLEASE NOTE THIS DEADLINE. The last day to submit items of new business is June 8, 2018.
The following information will be needed when submitting resolutions: 1. Name of organization: The name of the organization submitting the resolutions(s); 2. Name and telephone number of individuals: A contact in the event clarification or further information is needed; 3. Problem: A statement of the problem addressed by the resolution; 4. Intent: A statement of what passage of the resolution will accomplish; 5. Resolution Format: Please type and use double spacing. TITLE OF RESOLUTION NAME OF ORGANIZATION WHEREAS , AND
WHEREAS :
THEREFORE BE IT RESOLVED (THAT THE FPA OR SUBDIVISION OF FPA)
CONTACT NAME AND PHONE #: PROBLEM: INTENT:
Return this form to: Membership Coordinator, Florida Pharmacy Association, 610 North Adams Street, Tallahassee, Florida 32301 or fax (850) 561-6758
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FPA 128th Annual Meeting and Convention July 11-15, 2018 Bonita Springs, FL
,
55Daily Education Registration
Participant Information Participant Information
Daily registration does not include admittance to functions or handbooks. Handouts will be posted on our website July 10.
Name: _____________________________________________________ Name _______________________________________________ Address______________________________________________ Badge Name: _______________________________________________ City, State, Zip_________________________________________ Mailing Address: ____________________________________________ Phone___ ________________________ City, State, Zip: _____________________________________________ Email________________________________________________ Phone: (W) (H)_______________________ Practice Setting________________________________________ License: PS______________ PU _____________RPT_________ Fax: ______________________________________________________ NABP Date of Birth___________ License:e-profile#__________________ PS________________ PU_________ Other State________ Emergency Contact Name/Number_________________________
2
June 22
Onsite
Amount
FPA Member
$165
$185
$_______
Non Member
$215
$235
$_______
Member Technician
$65
$85
$_______
Non Member Technician
$90
$110
$_______
Handbooks
$40
N/A
$_______
Please select the day(s) you will attend: Thursday
Full Package Registration
Full package registration includes Educational Programs Thursday-Sunday, Exhibit Hall Friday and Saturday, and Awards Event on Saturday. Handbooks are not included in full package registration. Handouts will be available on our website, www.pharmview.com, the week of the convention. Before June 22
Onsite
Amount_
FPA Member
$345
$430
$_______
Non Member
$525
$610
$_______
Pharmacist BEST Value
$540
$625
$_______
Member Technician
$155
$185
$_______
Non Member Technician
$175
$210
$_______
Technician BEST Value
$185
$220
$_______
Student
$150
$170
$_______
Guest (no CE)
$160
$160
$_______
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Guest Name_ Handbooks
_______ $40
__ N/A
$_______
Please indicate below which functions you will attend. Tickets will be provided upon request during the pre-registration process and placed in your packet. If no boxes are selected, we will assume you will not attend any of the events listed below and tickets will not be available onsite. Please see box 5 for additional tickets.
House of Delegates (Thursday)
Exhibit Hall (Friday and/or Saturday)
Awards Event (Saturday)
I will not attend any of these functions.
4
Before June 22
Additional Tickets
Quantity
Price
Amount
Exhibit Hall
@ $30
$______
Awards Event
@ $80
$______
7
Special Events Registration
The events listed below must be purchased individually and are not included in any other registration packages. Quantity
Price
Amount
FPPC Reception _________ @ N/C (Complimentary event, indicate if attending)
$_____
Christian Fellowship
$_____
_________
@ N/C
(Complimentary event, indicate if attending)
8
_________
Quantity Price
9
@ $50
$_____
FPA Polo Shirt (Deadline is June 8, 2018) Yes
______ @ $35
Payment
M/F ______
Size ______
Amount $_______
Total Enclosed: $______
Check (To: FPA) AMEX Discover MasterCard Visa Account # ____________________________________________
$35
Onsite
Amount
$50
______
Billing Address ________________________________________ Signature ____________________________________________
Four Ways to Register
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Sunday
The following events are included in the Full Registration Package if requested. However, you must purchase additional tickets for guests who are NOT registered.
