Florida Pharmacy Today March 2018 by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association MAR. 2018

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florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 24 FPA News & Notes 26 Buyer’s Guide

VOL. 81 | NO. 1 MARCH 2018 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

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Test and Treat? Nope, Try Test and Defeat! FPA Elects New President-Elect, Board of Directors’ Members

128th Annual Meeting & Convention

MARCH 2018

Mission Statements:

FPA Calendar 2018

APRIL 3-4

Florida Board of Pharmacy Meeting Tallahassee

11-12 NCPA Fly-In Washington, D.C. 21-22 FPA Clinical Conference Tampa MAY 6-8

NASPA National Leadership Retreat Kansas City, Mo.

Deadline for the submission of House of Delegates Resolutions

of the Florida Pharmacy Today Journal JUNE

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 JULY 4

Independence Day FPA Office Closed

12 - 15 128th Annual Meeting and Convention of the FPA 21 - 28 FPA CE at Sea

19-20 FPA CE Conference Jacksonville 28

Memorial Day - FPA office closed

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....................... 11 PQC........................................................................ 9 KAHAN & ASSOCIATES................................. 11 PHARMACISTS MUTUAL.............................. 23 Rx OWNERSHIP.................................................. 2

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

Let Your Voice Be Heard Through Resolution Process

s we look back at the legislative session that just ended you may be thinking, “What can I do to shape the policies that affect pharmacy practice and patient care?” We have focused a lot on what happens after legislation is proposed at the state or national level and how pharmacists can speak out to advance the profession and protect our patients. But you may be wondering where those positions and ideas originate. Each year, the Florida Pharmacy Association House of Delegates meets at the annual meeting during the summer to discuss the issues brought to the association by the members and adopt policies that guide the association. Ideas and positions are brought to the House of Delegates through a resolution process. Some resolutions are position statements for the association and guide our responses to other associations, media, legislators and other entities. Other resolutions are calls to action for the association. These calls to action can direct the committees or the Board of Directors of the association to act.

olution. A resolution must contain a title, contact information, a Whereas statement, a Resolve statement, a statement of the problem and a statement of intent. The title should succinctly address the topic of the resolution. The Whereas statement should carry a message and develop a set of statements that requires a solution. Collect relevant facts to form the basis for the Whereas state-

The Resolution Process It all starts with an idea or thoughts on an issue that is affecting healthcare. When a member or a local unit association has something they would like to see in FPA policy they can draft a resolution to be considered by the House of Delegates. To get started with your resolution, you should begin by reviewing the previously adopted resolutions to see if there is already an adopted policy that addresses your idea. If the idea is not covered or differs from your idea, then it is time to start drafting your res-

ments in the resolution. Include only a few of these facts as their purpose is to outline a problem, not to provide an exhaustive discussion. Statements of fact in Whereas clauses should be cited with references. The Resolve clauses should address what the FPA should do or what position the FPA should take on the identified topic. If adopted by the House, the resolution may become the foundation of a new FPA program or policy. The Resolve clauses must make sense as standalone statements. When a resolution is ad-

When a member or a local unit association has something they would like to see in FPA policy they can draft a resolution to be considered by the House of Delegates.

Suzy Wise, Pharm.D./MBA CPh 2017-2018 FPA President

opted by the House, only the Resolve clauses become FPA policy; the Whereas clauses do not. The problem statement can give additional background information of the problem being addressed by the resolution. The intent statement provides the opportunity to explain what the resolution will do. Once the resolution has been drafted and submitted to the association (prior to the resolution deadline), it will be reviewed by the House of Delegates Board of Directors. During the review of all submitted resolutions, the Board will compare them to previous adopted policy, suggest potential edits to the author of the resolution and evaluate the fiscal impact of the resolution. During the financial impact review, the Board will evaluate the potential cost to implement any action directed by the resolution. The financial impact will be represented on the resolution as one to five dollar signs showing the relMARCH 2018

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

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FLORIDA PHARMACY TODAY

ative cost. The Board may also add additional comments to the end of the resolution to help the delegates during the House session. The resolutions are then placed on the agenda for the House of Delegates meeting at the annual meeting. The House of Delegates is made up of delegates representing each of the affiliated unit associations and other invited organizations. The number of delegates allowed to represent each unit is based on the number of FPA members in the respective unit. Prior to the annual meeting, each of the unit associations is provided with all of the proposed resolutions to review with their membership to discuss. At the annual meeting, the House of Delegates will convene to discuss all of the proposed resolutions. During the House session, each resolution is presented by the sponsor and read into the record. Once the resolution is presented, there is time for questions of the sponsor, discussion, debate and possible amendments. There are a few possible outcomes with a resolution during the House meeting. Once the discussion/debate has concluded, the resolution will be brought to a vote. The House may choose to adopt or reject the resolution in its original form or as amended by the House. Occasionally, based on the debate or discussion of the resolution, delegates may choose to refer the resolution to a committee. When a resolution is referred to a committee it will be discussed and researched and modified by the assigned committee over the next term and brought back to the next House of Delegates meeting the following year. After the close of the House of Delegates meeting, the FPA Board of Directors will review the adopted resolutions and determine the course of action required by these new policies. The speaker of the House and Board of Directors will ensure actions set forth by the resolutions are completed. The deadline for resolutions for this yearâ&#x20AC;&#x2122;s annual meeting is May 11, 2018. Please let your voice be heard in shaping the profession by writing your resolution today. n

