Key Healthcare Act Provisions That Take Effect Immediately (via Medscape)
Health Reform Contains Key Clinical Pharmacy Provisions (via ACCP)
Clinical Pharmacy Services
Specific to clinical pharmacy services, the law provides for:
MTM Grant Programs. The new law establishes a stand-alone grant program to ensure pharmacist-provided MTM services as defined by the pharmacy profession’s consensus definition on the Core Elements of an MTM program. The program ensures the testing of practice and care delivery models, such as patient-centered self-management programs, that improve patient outcomes through team-based collaborations between prescribers and pharmacists.
Integrated Care Models. The law also includes provisions to ensure that providers with expertise in pharmacotherapy, including pharmacists, are fully engaged in integrated, collaborative, team-based approaches to delivering care, including medical homes, accountable care organizations, community health teams, and home-based chronic care programs.
Transitional Care Activities. The law recognizes the gaps in care coordination and communication that often occur when patients are transferred from one care setting to another. Problems arising from inappropriate medication use are a primary reason for hospital readmissions. Pharmacists—by helping manage pharmacotherapy as part of a transitional care team—will be able to play major roles in preventing these events. Transitional care activities might include medication reconciliation, improved use of personal medication records, and discharge planning that may include MTM services.
Medicare Advantage Plan Incentives. The law provides bonus payments to Medicare Advantage plans that conduct care coordination and management activities. In particular, it acknowledges the need for MTM programs to address medication use issues such as poly-pharmacy through medication reconciliation, periodic reviews of drug regimens, and integration of medical and pharmacy care for chronically ill, high-cost beneficiaries.
Workforce. The law establishes a National Health Care Workforce Commission that will study health care workforce supply issues and make recommendations to Congress.
A nice summary from the American College of Clinical Pharmacy (ACCP) regarding the clinical pharmacist provisions in the Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872).
DEA interim final rule for e-prescribing controlled substances
The Drug Enforcement Agency (DEA) has released an interim final rule for electronic prescribing of controlled substances. The rule sets forth requirements for prescribers, application providers and pharmacies/pharmacists that will allow electronic prescribing of controlled substances.
Among other things, the rule calls for “identity proofing” and a two-factor authentication for physicians. Application providers are required to produce monthly logs for prescribers, and pharmacy systems are required to keep an audit trail of each prescription. The rule will be published in the Federal Register on March 31, and will take effect June 1.
Source: AMCP
Interim final rule [PDF]: http://www.federalregister.gov/OFRUpload/OFRData/2010-06687_PI.pdf
NIMH commentary about psychiatrists’ relationship with PhRMA [JAMA]
The National Institute of Mental Health (NIMH), which funded some of the accused individuals, has initiated an internal review system to detect potential problems with the management of financial conflicts of interest and has implemented changes to minimize possible bias in its funded studies. More broadly, the NIH is substantively revising its regulations on financial conflict of interest, which were originally adopted in 1995. The proposed new regulations are slated to be available for public comment in early spring 2010. But one of the largest effects of this scandal has been to raise a difficult and still unanswered question about the integrity of psychiatrists. Is the financial conflict of interest problem worse for psychiatrists or are psychiatrists just an easy target? A review of evidence is in order
Thoughtful editorial that suggestions caution regarding some of the current relationships that exist today. More transparency is the rule of the day.
Full text [HTML; subscription required]: http://jama.ama-assn.org/cgi/content/full/303/12/1192
FDA: Rotarix Vaccine Update to Clinicians
FDA is recommending that healthcare professionals temporarily suspend the use of Rotarix, a vaccine used to prevent rotavirus disease. FDA’s recommendation is a precaution taken while the agency learns more about the situation.
FDA has learned that DNA from porcine circovirus type 1 (PCV1) is present in Rotarix. PCV1 is not known to cause disease in humans. There is no evidence at this time that this finding poses a safety risk. Because available evidence supports the safety of Rotarix, no medical follow-up is needed for patients who have been vaccinated with Rotarix.
There are two licensed vaccines for rotavirus in the United States: RotaTeq and Rotarix. For children who have received one dose of Rotarix, CDC advises that clinicians can complete the series with RotaTeq for the next two doses.
Additional information, including information for healthcare professionals and parents, is provided in the document below.
[03/22/2010 - Update on Rotarix Vaccine1 - FDA]
Important information from the FDA; please disseminate!
Advocate for Pharmacist Provisions President’s HCR Proposal
A summary of the health care reform proposal released today by the White House offers few details about whether proposals that would expand patient access to pharmacists’ services will be a part of new legislation.
The summary, which is available on the White House website, appears in large part to be similar to the Senate version of health care reform. The proposal does not include a public plan option, but does include an excise tax on higher level (Cadillac) health plans. The proposal delays the tax until 2018. The proposal also closes the Medicare Part D doughnut hole, eliminates the Senate bill’s Nebraska Medicaid deal, and lowers the penalty for individuals who do not purchase insurance.
The summary does not drill down to the level of detail that bill language would on several issues of importance to health-system pharmacists, namely the delivery system reforms currently in both House and Senate bills that utilize the medication use expertise of pharmacists. We do not yet know the status of the medication therapy management grant program, the medical home model, or the independence at home provisions. In bills passed by the House and Senate, these provisions include the medication related services of pharmacists.
ASHP members are urged to contact their congressional representatives to ask them to retain provisions that would allow pharmacists to have a greater role in improving medication use.
Article : Pharmacy’s Fate Unknown in President’s Health Care Reform Proposal.
VA Clinical Research Pharmacy wins award
“The pharmacist-directed Clinical Research Pharmacy Coordinating Center for the Department of Veterans Affairs (VA) has been selected to receive a Malcolm Baldrige National Quality Award—the highest honor given by the U.S. president for innovation and performance excellence.
Working out of a one-story building in Albuquerque, New Mexico, the 111 employees at the center manage drug- and device-related activities for multicenter clinical trials conducted by the VA and other federal organizations.
In 2004, the center received the VA secretary’s Robert W. Carey Performance Excellence Award, which is based on the Baldrige Award’s criteria. For three of the past four years, the center has been a VA Circle of Excellence awardee.”
Source: ASHP news
American Pharmacists Association News
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Joseph Lassiter