Mail: FPA, 610 North Adams Street, Tallahassee, FL 32301 Phone: 850-222-2400 Fax: 850-561-6758 Web: www.pharmview.com 20
Saturday
Security Code _________________ Expiration Date __________
House of Delegates
House of Delegates (Non-convention registrants)
6
Friday
Student Awards Event
(BEST Value includes Registration & Membership)
3
Before
FLORIDA PHARMACY TODAY
Schedule Subject to Change
See what our tomorrow looks like at: phmic.com/tomorrow2
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C A L L
F O R
APhA Foundation and NASPA Bowl of Hygeia Awarded to a pharmacist for outstanding community service above and beyond professional duties. The use of the following selection criteria is required: ■■ The recipient must be a Florida licensed pharmacist and a member of FPA. ■■ ■■ T recipient has not previously received the award. ■■ two on its award committee or an officer of the association other than in an ex officio capacity. ■■ has compiled an outstanding record of community service, which, apart from his/her specific identification as a pharmacist, reflects well on the profession. James H. Beal Award Awarded to the “Pharmacist of the Year.” Criteria: ■■ must be a Florida registered pharmacist and a member of the FPA. ■■ has rendered outstanding service to pharmacy within the past five years. Technician of the Year Award Awarded annually to a Florida pharmacy technician who is recognized for his/her outstanding performance and achievement during his/her career. Criteria: ■■ Candidate must be a member of the Florida Pharmacy Association for at least two years. ■■ Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice. ■■ Candidate must have demonstrated contributions to the Florida Pharmacy Association and/or other pharmacy organizations. ■■ Candidate must have demonstrated
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N O M I N A T I O N S commitment to community service.
■■ Candidate is not a past recipient of
this award.
R.Q. Richards Award This award is based on outstanding achievement in the field of pharmaceutical public relations in Florida. Criteria: ■■ recipient must be a Florida registered pharmacist and a member of the FPA. ■■ has displayed outstanding achievement in the field of pharmaceutical public relations in Florida. Frank Toback/AZO Consultant Pharmacist Award Criteria: ■■ Candidate must be an FPA member, registered with the Florida Board of Pharmacy as a consultant pharmacist in good standing. ■■ Candidate should be selected based on their outstanding achievements in the field of consultant pharmacy. DCPA Sidney Simkowitz Pharmacy Involvement Award Presented annually to a Florida pharmacist who has been active at the local and state pharmacy association level in advancement of the profession of pharmacy in Florida. Criteria: ■■ A minimum of five years of active involvement in and contributions to the local association and FPA. ■■ Candidate must have held office at local level pharmacy association. ■■ Member in good standing for a period of at least five years in the FPA and must have served as a member or chairman of a committee of the association. ■■ Candidate must have been actively involved in a project that has or could potentially be of benefit to members of the profession.
F P A
Pharmacists Mutual Companies Distinguished Young Pharmacist Award Awarded to a young pharmacist for their involvement and dedication to the practice of pharmacy. Criteria: ■■ Licensed to practice for nine years or fewer. ■■ Licensed to practice in the state in which selected. ■■ Participation in national pharmacy association, professional programs, and/or community service. IPA Roman Maximo Corrons Inspiration & Motivation Award Interamerican Pharmacists Association created this award to honor the memory of Roman M. Corrons who inspired and motivated countless pharmacists to participate actively and aspire to take on leadership roles in their profession. Roman was always there with guidance and support that motivated pharmacists and encouraged visionary leadership, approachable active membership and succession planning. This award recognizes the motivators among us who inspire others to continue to advance the profession. Criteria: ■■ The recipient must be a Florida Licensed Pharmacist and a member of the FPA. ■■ Candidate should motivate others to excel within the profession by encouraging them to be leaders. ■■ Candidate is not necessarily an association officer, but guides, supports and/or inspires others. A brief description on the candidate’s motivational/inspirational skills must accompany the nomination. The Jean Lamberti Mentorship Award The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and experience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students.