Executive Insight BY MICHAEL JACKSON, RPH MICHAEL JACKSON, BPHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION

2018 Legislative Session Update and Summary

he 2018 legislative session has come to its end and not without a fair amount of work from the Florida Pharmacy Association volunteer leaders, advocates and lobby team. Health care issues get the attention of state lawmakers because it primarily represents a major cost of government. This year the House and Senate adopted an $88.7 billion budget. Compare that to the $66.5 billion budget approved for fiscal year 2009-2010. With an estimated 21 million Floridians calling our state home, the cost of state government is about $4,224 for every man, woman and child living in our state. This year’s budget planning was affectFPA Governmental Affairs Committee ■■ Aneesh Lakhani – Chair ■■ Scott Tomerlin - Board Chair ■■ Suzanne Wise – President ■■ David Mackarey – Speaker ■■ Jeanette Connelly – Vice Speaker ■■ Ashley Huff – Treasurer ■■ Angela Garcia – President Elect ■■ S. Mark Hobbs – FPPC Chair ■■ Kathy Baldwin – FSHP Liaison ■■ Christopher Konig – At Large Member ■■ Christina Laird – At Large Member ■■ Eric Larson – At Large Member ■■ Preston Mcdonald – At Large Member ■■ James Wright – Co-Chair ■■ Norman Tomaka – Past Chair ■■ Theresa Tolle – FPPC Treasurer ■■ Michael Jackson – FPA EVP ■■ Claudia Davant – FPA Lobbyist ■■ Rebecca Roman – FPA Lobbyist ■■ Dave Ericks – FPA Lobbyist ■■ TJ Morton – FPA Legal Council

ed by two costly hurricanes that hit our coast, as well as spending plans that were adopted to provide protective services in our state’s schools. You can bet that health care is a major part of the costs associated with state government. That includes, but is not limited to, providing health care benefits for state employees, Medicaid funding and local county health departments. It is obvious to us that pharmacists can play a major role in keeping those costs under control. To do that will require some long overdue changes in the Pharmacy Practice Act that we will discuss in this report below. An advocacy program requires a lot of planning and preparation as well as resources. Our work not only includes proactively advocating for pharmacy issues but we also expend effort on defense on things that we believe affect public health quality, costs and access. The planning actually begins during our annual meeting with policy statements from the FPA House of Delegates. Some of these policy statements may include action items that are then directed to the FPA leadership to implement. Because the FPA’s resources are not unlimited, it is necessary to begin with members of the appointed and elected Governmental Affairs Committee (GAC) of the FPA. The GAC is charged with providing guidance to the Board of Directors on legislative or regulatory issues and is required to meet at least annually. At their meeting last august the GAC formulated an advocacy plan and presented it to the Board of Directors at their August 2017 meeting for review and approval. For the past several years we have

Michael Jackson, B.Pharm

worked with our lobby team at Adams Street Advocates (ASA) to carry our issues to the Florida Capitol. It is difficult to get bills passed and for the past several years the governor of Florida has placed his pen on approved bills that had a lot of Florida Pharmacy Association advocacy efforts on it. Please allow me to give our many thanks to Claudia Davant, Rebecca Roman and Dave Ericks, along with T.J. Morton and John Lockwood at the Lockwood Law firm for their legislative and legal services.

MARCH 2018 |

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

2017 – 2018 Advocacy Plan

The members of the FPA Government Affairs Committee met in Orlando last August to review legislative activity for the past several years, and also policy statements adopted by the FPA House of Delegates. Their work resulted in the adoption and recommendation of the following list of issues to the Board of Directors: High Priority ■■ MAC Transparency Law Enforcement ■■ PBM Transparency ■■ Amending Collaborative Practice Agreements Advocate if Opportunity Presented ■■ PBM Enrollment Standards ■■ Revisions to current laws requiring the three (3) hour CE from an exclusive provider ■■ Pharmacist administration of narcotic antagonists Monitor ■■ Continuing of maintenance medication therapy ■■ Requirement for consultant pharmacist reviews in ALFs, surgery centers, etc. ■■ Equality of pharmacists ■■ Florida pharmacist dispensing of oral contraceptive medications without a prescription ■■ Pharmacist prescribing authority for prescription drug delivery aids, devices or accessories

The FPA Board of Directors received the recommendations from the FPA GAC and, with further discussion, recognized that there is an issue with gag clauses in PBM contracts and possible introduction of issues related to telemedicine that may affect the practice of pharmacy. The Board adopted the recommendations of the GAC as well as supported legislation that addresses gag clause contract issues. The Board also delegated to the President’s Committee to address any policy making surrounding telepharmacy. The FPA GAC under chair Aneesh Lakhani met weekly during the 2018 session to receive an update on the status of bill progress. Updates were also posted regularly in the FPA’s social media sites, as well as in Stat News that is emailed to members. What was the Legislative Landscape for 2018? This year we saw 989 bills that were filed in the Senate with 2,203 bills filed in the House. There were 135 bills that passed the Senate and 327 bills that were adopted by the Florida House. This means of the 3,192 bills that were filed, 462 were adopted in the House or Senate. In order for legislation to get to the governor’s desk, both the House and Senate must approve bill content. Only 200 bills passed both the House and Senate, which means that only about six percent of all the bills filed made it to the finish line. Last year, eight percent of the bills filed were sent to the governor, so this year’s productivity by the House and Senate was worse. Let’s examine what issues were addressed during this session:

