Latelines for May 7, 2001
Attorneys representing Aetna U.S. Healthcare and some 3,000 pharmacies in New York and New Jersey have reached a tentative settlement of a class action lawsuit that charged the HMO with fraud and failing to make payments as part of a capitation program it operated in 1993-97. Under the agreement, which must be approved by N.Y. Supreme Court Judge Ira Gammerman, Aetna would pay $550,000, said James R. Schiffer, a N.Y. independent pharmacist who helped launch the suit. The pharmacies would divide $300,000 based on their previous record of payments from the program; contributions totaling $100,000 received from individual pharmacists who volunteered to support the suit would be refunded; the N.Y. City Pharmacists Society would receive $60,000 for expenses and an unrestricted educational grant; and the attorneys for the class would receive $90,000. Attorneys for Aetna and the pharmacies did not respond to a request for comment.
OTCs that can be converted into methamphetamine are being more closely regulated in Arkansas, Nebraska, and Washington as a result of recently enacted legislation. Arkansas limits the amount of ephedrine, pseudoephedrine, and phenylpropanolamine that can be purchased at one time to three packages or 9 gm, whichever is smaller. Washington's law is similar, and Nebraska limits package size for PPA and pseudoephedrine to no more than 3 gm in blister packs of not more than two doses or to unit-dose packets.
If nurses can have legislation in Congress to address the nursing shortage, so can pharmacists. Speaking at the AMCP annual meeting in Tampa last month, William Zellmer, ASHP's deputy executive v.p., revealed that Rep. James McGovern (D, Mass.) might introduce a bill in mid-May to provide forgiveness for pharmacists' student loans; support for pharmacists to practice in rural, underserved areas; and technology for colleges of pharmacy to provide distance learning. Zellmer added that another strategy to ameliorate the R.Ph. shortage is to upgrade the training of technicians. To this end, the Council on Credentialing in Pharmacy is considering holding a consensus conference on technicians later this year.
A convenient location is the most important factor in consumers' selection of a pharmacy, according to a new survey conducted by Opinion Research Corp. International for AmeriSource Health Corp. Twenty-six percent of respondents cited convenience as the most important factor in selecting a pharmacy; 20% said low prices; 15% named "trust" and "personalized attention and service. "The survey polled 1,034 consumers nationwide.
The Anti-Infective Drugs Advisory Committee of the FDA has recommended approval of Aventis Pharmaceuticals' telithromycin (Ketek) for the treatment of community-acquired pneumonia800 mg oral dose once dailyin patients 18 years of age or older. The first in a new class of antibiotics called ketolides, which are essentially an engineered version of macrolides, telithromycin has been developed specifically to treat respiratory tract infections with a once-daily regimen. Additional studies are ongoing to support the approval of telithromycin for acute bacterial exacerbation of chronic bronchitis and acute sinusitis as well as to show clinical efficacy against resistant strains of Streptococcus pneumoniae. The FDA, although not required to do so, usually follows the recommendations of the advisory panel.
Alan B. Levin, president and CEO of Happy Harry's Inc., a regional chain headquartered in Newark, Del., has been reelected chairman of the board of NACDS. The announcement was made during NACDS' annual meeting in Phoenix last month. Other key posts include Mark E. Griffin, president and CEO of Lewis Drug Inc., Sioux Falls, S.D., who was elected vice chairman, and Mary Sammons, president and CEO of Rite Aid Corp., Harrisburg, Pa., who was elected treasurer. During his formal remarks, Levin applauded the regional chains as having "the power to make a difference" in large part because they have the "maneuverability the big guys don't have." Calling for "a unified voice," Levin stressed the importance of "working together within the bounds of the law to secure fair and responsible reimbursement policies that take into account the full value of [undervalued] pharmacy services." He also urged all chain members to "value your pharmacists and show them that you do."
U.S.-registered Internet pharmacies cannot fill prescriptions for controlled substances in Schedules III-V unless they contact the prescriber by telephone to confirm the legitimacy of the prescription, according to a new DEA guidance document. The pharmacy must have the original signed Rx for drugs in Schedule II, DEA said. No controlled substances can be purchased from foreign e-sites and shipped to the United States even with a valid prescription. The agency currently is working on a project to define when and how prescribers can electronically sign and transmit Rxs for controlled substances.
Five organizations representing pharmacists are urging Sen. Chuck Hagel (R, Neb.) not to reintroduce his Medicare drug bill that encourages uninsured senior citizens to buy Rx drug discount cards. The groups said the card programs represent price controls on pharmacies, which are the only entities contributing to the price reductions for seniors. They complained that PBMs often require pharmacies to participate in the card program as a condition of being part of their network for insured individuals and that they set reimbursement for the card carriers and the insured at the same level. APhA, ASCP, FMI, NACDS, and NCPA registered their views in a letter to Hagel on April 23.
DEA is seeking public comment about what to do with controlled substances dispensed but not administered to patients in long-term care facilities. Because most LTCFs are not DEA registrants, they can't maintain institutional stocks for general dispensing. When a patient's medication order is changed or discontinued, the unused Rxs can't be redispensedthey must, instead, be discarded. DEA is considering allowing pharmacy providers to register at the site of the LTCF and store controlled substances in an automated dispensing system for use as needed pursuant to a prescription.
New Mexico's pharmacist prescriptive authority law was expanded last month. It will now include flu shots, pneumonia vaccines, and emergency contraception. Uniform prescription card legislation and a drug discount bill were vetoed.
HHS secretary Tommy Thompson said it is looking "doubtful" that he will implement a law giving pharmacists and wholesalers the authority to reimport FDA-approved Rxs. Although then-President Clinton signed the measure, former HHS secretary Donna Shalala said late last year that the FDA would be unable to certify the safety and efficacy of the Rxs once they left the country. Thompson is reviewing that decision, although HHS has asked Congress to approve only $3 million for the possible inspection program, instead of the $23 million the FDA calculated it would need.
New needlestick regulations designed to protect health-care workers took effect April 18, but OSHA is conducting a 90-day outreach and education effort before enforcing them. The rules require hospitals and other health-care facilities to provide safer needles and mandate the involvement of front-line workers in their selection.
Pharmacists Planning Service Inc., a California-based R.Ph. activist group, has asked the FTC to investigate RxHub, the joint undertaking proposed by AdvancePCS, Express Scripts, and Merck-Medco Managed Care. The venture would electronically link prescribers with dispensers, health plans, and PBMs. PPSI raised concerns about patient confidentiality and sharing of information by competitors. It also suggested that Merck-Medco's parent, Rx manufacturing giant Merck & Co., would be in a position to place its Rxs on the RxHub formularies.
HCFA is revising a form that DME suppliers and M.D.s give to Medicare beneficiaries before they receive a medical service that may not be covered by Medicare. The form says, in part, "The fact that Medicare may not pay for a particular item or service does not mean that you should not receive it. There may be a good reason for your doctor to recommend it."
NACDS is taking aim at state laws requiring pharmacies that participate in Medicaid to charge cash-paying Medicare beneficiaries the same price. The association has filed a request for a preliminary injunction in federal court, hoping to block Florida's program. NACDS argued that the state must seek approval from HHS for the Medicaid tie-in. It has made a similar argument in California, although it has not yet turned to legal action there. Several other states are considering similar discount legislation.
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