DEA Notice of Proposed Rulemaking: Regulations Governing the Secure Disposal of Controlled Substances by Both DEA Registrants and Ultimate Users.

On Friday, December 21st, the DEA posted a Notice of Proposed Rulemaking for requirements to govern the secure disposal of controlled substances by both DEA registrants and ultimate users.

The proposed regulations would allow retail pharmacies, manufacturers, distributors, reverse distributors to voluntarily administer mail-back programs and maintain collection receptacles (all after obtaining authorization from the DEA to be a "collector"). In addition, this proposed rule expands the authority of authorized retail pharmacies to voluntarily maintain collection receptacles at long term care facilities.

For complete information, including the proposed regulations, please visit: http://www.deadiversion.usdoj.gov/fed_regs/rules/2012/fr1221_8.htm

SUMMARY: This rule proposes requirements to govern the secure disposal of controlled substances by both DEA registrants and ultimate users. These regulations would implement the Secure and Responsible Drug Disposal Act of 2010 (Pub. L. 111-273) by expanding the options available to collect controlled substances from ultimate users for purposes of disposal to include: Take-back events, mail-back programs, and collection receptacle locations. These proposed regulations contain specific language to continue to allow law enforcement agencies to voluntarily conduct take-back events, administer mail-back programs, and maintain collection receptacles. These regulations propose to allow authorized manufacturers, distributors, reverse distributors, and retail pharmacies to voluntarily administer mail-back programs and maintain collection receptacles. In addition, this proposed rule expands the authority of authorized retail pharmacies to voluntarily maintain collection receptacles at long term care facilities. This proposed rule also reorganizes and consolidates existing regulations on disposal, including the role of reverse distributors.

DATES: Electronic comments must be submitted and written comments must be postmarked on or before February 19, 2013. Commenters should be aware that the electronic Federal Docket Management System will not accept comments after midnight Eastern Time on the last day of the comment period.

ADDRESSES: To ensure proper handling of comments, please reference "Docket No. DEA-316" on all electronic and written correspondence. DEA encourages all comments be submitted electronically through http://www.regulations.gov using the electronic comment form provided on that site. An electronic copy of this document is also available at the http://www.regulations.gov Web site for easy reference. Paper comments that duplicate the electronic submission are not necessary as all comments submitted to http://www.regulations.gov will be posted for public review and are part of the official docket record. Should you, however, wish to submit written comments via regular or express mail, they should be sent to the Drug Enforcement Administration, Attention: DEA Office of Diversion Control (OD/DX), 8701 Morrissette Drive, Springfield, Virginia 22152.

FOR FURTHER INFORMATION CONTACT: John W. Partridge, Executive Assistant, Office of Diversion Control, Drug Enforcement Administration; Mailing Address: 8701 Morrissette Drive, Springfield, Virginia 22152; Telephone: (202) 307-4654.

Board of Pharmacy 12/12/12 Meeting Summary

The Virginia Board of Pharmacy met on Wednesday, December 12th for their quarterly meeting.  VPhA members have access to VPhA's summary of the Board meeting.  To access this information, please click here.

The next Board of Pharmacy full meeting will be held on March 12, 2013 beginning at 9am.

OPEN PUBLIC COMMENT PERIOD: Periodic Review of Board of Pharmacy Regulations - Comment Period Ends December 5th

Public comment periods have now opened to receive comments on regulations governing agencies under the Virginia Board of Health Professions.  This includes the Board of Pharmacy and the Prescription Monitoring Program regulations.  To view ALL of the open comment periods, please click here and scroll down to the "Secretariat: Health and Human Resources" and look for the comment periods scheduled to Close on December 5th.

The Virginia Board of Pharmacy will be conducting a periodic review of its regulations.  The first step to the review process is to receive feedback from the public on the regulations.  Beginning in 2013, the Board will review the regulations and take into consideration public comments received during the 30 day comment period.  The regulations to be reviewed are:

• 18VAC110-20: Virginia Board of Pharmacy Regulations
• 18VAC110-30: Regulations for Practitioners of the Healing Arts to Sell Controlled Substances
• 18VAC110-40: Regulations Governing Collaborative Practice Agreements
• 18VAC110-50: Regulations Governing Wholesale Distributors, Manufacturers and Warehousers

The review is part of the Governor's Regulatory Reform Project with the goal of:

1. Repealing regulations that are unnecessary or no longer in use;
2. Reducing unnecessary regulatory burdens on individuals, businesses, and other regulated groups; and  
3. Identifying statutes that require unnecessary or overly burdensome regulations. 

Further, the Board is seeking comment on whether this regulation should be terminated, amended, or retained in its current form.
 
Public comment is sought on the review of any issue relating to this regulation, including whether the regulation (i) is necessary for the protection of public health, safety, and welfare or for the economical performance of important governmental functions; (ii) minimizes the economic impact on small businesses in a manner consistent with the stated objectives of applicable law; and (iii) is clearly written and easily understandable. 
 