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PHARMACY BILLS THAT PASSED Regulation of PBMs House Bill 351 was sponsored by Representative David Santiago (R – Deltona) and supported by the Florida Pharmacy Association. Florida laws currently include a regulatory framework over pharmacy benefit managers (PBM) under the Board of Pharmacy. However, it was made clear to us that there was no enforcement mechanism in place. Early in the session, the FPA was successful in advocating for a workshop before the House Health Innovations Subcommittee on PBMs. FPA Past President and current FPPC Treasurer Theresa Tolle provided valuable comment before the committee on PBM issues. Also providing comment before the committee were FPA members James Wright, Preston McDonald and Aneesh Lakhani. A number of revisions were made to HB351 to address that issue, including the following: ■■ Moves regulation of PBMs away from the Board of Pharmacy (BOP) and into the Office of Insurance Regulation (OIR) ■■ Requires pharmacists to inform a patient if the cash price is lower than a patient’s coinsurance ■■ Plan contracts with PBMs must not allow PBMs to interfere with pharmacist obligation to disclose lower cost options (gag clause protection for pharmacies) ■■ Plan contracts with PBMs must not allow PBMs to require patients to pay more than the lesser of ●● Applicable cost share amount; or ●● The retail price of the drug in absence of prescription drug coverage ■■ Defines what a maximum allowable cost (MAC) is under OIR ■■ Defines what a PBM is under OIR ■■ MAC lists must be updated every seven days ■■ Must register (and renew) with the OIR instead of BOP ■■ Registration fee not to exceed $500 ■■ Must be a process for eliminating drugs from MAC list or modifying MAC costs or drug products if unavailable

FLORIDA PHARMACY TODAY

Original version of the bill (HB351) would have required plans to prohibit their contracted PBMs from forcing patients to use a pharmacy that the PBM has an ownership interest in. There was also an appeals process in the original bill that was removed by the legislature from the original bill. Also included in the original bill was language that would have subjected the PBMs to the Florida Deceptive Unfair Trades Practices Act. This was removed from the bill as well. While many of these provisions were removed from HB351, the legislature is beginning to take notice to PBM issues and we are told that there are plans to bring other items to the table during the 2019 session. HB351 was approved by both the House and Senate and, as of the publishing date of this article, is headed to the governor’s desk for his signature. What Does This Mean for Pharmacists and Pharmacies? The original law was placed in the pharmacy practice act, but that law gave no enforcement authority to the Board. There was no mechanism to discipline or take action against a PBM. This change in law now gives the Office of Insurance Regulation, which already has oversite over insurance plans, additional jurisdiction of a PBM. It also stops practices where PBMs have sanctioned pharmacies for disclosing lower cost alternatives of prescription drug therapy to patients. Controlled Substance Prescribing HB21 filed by Representative Jim Boyd (R – Bradenton) implemented a number of measures for the prescribing of controlled substances in Florida. Recent news reports have highlighted a continuing problem with opioid deaths in this country. In Florida, fentanyl caused 1,390 deaths, oxycodone caused 723 deaths and hydrocodone caused 245 deaths in 2016. In 2017, Governor Scott declared a state of emergency on this issue, giving rise to the language in this bill which became a priority of the Florida Legislature. HB21, once signed by Governor Scott, would: ■■ Define “acute pain” as the nor-

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mal, predicted, physiological and time-limited response to an adverse chemical, thermal or mechanical stimulus associated with surgery, trauma or acute illness “Acute Pain” would not include pain related to cancer, a terminal condition, palliative care or trauma injury with an injury severity score of nine or higher Creates a controlled substance CE requirement for prescribers CE can only be provided by the Florida Medical Association Licensing Board must not allow a licensee missing the CE to renew The CE must be two (2) hours and can be included in the hours required per biennial period Requires the Department of Health to adopt rules on the standards for treating acute pain Limits prescribing of C-II opioid drugs for acute pain to three days Continues to allow dispensing practitioners to dispense opioids for surgical procedures but clarifies that such dispensing is limited to 3 or 7 day supply The bill allows for the prescribing up to a 7 day opioid supply if noted “ACUTE PAIN EXCEPTION” on the Rx Requires documentation in patient’s medical record Patients that are being treated for non-acute pain have noted on their prescriptions “NONACUTE PAIN” on prescriptions for C-II opioids Prescriber must issue a prescription for opioid antagonist for trauma patients with an injury severity score of nine or higher when prescribing a C-II opioid Continues to require verification of patient’s government-issued ID by both pharmacists and dispensing practitioners If proper ID is not available, the pharmacist can validate the prescription and the patient’s identity with the prescriber or the prescriber’s agent Adjudication of health plan eligibility is considered proper identification Identification requirement not re-

