Legislative Update September 2007
Medicaid Tamper-Resistant, SB 203: Pharmacy Technicians
Kelly Vyzral, Director of Government Affairs
As we begin September we are anxious to get back into the swing legislatively. OPA is awaiting notice of committee hearings, and already we are working hard on several bills.
Tamper-Resistant Pads in the Medicaid Program
Thank you to everyone who called and emailed your Congressperson about the provision in the Iraq funding bill that would require that ALL Medicaid prescriptions be written on tamper-resistant paper. The provision states that as of October 1, 2007, all Medicaid prescriptions must be written on tamper-resistant paper. Any pharmacy that fills a prescription not written on the tamper-resistant paper would have 100% of the reimbursement for that prescription taken back on audit. The potential impact on Medicaid beneficiaries, pharmacists, and prescribers will be significant. Implementation issues range from whether a sufficient number of pads will be available to the thousands of prescribers who write prescriptions to Medicaid beneficiaries, to the action that the pharmacist should take if the prescription is not written on tamper-proof paper. The pharmacists would be forced to choose between filling the prescription for the patient and not being reimbursed, or sending the patient away with no medication. Neither one of these options is acceptable!
Rep. Charlie Wilson (D-Ohio) and Senator Sherrod Brown (D-Ohio) stepped forward and worked very closely with OPA to draft legislation to address the multitude of problems in this provision.
Rep. Wilson is the chief sponsor of H.R.3090: the Patient and Pharmacy Protection Act. He has been joined by 31 cosponsors. H.R. 3090 would limit the use of tamper-resistant paper to Schedule II narcotics in the Medicaid program. This will pinpoint the drugs that are the most common target of fraud and theft. Other Ohio co-sponsors include Rep. Pat Tiberi and Rep. Zack Space. If you haven't yet done so, please contact your Congressperson and urge him/her to lend their support to H.R. 3090. It is imperative that we get this bill moving.
Senator Sherrod Brown and Senator George Voinovich introduced S. 2013. This legislationwill initially also apply the required use of tamper-resistant prescription pads under the Medicaid Program to Schedule II narcotic drugs and delay the application of the requirement to other prescription drugs for 18 months.
At the time of writing, we have not seen the CMS guidance to Medicaid to interpret how this will apply in Ohio
SB 203: Pharmacy Technicians
Sen. Timothy Grendell (R- Chesterland) has introduced legislation in Ohio to certify pharmacy technicians and provide for other regulatory requirements. OPA has been working with Sen. Grendell for several months on this legislation. It is a significant improvement from the initial proposals circulated by Sen. Grendell, but there are still concerns that need to be addressed. Sen. Grendell has given us assurances that he will work with us through the committee process to make changes in the bill.
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 away with specific pharmacist-to-tech ratios. It allows the Board to address the situation in rule.
The bill is very lengthy, but I have included the link where you can look through the bill for yourself.
The legislature will reconvene committee hearings in September and OPA will keep you informed of any hearings that are scheduled for this bill. As I said before, the bill is far from perfect, but some important changes have already been made. OPA will continue to work with Sen. Grendell to address the more onerous provisions of this legislation.
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