November Legislative Update
Kelly Vyzral, Director of Legislative Affairs
President Signs 6-Month Delay for Tamper- Resistant Implementation
OPA is pleased to announce that President Bush signed H.R. 3668, the TMA, Abstinence Education, and QI Programs Extension Act of 2007, October 1 to delay the tamper-resistant paper requirement for Medicaid prescriptions. This bill delays the implementation of the tamper-resistant requirement until April 1, 2008.
As earlier reported, Congress passed HR 3668, which required all Medicaid prescriptions to be written on "tamper resistant" paper beginning October 1, 2007. OPA was instrumental in starting the fight to change the law in June, and Ohio legislators led the charge that resulted in last minute legislation to delay the program (see Exec Message on page 6). We will continue to work with CMS and Congress to make this proposal more reasonable.
We ask that you call Senators Sherrod Brown (216.522.7272) and George Voinovich (614.469.6697) to thank them, as well as your member of Congress for voting in favor of the delay (the vote was unanimous in both the House and Senate.)
Constituents of Rep. Charlie Wilson, as well as any other pharmacists, may also want to thank him for taking the lead on this issue. His Ohio office number is 740.633.5705.
HB 283: Donated Drug Bill. Rep. Shawn Webster (R-Hamilton) gave sponsor testimony on HB 283 on October 10, 2007. University of Cincinnati faculty member Bethanne Brown, PharmD and OPA Extern Jen Quellhorst gave proponent testimony October 17. This legislation would allow colleges of pharmacy in Ohio to accept donated and expired drugs for instructional purposes. These donations would be made by manufacturers, wholesalers, and pharmacies, not individual patients with leftover medication. No controlled substances are involved.
HB 283 was unanimously passed out of the House Health Committee on October 24. It will now be scheduled for a vote before the full House before moving on to the Senate.
HB 99: Rep. Schneider /Sub. SB 114: Sen. Coughlin- Epilepsy Drugs. This legislation would prohibit a pharmacist from interchanging a drug for epilepsy or seizures without notifying the prescriber and the patient. The bill allows the Board of Pharmacy to decide on method and timeframe for notification. Bills very similar to this one have been introduced in nearly 40 states. Both bills have received sponsor and proponent/opponent testimony. OPA Executive Director Ernie Boyd, member Brian Goshe and extern Jen Quellhorst testified in opposition for OPA.
Ohio law already allows prescribers to write D.A.W. on prescriptions which assures the patient receives the specified medication, and pharmacists are required to notify patients of switches with their medications.
OPA's position on this issue has consistently been education and communication on the part of all parties involved. OPA feels this type of legislation would both impede good patient care and put undue burdens on pharmacists who would have to notify the prescriber for each substitution. In addition, without the diagnosis on the prescription, the pharmacist wouldn't know if the prescribed drug was being used to treat epilepsy or seizures. It could potentially involve hundreds of prescriptions, and, as predicted, we are already seeing other brand name drugs trying to "jump on the bandwagon."
OPA will continue to oppose this legislation.
SB 203: Pharmacy Technicians. Sen. Timothy Grendell (R-Chesterland) introduced this legislation to certify and regulate pharmacy technicians. OPA has been working with Sen. Grendell and we have seen significant improvement from the initial version of the bill. But there are still concerns that need to be addressed.
As introduced, SB 203 would require pharmacy technicians to be certified by the Ohio Board of Pharmacy. To qualify for certification, pharmacy technicians would be required to be at least 18- years-old, have a high school diploma, complete a criminal background check, pass an examination administered by the Board or complete an employer educational program approved by the Board, and complete a minimum number of hours of pharmacy tech training to be established by the Board. A pharmacy technician, under direct supervision, may assist a pharmacist or pharmacy intern with all the following activities: receiving prescriptions, verifying the accuracy of the prescription, dispensing drugs in accordance with procedures established by the Board, compounding drugs, creating and maintaining patient information, preparing insurance forms, stocking and inventorying drugs, and any other activity that assists the pharmacist in the operation of the pharmacy. In a hospital, the pharmacy tech may review patient charts, package, label and deliver meds to patients. The introduced version of this bill does still includes the 3:1 tech to pharmacist ratio, but allows the Board to address the situation in rule and allows for exceptions depending on practice site.
The bill is very lengthy, but I have included the link where you can look through the bill for yourself.
HB 291: Pharmacy Freedom of Access. Rep. Tom Patton introduced this bill that prevents insurance companies from refusing to pay for drugs purchased from non-participating pharmacies, including mail order services, as long as the medication is already included as part of a prescription drug policy coverage. It would prohibit mandatory mail order, and require equal co-pays and equal days supply.
We see this bill as critical to pharmacy now that most of pharmacies business in Ohio is controlled by third-party payers. This is one of our top priority bills. If anyone has examples of being closed out of a network or examples of mandatory mail-order hurting your pharmacy's bottom line, please send them to OPA firstname.lastname@example.org
Rep. Patton gave sponsor testimony on this bill on October 17. OPA members Dom Bartone and Tom Whiston gave proponent testimony on October 23, which was well received. The pharmacists were thanked for testifying on legislation that will keep jobs in Ohio and keep independent pharmacies open.
2007 Pharmacy Legislative Day
Thank you to all the members and students who turned out for OPA/OSHP Pharmacy Legislative Day on Wednesday, October 10. Pharmacy issues are on the front burner right now, and it was important for the legislature to know that our members are informed and involved. The theme for this years' Legislative Day was Building Positive Relationships with Your Legislators and the overriding message was get involved, know your legislators, and make sure your legislators know you!
Senator Kevin Coughlin, Chairman of the Senate Health Committee, started off the day by talking about his role as committee chairman, and listing some of the legislation currently in his committee. Kelly Vyzral, OPA Director of Government Affairs, and Ernest Boyd, Executive Director, followed with a legislative update of bills that are currently in committee, as well as ideas for future legislation such as legislation that would allow the Board of Pharmacy to expand pharmacists' immunizations in rule instead of statute, and a bill that would regulate PBMs. They also gave the participating pharmacists a "To Do" list which included getting to know their legislators, inviting them to visit the pharmacy, writing or calling legislators on issues that are important, voting in primary as well as the general elections, and contributing to Pharmacy PAC (Political Action Committee) so that we can make sure the voice of pharmacy is heard at the Statehouse.
Mark Keeley, Legislative Affairs Administrator for the Board of Pharmacy, gave us an in-depth look at legislation being followed by the Board of Pharmacy, as well as an update on recent Board rules affecting pharmacist immunization.
Attendees also heard from Beth Vanderkooi, legislative aide for Senator Tim Grendell, who is sponsoring the previously mentioned technician legislation.
Following the CE presentation, the pharmacists and students were well prepared for the legislative reception that followed. The reception was well attended and gave attendees a great opportunity to meet one-on-one with their representatives and senators to discuss relevant pharmacy issues.
If you have any questions or comments about the issues mentioned in this article, please contact Kelly Vyzral, Director of Government Affairs, at 614.586.1497 or email@example.com