The comment period began November 5, 2012 and ends on December 5, 2012. 
 
Comments may be submitted online to the Virginia Regulatory Town Hall at: http://www.townhall.virginia.gov/L/Forums.cfm.

• Click here to submit comments concerning Board of Pharmacy Regulations
• Click here to submit comments concerning Regulations for Practitioners of the Healing Arts to Sell Controlled Substances
• Click here to submit comments concerning Regulations governing Collaborative Practice Agreements 
• Click here to submit comments concerning Regulations governing Wholesale Distributors, Manufacturers and Warehousers  

Comments may also be sent to:
Elaine J. Yeatts, Agency Regulatory Coordinator
Department of Health Professions
9960 Mayland Drive, Suite 300
Henrico, VA 23233
 
FAX: (804) 527-4434
EMAIL: elaine.yeatts@dhp.virginia.gov

In addition to the Board of Pharmacy's periodic review, comments are also encouraged for the following regulations impacting pharmacy:

• Regulations Governing the Health Practitioners' Monitoring Program for the Department of Health Professions
• Click here for more information
• Regulations Governing the Prescription Monitoring Program
• Click here for more information

Following the close of the public comment period, a report of the periodic review will be posted on the Town Hall and published in the Virginia Register of Regulations.

FDA reports voluntary recall of all Ameridose drug products

The U.S. Food and Drug Administration announced today (October 31) that Ameridose, LLC, based in Westborough, Mass., is voluntarily recalling all of its unexpired products in circulation. Products from Ameridose can be identified by markings that indicate Ameridose by name or by its company logo disclaimer icon. A complete list of all products subject to this recall can be accessed at www.ameridose.com disclaimer icon.

For more information on this voluntary recall, please click here for the complete FDA news release.

Presentation by CMS on "The 2012 Medicare Open Enrollment Period & The DMEPOS Competitive Bidding Program, Round 2" - Thursday, October 25th - Richmond

On Thursday, October 25, 2012 from 2:00 – 3:00 PM the Philadelphia Regional Office of the Centers for Medicare & Medicaid Services and The Virginia Bureau of Insurance will be hosting a meeting on: The 2012 Medicare Open Enrollment Period & The DMEPOS Competitive Bidding Program, Round 2

Featuring: Nancy B. O’Connor, Regional Administrator
Philadelphia Regional Office, The Centers for Medicare &

Medicaid Services

Thursday, October 25, 2012 from 2:00 – 3:00 PM

Hosted at the Virginia Bureau of Insurance
1300 East Main Street
Richmond, VA 23219
Court Room A

Please RSVP to: melissa.herd@cms.hhs.gov or 215-861-4165.

Southwest Virginia Prescription Drug Abuse Summit

Southwest Virginia Prescription Drug Abuse Summit
November 14, 2012
8:30 a.m. – 4:30 p.m.
Wytheville Meeting Center

For more information, please visit: http://www.justice.gov/usao/vaw/swvadrugsummit.html

Click here for Agenda

Click here for Registration

Welcome to the homepage for the Southwest Virginia Prescription Drug Abuse Summit. Hosted by the United States Attorney’s Office for the Western District of Virginia, and designed with partners in law enforcement, treatment and prevention and economic development, the summit will address the ever-expanding problem of prescription drug abuse and produce an action plan to combat it.

This one day, no cost, event will be held November 14, 2012 from 8:30 a.m. to 4:30 p.m. at the Wytheville Meeting Center in Wytheville, Virginia.

The goal of the first ever Southwest Virginia Prescription Drug Abuse Summit is to have members of the community, law enforcement, service providers and leaders of commerce join in and open and direct discussion about the impact the abuse of prescription drugs is having on our communities.

Panel discussions will address current trends in law enforcement; prevention, treatment and education, and the economic impact of prescription drug abuse in our area of the Commonwealth of Virginia.

USP-NF General Chapter 17 Prescription Container Labeling

In November 2012, USP will publish a new General Chapter <17> Prescription Container Labeling in USP 36-NF 31. The standard provides, for the first time, a universal approach to the format, appearance, content and language of instructions for medicines in containers dispensed by pharmacists. The new USP general chapter offers specific direction to label manufacturers, pharmacies and prescribers on how prescription labels should be organized in a "patient-centered" manner that reflects how most patients seek out and understand medication instructions. Read More

The USP effort to create these new standards developed from an Institute of Medicine (IOM)-led initiative to improve health literacy, which is defined as the degree to which people can obtain, process and understand the basic health information and services they need to make appropriate health decisions. According to IOM, 77 million Americans have limited health literacy, and a majority of Americans have difficulty understanding and using currently available health information and services. At a 2007 IOM workshop on Standardizing Medication Labels: Confusing Patients Less, USP Chief Executive Officer Roger L. Williams pledged that the organization would initiate work on a standardized prescription container label.  The resulting standard was finalized by the USP Nomenclature, Safety, and Labeling Expert Committee, which is chaired by Thomas Reinders, Pharm.D. The standard was developed by experts in patient safety, health literacy, pharmacy, medicine, human factors research and labeling technology. Key areas covered in General Chapter <17> include organizing the label in a patient-friendly way, using explicit language to describe dosages and intervals, improving readability with clear formatting, including "purpose for use" (e.g., "for high blood pressure") and addressing those with visual impairments and those with limited English comprehension.