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quired for patients in an institutional or long term care setting Tightens exemptions for pain clinic registrations Creates requirement to query the PDMP database or document a reason why not Requirement to query the PDMP ●● Not applicable to patients under the age of 16 ●● Not applicable for prescribing or dispensing of Schedule V nonopioid controlled substances ●● Not applicable if the system is down or during a temporary electrical failure If the PDMP is not checked, the prescriber is limited to prescribing or dispensing a three-day supply A person who willfully and knowingly fails to report dispensed data to the PDMP commits a misdemeanor of the first degree Failure to query the PDMP may result in citation Allows for PDMP data sharing with other states Allows for interconnectivity with

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prescribing and dispensing systems Adds Schedule V drugs that have to be reported to PDMP Adds or revises certain drugs in the scheduling of CS Clarifies that CS prescriptions can be electronically prescribed New data information to be reported to PDMP ●● Phone number of patient ●● Note whether “new Rx” or “refill Rx” Name of person picking up Rx Penalties for providing a medically unnecessary controlled substance to a patient by fraud, misrepresentation or other deception is now a second-degree felony Second-degree felony is punishable by $10,000 fine and 15 years in prison Possessing tableting and encapsulating machines to make controlled substances are prohibited unless you are a pharmacist or pharmacy

New Institutional Class III Pharmacy Permit HB675, sponsored by Representative Jason Brodeur (R – Sanford), was filed and created a new class III pharmacy permit. This new class III permit is a modifier of an existing institutional pharmacy permit. This new class III permit is designed for hospital-affiliated institutional pharmacies, including central distribution facilities that provide the same services authorized by a class II permit. The bill exempts class III permit holders from having to obtain and additional permits from the Department of Business and Professional Regulations to distribute medicinal drugs or repackaged drug products between entities under common control. This bill also exempts hospitals that participate in the 340B drug discount program from having to obtain a restricted prescription drug distributor permit when arranging for a prescription drug wholesale distributor to provide prescription drugs covered under the 340B program to their contracted pharmacies. There is also a provision in

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HB675 that allows the governor to appoint a pharmacist currently engaged in the practice of pharmacy in a class III institutional pharmacy to the Florida Board of Pharmacy. PHARMACY BILLS THAT DIED OR WERE WITHDRAWN There were no less than 33 different pieces of legislation that were filed this year and received the attention of FPA advocates. Some were directly related to pharmacist and pharmacy services, while others had the potential to have some impact on our industry. On occasion, there will be a bill filed that is so disliked by our members that it could distract us from our proactive agenda to press for changes beneficial to Florida consumers and the profession of pharmacy. Our members need to be reminded that the majority of proposed legislation introduced rarely get underneath the governor’s pen. If you review the vast list of bills and their final disposition you will see that a large number never even got a chance for a hearing. For the most part bills that were the priority of the senior leadership of the House and Senate generally are given a fair opportunity for a hearing. Below are the key bills that we were monitoring that did not pass the 2018 legislative session. We are sharing this information with you as in many cases these proposals or a similar format is reintroduced during future legislative sessions. Remote Dispensing Legislation SB848 and HB679 were filed to create 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. Language in these bills, if adopted by the legislature, would have; ■■ Created a new pharmacy permit for remote dispensing ■■ Included in the term remote dispensing as a location where prescription drugs are compounded or dispensed by a registered technician who is supervised electronically by an offsite pharmacist ■■ Allowed for a remote dispens12

FLORIDA PHARMACY TODAY

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ing pharmacy to operate without a pharmacist being present Allowed a registered pharmacy technician to compound and dispense medicinal drugs if supervised electronically Removed violations and penalties for anyone who operates a remote dispensing pharmacy and a pharmacist is not present Removed violations and penalties for anyone who is working as a registered technician in a remote dispensing pharmacy and a pharmacist is not present

This legislation was not supported by the Florida Pharmacy Association. House and Senate sponsors applied several amendments to the bills at our request, however, the proposals were still considered problematic. Ultimately time ran out and the bills were never fully adopted. Pharmacist Collaborative Practice SB914 sponsored by Senator Rene Garcia (R – Hialeah) and H689 sponsored by Representative Cord Byrd (R – Jacksonville Beach) were filed to clarify enhanced services that could be provided by Florida licensed consultant pharmacists. A collaborative practice agreement (CPA) is between a doctor and a pharmacist who work within the context of a defined protocol that specifies what function of patient care a prescribing physician delegates to a pharmacist. Under the proposed legislation, a

CPA would have: ■■ Allowed pharmacists to monitor medication therapy and patient outcomes ■■ Defined a pathway for pharmacist provided patient assessments, initiate, modify or discontinue medications ■■ Allowed pharmacists to administer medications in any health care facility, including a pharmacy ■■ Included a feedback loop that ensures the pharmacist updates and notifies the physician any time action is taken with a patient

