Legislative Update June 2001- Legislative Day, Prompt Pay Legislation, Immunization Rules

Alyson Welsh, Director of Government Affairs

Pharmacy Legislative Day a Huge Success!
Pharmacy Legislative Day, held on May 2, 2001 at the State Capitol, was a great event! Legislators and pharmacists had the opportunity to talk about pending legislative proposals during an educational program in Columbus. OPA and OSHP hosted the event that featured presentations by high-ranking elected officials, including State Senator Lynn Wachtmann who serves as Chair of the Senate Health, Human Services & Aging Committee, and State Representative Gregory Jolivette who serves as Chair of the Ohio House Health and Family Services Committee. Both Chairmen explained their hopes for the upcoming months in the Ohio General Assembly.
In addition, pharmacists listened to presentations by State Representative Bryan Williams regarding his bill, House Bill 53, which would provide pharmacies the freedom of access to participate in provider panels if willing to accept the same terms and conditions set by the insurer. Also participating in Pharmacy Legislative Day was State Representative Tim Schaffer who spoke about House Bill 210. This bill would alleviate the current concern of pharmacies that are being licensed as “retail food establishments” by local boards of health. Finally, pharmacists who attended this informative day were privy to a presentation by State Representative John Hagan who is the sponsor of House Bill 4, the Golden Buckeye Discount Card Program. Participants had a unique opportunity to explain the effects of this program on pharmacies to the sponsor of the legislation!
In the evening many state legislators attended the legislative reception. This part of the program provides a casual environment where pharmacists can talk one-on-one with their state legislator and talk about the district or their pharmacy. Thanks to everyone who attended Pharmacy Legislative Day!

House Bill 4: Golden Buckeye Discount Card
State Representative John Hagan (R-Alliance) introduced House Bill 4 in the Ohio General Assembly. This bill would provide a prescription drug discount to holders of the Golden Buckeye Card. Currently, any Ohio resident age 60 or older is automatically mailed an application for the Golden Buckeye Card from the Ohio Department of Aging. The Department of Aging estimates that there are currently two million citizens of Ohio who are eligible for the Golden Buckeye Card. HB 4, as introduced, states that the Ohio Department of Aging will contract with a Pharmacy Benefits Manager to run the Golden Buckeye Card discount program. The bill has received several hearings in the House Health & Family Services Committee and has been the subject of many “interested party” meetings aimed at discussing options to the program established in HB 4.

OPA has been in deliberations with Governor Taft’s office over the provisions contained within this bill and their implications on retail pharmacy. OPA has submitted amendment language to be included within the bill and is currently working with the sponsor of the bill and other interested parties on this legislation.

Prompt Pay Legislation Passes SenateUnanimously!
Senate Bill 4, the “prompt-pay” legislation sponsored by State Senator Larry Mumper, passed the Ohio Senate on Wednesday, May 16, 2001 by a vote of 32-0. OPA has been lobbying in support of this bill and is a member of the Ohio Healthcare Access Coalition. The Coalition represents over 44,000 health care providers in the state, and unified to bring a stronger voice to the table with dealing with insurance issues. SB 4 now makes its way to the Ohio House of Representatives where it will begin the committee process soon.
Provisions contained in Sub. SB 4 (as passed by the Ohio Senate) would require a third-party payer to pay a completed claim not later than 30 days after it is received, and requires payment within 45 days when reasonable supporting documentation is needed. Additionally, six months after the federal HIPPA regulations become effective, the provisions of the “prompt pay” requirements will only be applicable if a claim is submitted electronically. SB 4 also requires a third-party payer to establish a system whereby a provider may obtain information of the state of a claim being processed. Under this bill, the Ohio Superintendent of Insurance has been given the authority to fine third-party payers for violating the provisions within the bill.

OPA Members Attend NCPA Legislative Conference!
OPA President Kent Zellner was among the over 200 independent pharmacy leaders from across the country who attended the 33rd Annual Conference on National Legislation and Public Affairs sponsored by the National Community Pharmacists Association in Washington, D.C. This conference was designed to bring key issues facing the nation’s community pharmacists to the attention of lawmakers and federal regulators.
OPA members Kathy Karas, Tom Whiston and Bob Blake and OPA’s Lobbyist Alyson Welsh were among the Ohio representatives who met with Ohio’s federal legislators to discuss issues facing independent pharmacists. Ohio’s pharmacists traveled to Capitol Hill to meet with Senator Mike DeWine, Senator George Voinovich, Congressman Sherrod Brown, Congressman Paul Gillmor, and Congressman Mike Oxley. This event provides an excellent opportunity to meet with federal legislators and administrators to talk about the impact certain regulations and laws have on community pharmacy!

May 15 Public Hearing: Immunization Rules Approved
The Ohio State Board of Pharmacy held a public hearing on a number of issues May 15, 2001. OPA Executive Director Ernie Boyd testified in support of the immunization rules implementing SB 248. The full text of the rules can be accessed at the State Board of Pharmacy’s website, www.state.oh.us/pharmacy/. The following is a quick summary of the rules. The effective date is to be determined.
Section 4729-5-27 requires that records shall be maintained for three years by the pharmacist on all adult immunizations and must contain very detailed information about the patient (listed in the rules). A pharmacist who administers immunizations must show successful completion of a board-approved course in the administration of adult immunizations as well as a certificate of basic life-support procedures.
Computerized record-keeping is discussed in Section 4729-5-28 and requires that the system used must be able to provide immediate retrieval of patient information for all adult immunizations administered within the previous 12 months and retrieval within three working days of all adult immunizations administered within the previous 36 months. Course Requirements for administering adult immunizations are listed in Section 4729-5-36 and require a minimum of five hours in length and must be submitted to the State Board for approval.
Section 4729-5-37 lists the protocols required for administering adult immunizations. Requirements for each immunization include: name and strength, precautions and contraindications, intended audience or patient population, appropriate dosage, appropriate administration schedules, appropriate routes of administration and appropriate injection sites. Also observations times, emergency procedures, and a method to notify the physician or local board of health within 30 days are addressed. Finally, all physician established protocols must be signed and dated by the physician prior to pharmacist’s administration and must be reviewed annually with the physician. Upon the request by the State Board, a pharmacist shall immediately provide the protocols for review.
Section 4729-5-14, which explains the prescription format for a hospice outpatient, was also discussed at the hearing. Preprinted prescription forms may contain multiple orders and the prescriber may select as many drugs as necessary. Preprinted forms may not contain orders for Schedule II drugs, but can be manually added and signed by the prescriber. The prescriber shall indicate on each preprinted drug form by manually indicating the total drug orders authorized on the form or manually initialing each drug order. Each written drug order must be signed by the prescriber and may be faxed to the pharmacy from the hospice or prescriber. At the direction of the prescriber, verbal drug orders may be transmitted to the pharmacy by the hospice nurse, except for schedule II drug orders.