Enforcement of the standard will be the decision of individual state boards of pharmacy, which may choose to adopt it into their regulations-similar to USP standards for sterile and nonsterile pharmaceutical compounding, both of which are widely recognized by states. At its 2012 annual meeting, the National Association of Boards of Pharmacy passed a resolution supporting state boards in requiring a standardized prescription container label.

Background

Resources

• Download USP-NF General Chapter <17> Prescription Container Labeling
• USP Press Release: First Universal Standards Guiding Content, Appearance of Prescription Container Labels to Promote Patient Understanding of Medication Instructions
• Sample labels illustrating key elements of General Chapter <17> (Note: The following examples do not reflect all possible configurations for a patient-centered label).
• Video: USP Nomenclature, Safetyand Labeling Committee Chair Thomas Reinders, Pharm.D.

DEA Regulations for Pre-populated Controlled Substance Prescription Requests

It has come to the attention of VPhA that significant concern exists in the industry regarding pre-printed forms that both retail and long-term care pharmacies use to "remind" prescribers that a patient is out of refills on certain controlled substance prescriptions. There has been a lot of messaging and general confusion in the marketplace since the letter from the Drug Enforcement Administration headquarters to Omnicare's general counsel regarding this topic surfaced. Click here for the letter.

NCPA spoke with the DEA regarding this issue in order to gain clarity. The DEA told NCPA that the pharmacist can't send a reminder letter that "provides a partially or fully pre-populated form" for the prescriber or prepare a prescription for signature because the pharmacist is NOT an agent of the prescriber. Any "reminder letters" can't look like a prescription.  DEA stated that it is aware of software that makes these forms look like prescriptions and this is not allowed. In other words, if a pharmacy faxes a refill request for a controlled substance to the prescriber that includes all of the previous prescription information pre-populated on the request form the prescriber cannot simply sign and return the reminder letter to the pharmacy and that serve as the original prescription. If a form has a reminder on the top portion and the bottom is blank whereby the prescriber has to write the prescription and sign, that is permitted.

VPhA encourages pharmacists to work with technology vendors to ensure that these forms are in full compliance with DEA rules. This may require a significant change in current practice that will be new to many prescribers.

VPhA would like to remind members that you should be aware of all requirements by the Virginia Board of Pharmacy for both written and faxed prescriptions.  These can be easily found on Guidance Document 110-35 by clicking here. 

Continuous Quality Improvement Programs Emergency Regulations Finalized - Effective October 1, 2012

Governor McDonnell has approved the emergency regulations requiring the implementation of continuous quality improvement (CQI) programs for all pharmacies.  These emergency regulations went into effect on October 1, 2012.  Of note, there will be a 6 month implementation allowance before enforcement will occur.  Thus, pharmacies will have until March 31, 2013 to come into compliance with the emergency regulations.

Since these are emergency regulations (effective for 1 year), a public comment period will open on October 8th to receive comments on the regulations and if changes are needed, the Board of Pharmacy will review and propose alternate permanent regulations in 2013.  More information on the future public comment period can be found by clicking here.

There are two ways that pharmacies can implement a CQI program.  

• Reporting dispensing errors to a "Patient safety organization" (PSO).  A complete listing of PSOs can be found at the AHRQ's webpage.  If you are "actively reporting" (reporting all dispensing errors and analyses of such errors to a PSO as soon as practical or at least within 30 days of identifying the error) to a PSO, your pharmacy is in compliance with the regulation
• Implementation of a CQI program that includes the following:
• Notification as well as Documentation and record requirements
• (a detailed list of the requirements can be found on pages 10 and 11 of the emergency regulations document)

Click here for the full text of the emergency regulations.  NOTE: the CQI requirements can be found in all text that is underlined in the document.

 

NPLEx Information (Electronic Pseudoephedrine log)

Pharmacies that sell pseudoephedrine-containing products must begin reporting all sales via an electronic reporting system (NPLEx) by January 1, 2013.  Pharmacies are encouraged to begin reporting to the system now to ensure compliance by the turn of the year.

NOTE: the NPLEx program and training should be made available to pharmacies AT NO CHARGE.  If you are experience any charges with accessing the program or training, please let us know at vpha@virginiapharmacists.org.

If you have not yet registered your pharmacy for NPLEx access, please visit: https://nplex.appriss.com/retail/pharmacy/loginRegister.do

Steps to Register:

1.  You will be prompted to enter store information.
1. A verification email will be sent to the email address you provide.
2. Make sure this email address is valid and accessible
2. Click the link provided in the email to continue registering.
3. You will be prompted to create an Account ID and password for the store. Click Continue.
4. You will be prompted to create an Administrative User and a PIN for the store. Click Save. This will complete registration.