This FPA-supported legislation passed all House committees and was adopted by the Florida House on a 113 to 0 vote. However, the Senate version never received a hearing in its first committee and will not be signed by the governor. Pharmacist Testing and Treating of Influenza and Streptococcus SB524 sponsored by Senator Jeff Brandes (R – St. Petersburg) and HB431 sponsored by Representative Rene Plasencia (R – Orlando) was filed to allow pharmacists to test patients and treat them for influenza and streptococcus infections under a written protocol agreement with a Florida licensed practitioner. The bill was referred to three committees in the House and the FPA was successful in getting one committee reference removed to get it to the House floor faster. Unfortunately, the

bill was never heard in the final House Committee and did not get an opportunity to get a fair hearing in the Senate. These bills were filed to help expedite therapy for patients during what the FPA found was a very active flu season. These bills could have helped patients get needed care from their community pharmacy rather than having to visit already crowded emergency rooms of hospitals. Expansion of the Cancer Drug Donation Program SB710 and HB291 were filed to expand the current cancer drug donation program. The Drugs, Devices and Cosmetics division of the Florida Department of Business and Professional Regulation oversees a program that allows for the issuing of donated previously dispensed cancer drugs. These bills were filed in an attempt to expand the program to all prescription drugs. The bill passed the Senate, but only passed one committee in the House. Proposed Revisions to Pharmacist Dispensing Requirements SB1372 and House bill 605 were filed to prohibit a pharmacist from dispensing certain opioid drugs unless the container includes a special sticker approved by the Department of Health. This bill also would have required pharmacies to offer for sale to consumers a special prescription drug lock box and include signage indicating that these lock boxes are available in the pharmacy. The Department of Health would have been required to develop a written pamphlet that includes public awareness educational information on controlled substances. If the Department of Health were to provide these pamphlets and make them available to pharmacies, there would be a requirement to offer them to consumers at no charge. Both bills died in committee. Pharmacist Collaborative Practice SB714 and HB143 were filed to prohibit health plans from restricting a patient’s choice of provider. These bills would have allowed any provider who

is willing to accept the terms and conditions of a contract to participate in networks. This is similar legislation that we have seen filed over the past several sessions. Neither of these bills had an opportunity for a hearing and will not get to the governor for signature. Mandatory Mail Order Restrictions SB492 by Senator Rene Garcia (R – Hialeah) and HB289 by Representative Holly Raschein (R – Key Largo) was filed to prohibit health plans from requiring mandatory mail order for patients being treated for HIV infections, epilepsy, hypertension or diabetes. The Senate version was found favorable by the Banking and Insurance Committee and also the Senate Committee on Health Policy, but advanced no further. The House version was amended in the House Health Innovations Committee in January limiting the bill to just patients being treated for HIV. The bill was never heard in any other committees. This legislation was similar to bills filed during the 2017 session. These bills died in committee and will not get to the governor for his signature. Consumer Protection from Nonmedical Changes to Prescription Drug Formularies Legislation was filed during this session that mimicked similar bills during the 2017 session that dealt with PBM formulary switching. SB360 and HB229 were filed to prohibit changes to prescription drug policy formularies with some exceptions. Last year the Senate version of this bill passed, however, the House version managed to get past only one committee. This year, neither bill got a single hearing in committee and will not be presented to the governor for signature.

pages long and with the delete-everything amendment the proposed legislation grew to almost 90 pages. His amendment added a lot of concerning language for an array of practitioners, including pharmacists. The bill would have allowed automated dispensing machines for outpatient use. While this amendment couldn’t be stopped in the House, we worked with the sponsor of the Senate companion, Senator Grimsley, to ensure she would refuse to take that language. In the end, HB1047 died before passage. The above issues are most of the many bills that we were monitoring or working on during the 2018 session. Other issues, including links to voting activity by members of the House and Senate, are published on the FPA web site at www.capwiz.com/pharmview/ issues/bills/. We are pleased that we were able to move our PBM bill through the process. It is not the end of the road for that issue and it is anticipated that FPA leadership will be examining our advocacy plan for the 2019 legislative session for further opportunities. A full report will be made available at the 2018 FPA convention in Bonita Springs. Consider adding to your calendar to attend that meeting July 11 – 15, 2018. n

Department of Health Changes and Automated Dispensing HB1047 sponsored by Representative Julio Gonzalez (R – Venice) to address some policy changes recommended by the Department of Health. On February 20, the bill’s sponsor added to the bill a late filed amendment related to pharmacy. The bill was originally about 60 MARCH 2018

Test and Treat? Nope, Try Test and Defeat! By Tavian Cummings Pharm.D. Candidate at Florida A&M University College of Pharmacy and Pharmaceutical Sciences and FPA Intern

As a future pharmacist and healthcare provider, all mea su r e s of patient care come first. House Bill 431 and its Senate companion SB 524 would have allowed patients to go into their local pharmacies for a swab test with results given back in five minutes or less. These tests would determine if patients have the influenza virus or active streptococcus cases. The bill would al14

FLORIDA PHARMACY TODAY

low pharmacists to treat a patient with a positive test using an antiviral for the flu virus. Antivirals are most effective if taken within 48 hours of the onset of flu symptoms. This yearâ&#x20AC;&#x2122;s flu has produced numbers the CDC has never seen. The number of cases has skyrocketed to an alltime high, as well of the number of deaths. With 86 percent of pharmacies being within a 5-mile radius of 9 in 10 Floridians, the majority of these tragedies could possibly have been prevented. I strongly support these bills be-

cause they provide patients, with or without a primary care physician, access to a health care provider who can assist them. These changes in Florida law would enable patients to get timely care when they are unable to make an appointment right away or may be using their community emergency room as their primary care provider. Hospital emergency rooms are important service providers for patients with severe acute illnesses. Patients suffering with influenza will be triaged next to patients with more severe issues such as cardiovascular crisis, trauma

