July Legislative Update
Immunization Bill Signed, Epilepsy Drug Bills,
Kelly Vyzral, Director of Government Affairs
Governor Signs Immunization Bill!
The Pharmacists Immunization Bill is signed into law! Our long hard-fought battle is over! SB 58, the Pharmacist Immunization bill, was voted out of the House on May 16 by a vote of 91-1. The Governor signed the bill on May 31. SB 58 will expand the number of adult immunizations that pharmacists are permitted to administer to include diphtheria, meningitis, and pertussis; allow pharmacists to administer epinephrine and diphenhydramine in case of emergency; allow pharmacists to administer flu vaccines to those 14 years and older; expand the list of qualified professionals able to administer flu vaccines to include trained pharmacy interns, acting under the direct supervision of a trained pharmacist, to those 18 years and older; and remove the requirement for pharmacists to notify the patient's primary care physician or local Health Department within 30 days after providing the flu vaccine, except in the case of those between the ages of 14 and 17. The Board of Pharmacy will vote on the rules at their July meeting and file them accordingly.The rules will then be scheduled for public hearing and the Joint Committee on Agency Rule Review. We will alert our membership when the rules are published for comment. We expect implementation before October 1, 2007. A huge "thank you" to everyone who wrote and called their legislators about this bill, especially the students who initiated writing campaigns within their colleges of pharmacy, and the pharmacists and students who testified. The Governor was happy to sign what he commented on as a "good piece of common-sense legislation."
SB 114 and HB 99: Epilepsy Drug Bills
Under current law, pharmacists are required to verbally notify a patient when any substitution is made. This legislation would prohibit a pharmacist from interchanging a drug for epilepsy or seizures without receiving the written consent of the prescriber and the patient. Bills very similar to this one have been introduced in nearly 40 states. Both bills have had sponsor testimony (Sen. Coughlin [R-Cuyahoga Falls] and Rep. Schneider [R-Cincinnati]), as well as proponent and opponent testimony. OPA member Brian Goshe, R.Ph. testified before the House Health Committee as an opponent. Both sponsors have indicated that they want to work on this through interested party meetings and avoid legislation if possible. OPA's position on this issue has consistently been education and communication on the part of all parties involved. Each party in this equation has a responsibility: the patients should be familiar with what medication they are taking, and what it looks like; the physicians should be writing D.A.W. on prescriptions where they feel the patient needs to receive a certain medication; and pharmacists must counsel patients and let them know when a substitution is being made in their medication. We feel there is a degree of both patient and prescriber responsibility that is being overlooked by this legislation. This legislation would require the pharmacist to physically call the prescriber each time a substitution is made, and many times these substitutions are required by the patient?s health plan or third party payer.
Let me take this opportunity to repeat that, under Ohio law, a pharmacist is required to verbally notify a patient when a substitution is made. We need to make sure this is happening.
HB 119: Budget Bill
New budget language that protects us against a severe AMP cut was included in the Senate version of the budget bill! In a nutshell, the amendment requires the Ohio Department of Job and Family Services (ODJFS) Director to do an analysis within 30 days of any cut to generic drug prices and determine how much money Ohio pharmacies will lose.Then the Director must increase the dispensing fee an amount that equals the amount of money we lose.This was the first real test of a new grassroots program we recently started using called "Voter Voice." All of you should have received an email asking you to contact your state senator. It worked great, by the way, with nearly 250 contacts made by pharmacists to the Senate. That is one of the best responses we?ve had to a request for legislative contact. Every one of those contacts was important. HB 119 was voted out of the Senate Finance Committee and voted unanimously out of the Senate on Wednesday, June 13. This legislation then went to Conference Committee where select members of the House and Senate crafted a compromise bill that both Houses agreed on. The Governor now has the power of "line item veto," and could simply strike out this language. So we'll be actively working this one to the very last day, which should be June 30. Thanks for working with us.
HB 229: Pharmacy Fees
HB 229 (Rep. Shannon Jones [R-Springboro]) is a fallback measure to our amendment in the budget bill (HB 119 on page 11) that protects us against a severe AMP cut. This legislation would require the Director of ODJFS to do an analysis within 30 days of any cut to generic drug prices required by the Federal DRA, and determine how much money Ohio pharmacies will lose.Then the Director must increase the dispensing fee by an amount that equals the amount of money pharmacy lost. Rep. Jones worked closely with us to have this language included in the House version of the budget, but unfortunately it did not make it in. But she did not give up and introduced this language to help pharmacy a few days later. It was assigned to the House Finance and Appropriations Committee where it awaits sponsor testimony.
NCPA Legislative Conference
OPA was well represented at the NCPA Annual Legislative Conference held in Washington DC, May 13-16. Ten pharmacists and 12 students attended from Ohio. Our large number of attendees from around the state allowed us to meet with almost every member of the Ohio delegation, including 12 Congressional offices and both Senatorial offices.
OPA member pharmacists lobbied Congress on three very important issues:
- H.R. 971, which would let independent pharmacies collectively negotiate with PBMs, and which has 100 bipartisan supporters in the House.
- H.R. 1474, which would require Medicare Part D prompt payments, with 125 supporters from both parties.
- AMP, asking members of Congress to require CMS to revamp a proposed Medicaid reimbursement formula that does not cover community pharmacy acquisition costs for generic drugs.
We received a very good response from all the legislators and their staff. Several of them showed interest in sending letters to CMS on behalf of the pharmacies in their districts.