EXEMPTION TO REPORTING:
Pursuant to § 18.2-265.8(B) of the Code of Virginia, a pharmacy or retail distributor which lacks broadband access or maintains a sales volume of less than 72 grams of ephedrine or related compounds in a 30-day period may be temporarily exempt from the requirement to report transactions to the electronic system, if an exemption is granted by the Department of State Police, pursuant to § 18.2-265.8(C) and § 19VAC30-220-20 of the Virginia Administrative Code.

To request an exemption from electronic reporting, a pharmacy or retail distributor must complete the entire form, provide any supporting documentation, and submit the form and supporting documents to:

Virginia Department of State Police
VAMPIS
PO Box 27472
North Chesterfield, Virginia 23261-7472

Questions may be directed to the Virginia State Police VAMPIS Coordinator at 804-674-2809.

BOARD OF PHARMACY OPEN PUBLIC COMMENT PERIOD: Working conditions for pharmacists

A public comment period is currently in progress to receive public comments for the Board of Pharmacy to consider addressing hours of continuous work by pharmacists.

"The purpose of the planned regulatory action is to address a petition for rulemaking requesting amendments that will specify a limitation of excessive hours of work without any breaks for pharmacists. Regulation is necessary to prevent, to the extent possible, prescription errors due to fatigue and lack of concentration by pharmacists in the important task of assuring the accuracy and integrity of controlled substances. The action is the result of a petition for rulemaking (notice originally published in the March 30th VPhA E-News) by a pharmacist and was strongly supported in comment on the petition."

Following receipt of all comments, the Regulation Committee of the Board will review regulations from other states and any comments received from the open public comment period. Draft regulations would then be proposed to the full Board.
 
The public comment period is open until October 10th to provide feedback on the potential regulations.

• Details can be found at: http://www.townhall.virginia.gov/L/viewaction.cfm?actionid=3755&display=general
• To submit comments to the Virginia Board of Pharmacy, please visit: http://www.townhall.virginia.gov/L/entercomment.cfm?stageid=6265

Vote & Vax 2012 Offers Flu Vaccinations and Preventive Services on Election Day

Only 34.7 percent of women and 29.3 percent of men in Virginia are up to date with a combination of select clinical preventive services, such as influenza vaccination, colorectal cancer screening and breast and cervical cancer screenings according to the National Association of Chronic Disease Directors. Thanks to a Health Aging grant from the National Association of Chronic Disease Directors, Virginia is taking action this fall to improve delivery of clinical preventive services and offer seasonal flu vaccine through a national initiative titled “Vote & Vax” (www.voteandvax.org). 

Vote & Vax Virginia 2012 builds on a decade of experience by Project Immunize Virginia by offering flu vaccines at polling locations in the following health districts: Central Shenandoah, Cumberland Plateau, Hampton, Peninsula, Prince William, and Richmond City.  This year, pharmacist-staffed clinics located at polling sites will offer insurance billing and collect co-pays or out-of-pocket payment for vaccines. 

In addition to vaccinations, activities such as education and referral for cancer and hypertension screening will be offered at each site by local coalitions.  Led by volunteers from the Medical Reserve Corps, these coalitions include area agencies on aging, nursing students, and other stakeholder groups, such as the Cancer Action Coalition of Virginia, AARP Virginia, and the Baptist General Convention of Virginia.

By lending your time and skills to a local coalition, you can help protect your community from the flu and play a role in the delivery of important preventative health services.  Please contact Joseph Hoyle, Clinical Preventive Services Coordinator, Virginia Department of Health at joseph.hoyle@vdh.virginia.gov for more information.

New Video, Website Help Health Plan Sponsors, Patients and Policymakers Maximize Prescription Drug Benefits, Reduce Wasteful Spending

A new video and website offer health plan sponsors (i.e., employers, unions, government programs, etc.), policymakers and patients resources to get the most out of their prescription drug benefit and to reduce unnecessary spending, the National Community Pharmacists Association (NCPA) announced. At the website www.whorunsmydrugplan.com, visitors can learn about common practices of giant pharmacy benefit managers (PBMs), who are hired to administer drug plans and negotiate prices for payers, but drive up health insurance costs and restrict patient choice. There they can also watch "The Third Wheel," a video that takes a humorous look at how prescription middlemen affect consumers' prescription benefit by inserting themselves into the relationship between patients, doctors and pharmacists.

For the complete press release from NCPA, please click here.

Team Up. Pressure Down. Coaching Patients to Take Control.