or other medical issues. With that being said, wouldn’t it make better sense to have quicker access for a flu test with a treatment solution, if positive, from your local community pharmacist provider? It is not uncommon for patients with influenza to try to see their doctor only to be informed that the only opening for an office visit would be in about two weeks. Your other option, of course, would be a long wait in the ER or urgent care center. All this sounds like a no-brainer for the inclusion of pharmacist provided care. After all, we have the ability to immunize patients for influenza as well as a number of other diseases. Consultant pharmacists can also order and evaluate clinical tests for patients in nursing homes and home health agencies. Unfortunately, the policy to enable pharmacists to provide these services is not going to change in 2018 because of concerns raised by the Florida Senate. Apparently, a few of our physician colleagues do not think pharmacists are trained or knowledgeable enough to assess and treat patients for influenza and streptococcus infections. They are claiming that what you are doing is the differential diagnosis of patients, which they maintain is not within our scope of practice and training. We acknowledge and concede that in medicine a differential diagnosis is the distinguishing of a particular disease or condition from others that present similar clinical features. Assessment, on the other hand, is the appraisal of conditions, disorders, data or a patient’s overall state to gather information. This includes access to a patient’s history, physical examination and available laboratory results to execute a treatment plan. These are definitely things that pharmacists are trained to do. What is interesting is that many patients with the flu will be diagnosed over the telephone and treatment ordered without ever being seen by their doctor. This is from the testimony of a physician arguing against the need for this legislation. These bills result in treatment after an in-person assessment by the pharmacist, all under a collaboration with a

THIS YEAR’S FLU HAS PRODUCED NUMBERS THE CDC HAS NEVER SEEN. THE NUMBER OF CASES HAS SKYROCKETED TO AN ALL-TIME HIGH, AS WELL OF THE NUMBER OF DEATHS. participating physician. During a committee debate at the Florida Capitol, a physician advocate stated that the test is only 40 percent sensitive, which is surprising as this is the same exact test that physicians use in their offices. Our information suggests that the tests are 90 percent sensitive. Now back to the phone diagnosis… What percent of that phone conversation is sensitive to the flu? The overall focus of the bill is not to take away from the practice of a physician but to effectively help and give time-sensitive treatment to patients. As a pharmacist candidate in training, it is disappointing to hear our physician colleagues state in a public forum that pharmacists should not be providing these services. These are the same health care providers who rely upon us to identify unforeseen clinical issues with patients when they are prescribed medications they should not be taking or are not on medications that are more appropriate for their health issues. It is very confusing to hear comments from a physician arguing against patient access when such a program would not even exist without a signed protocol agreement by a Florida licensed physician. It is almost as if they are saying that they don’t trust their own stakeholders to make good practice decisions. Journal readers should note that under these two bills, a patient would be advised by the pharmacist to seek their primary care physician or visit the ER for further evaluation and tests, if signs and symptoms persist or if they do not qualify for treatment under the protocol. The pharmacists and healthcare providers are not here for handouts or to take away business. Rather, this concept is about the patient, their health

and timely access to care. We serve as the most accessible healthcare professionals when a doctor’s office closes at 5 p.m. Monday-Friday, does not open on weekends, and is not available 24 hours a day. Also, let’s not forget the overcrowded hospitals, urgent care centers and clinics during this year’s influenza epidemic. Florida should consider the addition of pharmacists during the war on influenza, and allow us to help save lives. Now answer this question: When will the Legislature look past confusing talking points that include questionable information and make decisions that are good for the public? Do you remember when you had the flu and how you felt? Do you think the public would have comfort in knowing that a trip to the pharmacy can result in something more than a referral to the emergency room or acute care clinic? I honestly believe that our physician colleagues want us on their team in helping to manage their patients. There is too much literature that shows the benefits of pharmacist and physician collaboration. A good medical practice will take care of patients. A great medical practice will include collaboration with pharmacists. Tavian Cummings is a Pharm.D. candidate in his fourth professional year at the Florida A&M University College of Pharmacy and Pharmaceutical Sciences. A Florida licensed pharmacy intern since August 2014, his rotations include Neighborhood Health Services of Tallahassee, Fla., Tallahassee Memorial Healthcare, Capital Regional Medical Center, Walgreens and CVS.

MARCH 2018

FPA Elects New President-Elect, Board of Directors’ Members President-elect and Board of Directors’ members to be installed at FPA Annual Convention PRESIDENT-ELECT Meet Incoming President-elect David “Chachi” Mackarey David “Chachi” Mackarey, RPh., AAHIVP, is a licensed and registered pharmacist, practicing pharmacy in South Florida for almost 30 years. He is a native of Scranton, Penn., and received his Bachelor of Science in Pharmacy from Duquesne University in Pittsburgh, Penn. His professional pharmacy experience includes major retailers such as Walgreens, CVS, Target and Publix, as well as independent and specialty pharmacies. Most recently, David created and formed his own company, 3DPMhealthcare, LLC., that involves MTM, CCM and pharmacogenetics. David has also had additional professional training that includes Certification in the Pharmacy Immunization Program, CPR Certification, as well as Citizens Emergency Response Team (C.E.R.T.) training and certification. During his spare time, David is an avid sports enthusiast, who enjoys playing golf, tennis, skiing, photography and spending time with his friends and family, especially watching his daughter, Madalyn, perform as she pursues her musical theater career.