A W A R D S
2 0 1 7 - 2 0 1 8
Criteria: ■■ The recipient must be an FPA member. ■■ The recipient must serve as a role model for the profession of pharmacy. Upsher Smith Excellence in Innovation Award Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care. Criteria: ■■ The recipient has demonstrated innovative pharmacy practice resulting in improved patient care. ■■ The recipient should be a practicing pharmacist within the geographic area represented by the presenting Association.
Qualified Nominee: A pharmacist practicing within the geographic area represented by the presenting Association. Cardinal Generation Rx Award The Cardinal Health Generation Rx Champions Award recognizes a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention. The award is intended to recognize outstanding efforts within the pharmacy community to raise awareness of this serious public health problem. It is also intended to encourage educational prevention efforts aimed at patients, youth and other members of the community. The nominee must be a pharmacist who is a member of the state association. Self-nominations are allowed. Applica-
tions will be evaluated based upon the following criteria: ■■ Commitment to community-based educational prevention efforts aimed at prescription drug abuse ■■ Involvement of other community groups in the planning and implementation of prevention programs ■■ Innovation and creativity in the creation and implementation of prevention activities ■■ Scope/magnitude of prescription drug abuse efforts ■■ Demonstrated impact of prescription drug abuse prevention efforts
DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2018 FPA AWARDS NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:
NOMINATED BY:
Name:
Name:
Address:
Date Submitted: Signature:
FOR THE FOLLOWING AWARD: (Nomination Deadline February 28, 2018) APhA Foundation and NASPA Bowl of Hygeia James H. Beal Award
Please describe briefly below the nominee's accomplishments, indicating why you feel he or she should receive this award. (Attach additional sheets if necessary.)
R.Q. Richards Award Frank Toback/AZO Consultant Pharmacist Award DCPA Sydney Simkowitz Award Pharmacists Mutual Co. Distinguished Young Pharmacist Award IPA Roman Maximo Corrons Inspiration & Motivation Award The Jean Lamberti Mentorship Award Upsher Smith Excellence in Innovation Award Cardinal Generation Rx Award
MAIL NOMINATONS TO: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS FEBRUARY 28, 2018
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florida BUYER’S GUIDE PHARMACY TODAY
ADVERTISERS: This is a special section designed to give your company more exposure and to act as an easy reference for the pharmacist.
PHARMACY RESOURCES PPSC Retail Pharmacy Purchasing Program (888) 778-9909
LEGAL ASSISTANCE Kahan & Associates, PLLC Brian A. Kahan, R.Ph., Attorney at Law (561) 392-9000 The Health Law Firm George F. Indest III, J.D., M.P.A., LL.M. (407) 331-6620
PHARMACEUTICAL WHOLESALER McKesson Drug Company Jim Springer (800) 804-4590 FAX: (863) 616-2953
FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 412-4166 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.pharmacist.com AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS Bethesda, MD (301) 657-3000 www.ashp.com/main.htm DRUG INFORMATION CENTER Palm Beach Atlantic University (561) 803-2728 druginfocenter@pba.edu FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way Bin #C04 Tallahassee, FL 32399-3254 (850) 245-4292 www.doh.state.fl.us/mqa FLORIDA POISON INFORMATION CENTER NETWORK (800) 222-1222 www.fpicn.org NATIONAL COMMUNITY PHARMACISTS ASSOCIATION 100 Daingerfield Road Alexandria, VA 22314 (703) 683-8200 (703) 683-3619 fax info@ncpanet.org
Advertising in Florida Pharmacy Today Display Advertising: please call (850) 264-5111 for a media kit and rate sheet. Buyers’ Guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. Professional Referral Ads: FPA Members: $50 per 50 words; Non‑members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt. 24
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RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”