Citing strong evidence of effectiveness, the U.S. Preventive Services Task Force in May 2012 recommended team‐based care ‐‐ uniting the efforts of physicians, pharmacists, nurses and other health care professionals ‐‐ to improve blood pressure control. Join the launch and/or one of four live CPE webinars (starting on September 5th) to learn more about Team Up. Pressure Down., a new Million Hearts™ educational program that offers support and resources for health care professionals working to help Americans improve medication adherence and more effectively manage their blood pressure. To register for the launch webinar, visit http://TeamUpPressureDown.webex.com. To learn more about the free CPE webinar and to register, visit www.GoToCEI.org under “Of Interest”.

Reminder: Utilize Konvoke to review and compare pharmacy products. Your Use of Kovoke Supports VPhA

The Virginia Pharmacists Association (VPhA) and Konvoke, Inc. have announced an agreement to create a benefit to support the awareness and growth of both member organizations.

VPhA and Konvoke, Inc. share a common vision to use www.konvoke.com to educate their members about current pharmacy technology, products and services, while also providing a venue for members to write their own product reviews. 

“A web-based community forum for pharmacy professionals to provide feedback on their vendor experiences is vital for today’s decision makers,” said Konvoke’s V.P. of Sales and Operations John Grove. “Our relationship with VPhA solidifies our commitment to continue to provide this free service to our members.”

“VPhA is always looking to provide additional benefits to our members,” said Tim Musselman, VPhA Executive Director.  “Our partnership with Konvoke will offer our members the ability to review products and services through expanding connections with other pharmacy professionals.”

About Konvoke

Konvoke, Inc. (www.konvoke.com) is an online peer review website for all pharmacy related technology, products, and services.  Konvoke facilitates communication between pharmacy professionals across the country and provides a forum where they can share their experiences with vendors and their products.  Review content on Konvoke is 100% controlled by its members.  Membership is FREE! 

The value that Konvoke provides to its members as a resource for product information is directly proportional to the amount of members that utilize the site and the content they provide.  Konvoke utilizes several avenues for membership marketing and growth, including tradeshows, advertising, member promotions, social media, word-of-mouth, and relationships with Pharmacy Associations.  Pharmacy Associations play an important role in providing information and services to their members.  A partnership with Konvoke can play a key role in providing product information to association members. 

REMINDER: Comment today on proposed Community Pharmacy Practice Accreditation standards - COMMENTS DUE AUGUST 15 & 17

Just recently, two organizations have released draft Community Pharmacy Practice Accreditation standards for public comments.

Center for Pharmacy Practice Accreditation
The Center for Pharmacy Practice Accreditation (CPPA), a joint initiative by the American Pharmacists Association (APhA) and the National Association of Boards of Pharmacy (NABP) seeks your input on draft standards for community pharmacy practice accreditation (read press release).  These standards will serve as the basis for community pharmacy practice accreditation and are designed to both facilitate the provision of quality pharmacy services to patients and stimulate and recognize innovative community pharmacy practices.

Comments will be accepted from July 1 to August 15, 2012 via the online comment submission form.

For more information on CPPA, please visit the APhA's website by clicking here.  

URAC
URAC, an organization who currently accredits PBMs, mail order pharmacies, and specialty pharmacies, opened a call for public comment to share input and opinions on proposed Community Pharmacy Accreditation standards.

To review the draft standards and submit comments by 6:00pm EDT, August 17, 2012, go tohttp://www.urac.org/publiccomment/.


VPhA encourages you to review the draft standards and submit your comments to CPPA and URAC prior to the August deadlines.    

Public Comment – Draft Community Pharmacy Practice Standards

The Center for Pharmacy Practice Accreditation (CPPA), a joint initiative by the American Pharmacists Association (APhA) and the National Association of Boards of Pharmacy (NABP) seeks your input on draft standards for community pharmacy practice accreditation (read press release).  These standards will serve as the basis for community pharmacy practice accreditation and are designed to both facilitate the provision of quality pharmacy services to patients and stimulate and recognize innovative community pharmacy practices.

Comments will be accepted from July 1 to August 15, 2012 via the online comment submission form.

About CPPA
The Center for Pharmacy Practice Accreditation is a partnership between the American Pharmacists Association and the National Association of Boards of Pharmacy. CPPA develops and implements comprehensive programs of pharmacy practice site accreditation, including the promotion, development and maintenance of principles, policies and standards. CPPA offers the general public and users of pharmacy services a means of identifying those pharmacies that satisfy the accreditation criteria and are focused on advancing patient care, safety and quality.

For more information on CPPA, please visit the APhA's website by clicking here.

Dividends Returned to Pharmacists Mutual Policyholders

Pharmacists Mutual Insurance Company, the leader in serving the insurance needs of pharmacists and pharmacies, is pleased to announce the distribution of dividend* checks for 2011.  Over 13,000 mutual company commercial policyholders received a dividend check.  Pharmacists Mutual has returned dividends to policyholders every year since their founding in 1909.