REGION 2 DIRECTOR Meet Region 2 Board of Directors’ Member Neil Barnett Neil sought membership with Duval County Pharmacy Association in 2003 upon moving to Jacksonville after earning his Pharm.D. from Nova Southeastern University. Neil has practiced in all facets of pharmacy, from retail to hospital and ambulatory care. He has worked for the VA for nearly 10 years, and is now program director at Clyde E. Lassen State Veterans’ Nursing Home. Neil is currently living in Ponte Vedra Beach with his wife and four children, and has been actively involved with DCPA as a past board of directors’ member, vice president and president. He has represented DCPA as a 16

FLORIDA PHARMACY TODAY

delegate at the FPA Annual Convention for the past four years and he has also served on the FPA Board of Directors for Region 2.

REGION 4 DIRECTOR Meet Region 4 Board of Directors’ Member Cheryl Rouse Cheryl began her pharmacy career as a clinical pharmacist at AMI Brookwood Hospital. Her professional experiences include hospital pharmacy administration, home health, psychiatric and retail pharmacy. Cheryl and her husband opened the doors of C&C Community Pharmacy in 1992 and have been serving the community in which she was raised for 25 years.

REGION 6 DIRECTOR Meet Region 6 Board of Directors’ Member Barbara Beadle Barbara has lived in Brevard County since 1979. Barbara received her Pharm.D. from the University of Florida in 2013. She began her career with Target in 2013 and is currently the manager of a CVS in Brevard County. While in school, she founded the student chapter of NCPA at the University of Florida – College of Pharmacy’s Orlando Campus and served as the president for the inaugural year. Since graduating, she has become active within the Brevard County Pharmacy Association, holding the position of treasurer and president. She also served in the FPA House of Delegates from 2015-2017. She lives in Palm Bay, Fla. with her husband, Howard, and has a 26-year-old son.

REGION 8 DIRECTOR Meet Region 8 Board of Directors’ Member Ramy Gabriel Ramy grew up in Miami and is currently living there. Ramy has been active with the FPA since 2009 and graduated from Nova Southeastern University in 2010. Ramy worked in retail pharmacy for five years and has been working at a hospital inpatient pharmacy for the past two years.

JOIN TODAY!

TECHNICIAN BOARD OF DIRECTORS MEMBER Meet Technician Board of Directors’ Member Julie Burger Julie is a certified pharmacy technician (CPhT) and is currently the pharmacy technician program Director at Pensacola State College. She also continues to work as a retail pharmacy technician in Pensacola, adding to her more than 10 years of combined experience in clinical trial, compounding and hospital pharmacy. She became a CPhT in 2000, while continuing to work toward her Bachelor of Science in Health Science Education and Chemistry from the University of Arizona, which she received in 2006. Julie gained a strong background in public service since completing her Master of Public Health in 2013. Prior to her current position, Julie served in public health after volunteering with AmeriCorps for one year. During her tenure in public health, Julie served as the Public Health Emergency Management planner, Emergency Support Function (ESF 8) leader, and Medical Reserve Corps coordinator in Escambia County. Julie was also the health assessment leader for the Florida Department of Health in Escambia County. Her publications include the 2015 Community Health Assessment for Escambia County, and a chapter titled “Pharmacies and Preparedness” in the second edition of “Emergency Preparedness and Disasters for Health Professionals (2017)” published by Paradigm. As a military spouse, the pharmacy profession has afforded her the flexibility to work in a range of settings in Arizona, Colorado, Florida and Pennsylvania. This variety of roles and responsibilities as a pharmacy technician has led to a passion for education, mentorship and leadership in the field of pharmacy. In addition to her CPhT, Julie is Certified in Public Health (CPH), a certified health education specialist (CHES), and has taught at the secondary and post-secondary levels. Julie has been a member of the Pharmacy Technician Educators Council since 2007 and was awarded Adjunct Faculty of the Year at Pikes Peak Community College, 2009-2010.

MARCH 2018

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

FLORIDA PHARMACY TODAY

MARCH 2018

FLORIDA PHARMACY TODAY

MARCH 2018

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_________________________

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

$_______

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.

Before June 22

Additional Tickets

Quantity

Price

Amount

Exhibit Hall

@ $30

$______

Awards Event

@ $80

$______

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)

_________

Quantity Price 

@ $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

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 22

Saturday

Security Code _________________ Expiration Date __________

House of Delegates

House of Delegates (Non-convention registrants)

Friday

Student Awards Event

(BEST Value includes Registration & Membership)

Before

FLORIDA PHARMACY TODAY

Schedule Subject to Change

Pharmacy

Tomorrow. Imagine That.

phmic.com

All products may not be available in all states and territories.

MARCH 2018

FPA News & Notes Survey Reminder on Contraceptives In February we shared with you a request from the American College of Clinical Pharmacy Women’s Health Practice and Research Network for feedback on a survey. This survey, which is still open, will take about 15 minutes to complete. This online survey is a study of pharmacists in the US regarding access to contraception in pharmacies. To participate please follow this link: https://www.surveymonkey.com/r/FLpharmacists

The linked Data Submission Dispenser Guide explains the process to register and transmit data to the Appriss PMP Clearinghouse. The Appriss PMP Clearinghouse is for data submission only.