Currently licensed in 49 states, Pharmacists Mutual Insurance Company strives “To help our customers attain peace of mind through specialized insurance solutions and superior personal service.”  Pharmacists Mutual Companies (Pharmacists Mutual Insurance Company, The Pharmacists Life Insurance Company and Pro Advantage Services, Inc., d/b/a Pharmacists Insurance Agency (in CA)) provide business, personal, life, health, and investment products for its core markets of pharmacy, dentistry, home medical/home health, and card & gift stores. Learn more at www.phmic.com or call 800.247.5930.

*Dividends cannot be guaranteed; however, they have been returned uninterrupted since 1909.

Click here for the press release.

U.S. Supreme Court Upholds Affordable Care Act: Next Steps for Virginia

Yesterday (as announced in the VPhA Pharmacy News Flash) the United States Supreme Court upheld the Affordable Care Act (ACA) in a 5-4 decision with Chief Justice Roberts voting with the liberal side of the court.  There were 3 main points that the Supreme Court addressed.  They are: 

1. The Individual Mandate (requirement to purchase and maintain health insurance) was deemed Constitutional as it is construed to be a tax on those that refuse to purchase insurance.
2. The Federal Government cannot withhold all Medicaid funding from a state if said state opts to not participate in the expansion of the Medicaid program
3. Even with the rejection of the withholding of Medicaid funds, the rest of the Affordable Care Act was deemed that it could stand on its own thus the act was upheld 

How will this impact Virginia?  Speaker of the House William Howell confirmed yesterday in a statement that "Work will begin shortly implementing a state-run health benefits exchange in Virginia, as required by the PPACA (Patient Protection and Affordable Care Act)".  As far as the implementation of the Medicaid expansion, we will be waiting on a response from the Governor's office on how the Commonwealth will proceed on possible implementation of the Medicaid expansion.

Free Continuing Education for all Healthcare Professionals - The Nation's Poison Control Centers

VPhA members are invited to take advantage of a free educational event with continuing education credits  to help increase awareness of our nation’s poison centers accessed by calling the toll-free Poison Help number 1-800-222-1222.

You may know that poison centers provide medical treatment and triage for poisonings to help people of all ages and in all kinds of poisoning situations. Poison centers are also a resource for healthcare professionals.  On average, 16% of all calls to poison centers are placed from healthcare facilities each year.  The eLearning module provides an overview of poison center resources, relevant poisoning trends, strategies for integrating poison center services into clinical practice and information about accessing a poison center.

Continuing education credits are available from June 15 to September 28, 2012.

• Please visit the eLearning link:
• http://pssc.aphanet.org/resources2/pssc-presentations/  
• Learn more about the Poison Help line and HRSA’s Poison Control Program by visiting:
• http://poisonhelp.hrsa.gov/

This eLearning module has been developed by the Health Resources and Services Administration’s (HRSA) Poison Control Program and Office of Pharmacy Affairs with the support of the HRSA Pharmacy Services Support Center.

Information From June 12th Board of Pharmacy Meeting (Members Only)

As a benefit to VPhA members, VPhA is providing to you materials from the Board of Pharmacy meetings.  Included for your information is the following:

• A summary by VPhA on activities of the Board during the meeting so that you are aware of actions as soon as possible
• Link to the meeting agenda and information packet
• Minutes from the meeting (these will stay in draft form until the Board reviews and adopts the minutes at their next meeting)
• Inspection Report document that includes the most commonly cited Major and Minor deficiencies for the months prior to the Board meeting

Please click here for information on the June 12th meeting of the Board of Pharmacy.

Virginia Medicaid Delayed Remittance Scheduled for June 29, 2012

The 2012 Appropriation Act, Item 297 PP.1. requires that the remittance that normally would be paid on Friday, June 29, 2012 will instead be paid on Friday, July 6, 2012. This annual delay was originally communicated in DMAS' Medicaid Memo of May 14, 2010.

All claims will be processed as usual based on the date they are received. Furthermore, providers will be able to verify claims status information via MediCall and ARS without disruption.

Providers should plan accordingly and prepare for this delay in claims payment. DMAS will not issue advance pays associated with this delay.

Various Physician and Pharmacy Systems Go Live on e-Prescribing of Controlled Substances

We are now beginning to see computer systems for prescribers and pharmacy become verified for theelectronic prescribing of controlled substances (EPCS).

As of this notice, the following systems have completed the process of becomingcertified and audited to connect to the Surescripts network for EPCSpurposes: 

• Physician application vendors
• DrFirst
• NewCrop
• NextGen
• RxNT

• Pharmacy application vendors
• Cerner Etreby
• Rite Aid
• SUPERVALU
• Walgreens

Additional vendors are expectedto go live in the near future.

  

If you do not see your pharmacyvendor listed here, we encourage you to contact your vendor and inform them ofthe physician vendors in your area that are approved for EPCS.

  

For more information, please click here for the announcement from Surescripts.

Virginia General Assembly Approves 2013-14 Budget

This week, the General Assembly approved the State budget for the 2013-14 fiscal year.  All items related to pharmacy have been included in the final budget.  Those items are:

• Transparency requirement for future contract administration of the State Employee health insurance program
• Prohibits the establishment of a retail maintenance network for maintenance drugs for the State Employee health insurance program 
• Creation of a Medication Therapy Management pilot program for the State Employee health insurance program
• Restoring funding for the Pharmacy Connection program
• Pharmacy Connect provides access to free prescription drugs, for adults without drug coverage, from participating pharmaceutical companies in Southwest Virginia
• Adds behavioral health drugs to the Medicaid Preferred Drug List (PDL)
• Behavioral health drugs were scheduled to be added to the Medicaid PDL in fiscal year 2014.  This amendment adds those drugs to the PDF one year early starting in 2013

 We will release more information once it is available on the MTM pilot program for the State Employees.

CMS Expands Medical Staff Definition to include APRNs, PAs, Pharmacists

On Wednesday, May 9th, CMS released new regulations that introduced a variety of changes in the hospital and health system setting including "broadened the concept of “medical staff” and have allowed hospitals the flexibility to include other practitioners as eligible candidates for the medical staff with hospital privileges to practice in the hospital in accordance with State law. All practitioners will function under the rules of the medical staff. This change will clearly permit hospitals to allow other practitioners (e.g. APRNs, PAs, pharmacists) to perform all functions within their scope of practice. (CMS has) required that the medical staff must examine the credentials of all eligible candidates (as defined by the governing body) and then make recommendations for privileges and medical staff membership to the governing body."

Click here for more information.

Fourth DEA National Prescription Drug Take-Back Event Collects Record 276 Tons

From the DEA's website: http://www.deadiversion.usdoj.gov/drug_disposal/takeback/takeback_042812.html
 
May 03 (Washington, D.C.) – The American people have again responded overwhelmingly to the most recent DEA-led National Prescription Drug Take-Back Day. On April 28th, citizens turned in a record-breaking 552,161 pounds (276 tons) of unwanted or expired medications for safe and proper disposal at the 5,659 take-back sites that were available in all 50 states and U.S. territories. When the results of the four Take Back Days to date are combined, the DEA and its state, local, and tribal law-enforcement and community partners have removed over 1.5 million pounds (774 tons) of medication from circulation.

"We are pleased at the response of the American people once again, and we thank them for participating and contributing to the battle against prescription drug abuse,” said DEA Administrator Michele M. Leonhart, who added that 4,268 agencies participated with DEA nationwide in Saturday’s event. “While a uniform system for prescription drug disposal is being finalized, we will continue to sponsor these important take-back opportunities as a service to our communities. Our take-back events highlight the problems related to prescription drug abuse and give our citizens an opportunity to contribute to the solution. These events are only made possible through the dedicated work and commitment of our state, federal, local, and tribal partners and DEA thanks each and every one of them for their efforts on behalf of the American people.”

This initiative addresses a vital public safety and public health issue. Medicines that languish in home cabinets are highly susceptible to diversion, misuse, and abuse. Rates of prescription drug abuse in the U.S. are alarmingly high--more Americans currently abuse prescription drugs than the number of those using cocaine, hallucinogens, and heroin combined, according to the 2010 National Survey on Drug Use and Health. Studies show that a majority of abused prescription drugs are obtained from family and friends, including from the home medicine cabinet.

Four days after the first Take-Back event in September 2010, Congress passed the Secure and Responsible Drug Disposal Act of 2010, which amends the Controlled Substances Act to allow an “ultimate user” of controlled substance medications dispose of them by delivering them to entities authorized by the Attorney General to accept them. The Act also allows the Attorney General to authorize long term care facilities to dispose of their residents’ controlled substances in certain instances. DEA is in the process of drafting regulations to implement the Act.

Medicaid Managed Care Pharmacy Resource Guide

The Virginia Department of Medical Assistance Services' managed care group has created a Pharmacy Resource Guide.   Included in the guide is the BIN and PCN number for each of the Managed Care Organizations (MCOs).

Click here for the Pharmacy Resource Guide.

Board of Health Professions Scope of Practice Barriers report for Pharmacy - Dates Released

This morning, the Regulations Committee of the Board of Health Professions met and outlined the schedule for the Scope of Practice Barriers study for Pharmacy.

• July 13^th – First draft of study to Regulations Committee and posted for the public
• July 23^rd – Public Hearing on the study
• Middle of August – Second draft of study will be presented to the Committee 
• September 17^th – Regulations Committee to finalize study and recommendations
• October 2^nd – Board of Health Professions to vote on final study and recommendations

This schedule could change slightly.  VPhA will provide information on the work of the committee when it is available.