Space Shuttle Astronaut to Keynote at FPA Convention Mark your calendars for July 12 – 15, 2018 for a special treat at the 128th Annual Meeting and Convention of the Florida Pharmacy Association. This year we will have for you a banquet of continuing education opportunities and events for pharmacists, technicians and students from every practice setting. Plan to attend our special keynote address, where we will hear remarks from Colonel Robert Shane Kimbrough as he shares with us his experience of life above the planet Earth in both the space shuttle, as well as aboard the International Space Station. The annual meeting registration is now open.

■■

Provider Status Advocacy Continues Our efforts are continuing to support federal provider status legislation. HR592 currently has 259 cosponsors in the House (18 from Florida) and 51 cosponsors on S109 in the Senate. Congresswoman Federica Wilson just signed on as a cosponsor last week, joining Rep. Tom Rooney, Rep. Gus Bilirakis, Rep. Daniel Webster, Rep. Ted Yoho, Rep. Alcee Hastings, Rep. Ron DeSantis, Rep. Al Lawson, Rep. John Rutherford, Rep. Darren Soto, Rep. Debbie Wasserman Schultz, Rep. Charlie Crist, Rep. Carlos Curbelo, Rep. Dennis Ross, Rep. Val Demings, Rep. Kathy Castor, Rep. Ted Deutch and Rep. Lois Frankel. If your representative is not on this list give them a call and invite them to join with the majority of Congress in support of recognizing pharmacists as health care providers. There is a lot of gridlock in Washington, D.C. that can be fixed with a strong advocacy campaign. Let’s keep the pressure on D.C. to fix this long overdue issue. PDMP Program Software Systems to Change in April E-FORCSE®, the Florida Prescription Drug Monitoring Program, will be changing software systems on April 18, 2018. We will be moving to the Appriss PMP AWARxE software.

FLORIDA PHARMACY TODAY

IMPORTANT DATES TO REMEMBER: ■■ ■■

March 22, 2018: Appriss PMP Clearinghouse registration available April 17, 2018: Last day to send data to the existing system April 18, 2018: All reporting must go through the new system

HOW IT AFFECTS ME:

All uploaders currently submitting data to http:// www.hidesigns.com/flpdmp are required to register with the Appriss PMP Clearinghouse. Are you currently registered with the PMP Clearinghouse as a data submitter for another state? If so, you do not need to re-register. Instructions to add Florida to your list of states for record submission are in the linked Data Submission Dispenser Guide. Don’t forget that current Florida laws require the reporting of dispensed controlled substances no later than the close of the next business day to the E-FORCSE database. If you have any questions or concerns regarding how to make this change, please contact support directly at 1-877-719-3120 or flpdmp-info@apprisshealth.com. Transparency and Accuracy in Medicare Part D Spending DIR fees have become a growing and aggravating issue for Medicare Part D pharmacy providers. Changes are needed that require Congress to act. S413 and HR1038 have been filed in Congress that would prohibit retroactively reducing payment on clean claims submitted by pharmacies under Medicare Part D. A study has suggested that the changes in these two bills would reduce Medicare costs by $3.4 billion over 10 years. It would also increase transparency in the Part D program and lower out-of-pocket cost sharing for seniors. So what can you do about this? Contact your member of Congress and ask for their support of S413 and HR1038. Prescription Drug Price Transparency Act Generic drugs account for more than 80 percent of medications dispensed by community pharmacies. Yet, the method used by PBMs to set pricing is a mystery that

is impossible to solve. Congress has a bill that would create some transparency provisions in the setting of maximum allowable costs (MAC) for generics and apply them to TRICARE and the Federal employee health benefit plan. HR1316 would also establish a MAC appeals process and prohibit PBM requirements to use a PBMowned pharmacy. This is similar to one of the original provisions in HB351 recently passed by the Florida legislature. That provision was removed from HB351 late in the Florida session. Please contact your member of the Congressional House and ask that they support HR1316. Senior Access to Local Pharmacies Act We have heard the stories where patient copays or coinsurance is higher from one pharmacy to another. We also know about restricted networks, where some pharmacies are allowed to participate on certain plans while others are excluded. S1044 and HR1939 are two congressional bills that would give seniors more access to discounted copays for prescription drugs at their pharmacy of choice. It would allow pharmacies in medically underserved areas to participate in Medicare-preferred phar-

macy networks if they accept the drug plan’s terms and conditions. The Florida delegation of Congress should all be asked to support these bills. Access to Compounded Medications Act The art of compounding is as time honored as the profession of pharmacy. Millions of Americans have benefited from the customized services provided by compounding pharmacies. There is continuing debate over who has enforcement authority over compounding pharmacies, which we see as the regulatory domain of state boards and not the federal government. HR2871 has been filed in Congress to make clear that compounding is the practice of pharmacy. The Florida delegation of the Congressional House should be asked to support HR2871.

FPEA CE at SEA 2018 July 21-28, 2018

On board the Freedom of the Seas, Departing from San Juan, Puerto Rico Offering up to 10 hours of ACPE continuing education for pharmacists and pharmacy technicians. You’ve worked hard the past 12 months. Treat yourself and get some CE credit while you’re at it. More Information: http://www. pharmview.com/events/EventDetails. aspx?id=962115&group=

MARCH 2018

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. 26

FLORIDA PHARMACY TODAY

RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”