Virginia General Assembly: Governor McDonnell Approves Pharmacy Items in Budget

Today, Governor McDonnell's amendments to the 2012-14 state budget were released to the public.  VPhA is pleased to report that the pharmacy items that were passed by the General Assembly remain standing following the Governor's amendments.  Those items are:

• Transparency requirement for future contract administration of the State Employee health insurance program
• Prohibits the establishment of a retail maintenance network for maintenance drugs for the State Employee health insurance program 
• Creation of a Medication Therapy Management pilot program for the State Employee health insurance program  

Of note, there was an amendment introduced by Governor McDonnell in the Transparency language that clarified how pharmaceutical rebates are reported.  We expect the General Assembly to pass this amendment.  VPhA would like to point out that in the "Explanation" section of this amendment, the following comment was made: "the financial information that will be collected will be extremely beneficial to the Commonwealth."

The Governor also introduced two additional amendments relating to pharmacy.  They are: 

• Restoring funding for the Pharmacy Connection program
• Pharmacy Connect provides access to free prescription drugs, for adults without drug coverage, from participating pharmaceutical companies in Southwest Virginia
• Adds behavioral health drugs to the Medicaid Preferred Drug List (PDL)
• Behavioral health drugs were scheduled to be added to the Medicaid PDL in fiscal year 2014.  This amendment adds those drugs to the PDF one year early starting in 2013 

The General Assembly will now come back into session on Monday, May 14th to review and accept or reject amendments proposed by the Governor.  As stated above, VPhA is expecting that these amendments will pass the General Assembly and we will let you know the final vote on May 14th.

VPhA partners with Konvoke, an online peer review website for all pharmacy related technology, products, and services

The Virginia Pharmacists Association (VPhA) and Konvoke, Inc. have announced an agreement to create a benefit to support the awareness and growth of both member organizations.

VPhA and Konvoke, Inc. share a common vision to use www.konvoke.com to educate their members about current pharmacy technology, products and services, while also providing a venue for members to write their own product reviews. 

“A web-based community forum for pharmacy professionals to provide feedback on their vendor experiences is vital for today’s decision makers,” said Konvoke’s V.P. of Sales and Operations John Grove. “Our relationship with VPhA solidifies our commitment to continue to provide this free service to our members.”

“VPhA is always looking to provide additional benefits to our members,” said Tim Musselman, VPhA Executive Director.  “Our partnership with Konvoke will offer our members the ability to review products and services through expanding connections with other pharmacy professionals.”

About Konvoke
Konvoke, Inc. (www.konvoke.com) is an online peer review website for all pharmacy related technology, products, and services.  Konvoke facilitates communication between pharmacy professionals across the country and provides a forum where they can share their experiences with vendors and their products.  Review content on Konvoke is 100% controlled by its members.  Membership is FREE! 

The value that Konvoke provides to its members as a resource for product information is directly proportional to the amount of members that utilize the site and the content they provide.  Konvoke utilizes several avenues for membership marketing and growth, including tradeshows, advertising, member promotions, social media, word-of-mouth, and relationships with Pharmacy Associations.  Pharmacy Associations play an important role in providing information and services to their members.  A partnership with Konvoke can play a key role in providing product information to association members. 

Register Today for the 131st Annual Convention - August 5-8 in Virginia Beach

Join us August 5-8, 2012 for VPhA's 131st Annual Convention. The meeting will be hosted at the Wyndham Virginia Beach Oceanfront hotel in Virginia Beach.  Attendees will have the ability to obtain 18 hours of live CE for pharmacists and technicians, network with old friends as well as new friends, and enjoy entertaining events such as Dancing and Dice and the 7th annual NASPA/NMA Student Pharmacist Self-Care championship.

Click here for more information

Pharmacists included in loan repayment program

National Health Service Corps grant program supports health care providers in underserved communities.

Pharmacists are now included in the National Health Service Corps (NHSC) State Loan Repayment Program (SLRP), which gives grants to states to operate their own loan repayment programs for primary care providers in medically underserved areas.

For the first time, participating states, including Virginia, have the option to expand their programs to include pharmacists and registered nurses. These professions join physicians, nurse practitioners, physician assistants, dental professionals, and mental health professionals on the list of eligible professionals.

“Pharmacists are often an important source of information and counsel in their communities and are increasingly a key member of the primary care team,” Health Resources and Services Administration (HRSA) spokesperson Michelle Daniels told pharmacist.com. “The National Health Service Corps aims to support health care providers who will increase access to care in underserved communities. Providing states additional flexibility to meet the unique needs of their underserved communities benefits the patients the State Loan Repayment Program is designed to serve.”

The SLRP funding opportunity is competitive and requires states to apply online by June 5. The majority of states participate in SLRP, according to a map on the NHSC website. State participation in SLRP requires matching funds by the state and administration of the program by a state agency. States that apply and are selected can then set up their program to fund pharmacists, Daniels said. "So individuals should be aware that there probably are not any immediate opportunities. They would need to contact the individual SLRP states to see if they will have LRP for pharmacists in the future."

A federal government program, NHSC is administered by HRSA, part of the U.S. Department of Health & Human Services.

For more information, please visit the APhA website by clicking here.