LTC Pharmacy News
April 2018
The healthcare industry is in the beginning of massive change and the long term care pharmacy industry will be affected by this change. is your guide to understanding this process, the legislation and regulation that will implement this change and the key to adjusting your approach to succeeding in this new environment. We will try to not just tell you the "what" of this change, but the "how" as well.
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Legislative Highlights

House Energy and Commerce Cmte Concerns about Nursing Home Safety
The House Energy and Commerce Committee leadership has sent a letter to CMS expressing concerns about the agency's oversight of nursing home following a highly-publicized tragedy in Florida when 14 nursing home residents died as a result of air conditioning failure during hurricane Irma. Committee members are interested to hear from CMS about its oversight of the nursing home in question.
Blog Post: CMS Call Letter and 2019 Final Rule
CMS has issued its annual rate update and Call Letter for the 2019 plan year. Take a look and see the highlights of what's in store for next year. 
Catch up on Elise Smith's Latest
I know many of you were expecting another informative post from Elise, but she is busy putting together another article, which should be ready for our next issue in approximately two weeks.
Meanwhile, if you missed the last post, or her previous work, you can catch up here.
Will I See You at the ASCP Forum?
Don't put it off. Register today for the upcoming ASCP Forum in Arlington, VA on May 17-18. This is a program you won't want to miss. Look forward to seeing you in May!
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Federal Agency News
DEA Schedules Drug Take Back Day for April 28
The Drug Enforcement Agency has scheduled April 28th as its next National Prescription Drug Take Back Day. DEA's last Take Back Day, held in October 2017, netted 456 tons of medicines returned for disposal to local law enforcement agencies.

CMS issues Final Rule and Call Letter for 2019
CMS has announced the Final payment rates and Call Letter for calendar year 2019 as well as the Final Rule on Policy and Technical Changes for 2019. Among the highlights:
  • Transition supply fills for LTC residents will be reduced from 90 days to one month supply.
  • Health plans will be required to make contract terms and conditions available to pharmacies by September 15 and will establish deadlines for plan response for pharmacies wishing to be included in networks
  • CMS has codified that LTC residents will not be subject to pharmacy drug utilization management for drugs with abuse potential.
  • CMS will allow plans to include generics on formularies without a waiting period.
  • CMS decided to take no action on requiring discounts and rebates applied at point of sale.
ACL Webinar on Safe and Effective Use of Medications in Older Adults
The Administration for Community Living is sponsoring a webinar on April 18th at noon. The speakers will provide an overview of these important medication issues related to older adults, along with the need for management and coordination among the care team members and the beneficiary. Register here

HHS Announces Patient's Guide to Health Record
The Health and Human Services Department announces the availability of a new resource to help patients understand their rights to obtaining their health record and some helpful information on how to access their records.

HHS Secretary Appoints Drug Price Reform Coordinator and Opioid Policy Guru
HHS Secretary Alex Azar announced the appointment of Dan Best, former CMS and Pfizer executive as Senior Advisor to the Secretary for Drug Pricing Reform, and Brett Giroir, M.D. as Senior Advisor to the Secretary for Mental Health and Opioid Policy.

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Go to the LTC Pharmacy website for regular updates on what's coming from CMS, including proposed and final rules, new programs, news from Medicare and Medicaid and updated Medicare Learning resources. Go there now.

The FDA often updates its website with drug safety information, news about drug approvals and implementation information on laws, such as the Drug Quality and Security Act. Keep checking our site for the latest news from FDA.

THE HHS Office of Inspector General publishes audit reports and results of investigations on federal health programs, such as Medicare and Medicaid. Congress frequently looks at these reports when deciding where to focus on oversight and legislation. Keep in touch here.

The Government Accountability Office is the official investigative arm of Congress and publishes important reports that often guide the national conversation. We keep track of announcements coming out of GAO, so you don't have to. All you need to do is click here.
News Items of Interest
Axios Exposes PBM Tactics
The online news service Axios recently published Express Script's customer contract template, which discloses the extent to which the pharmacy benefit manager (PBM) operates under a veil of secrecy. Axios went on to publish an extensive series of reports on PBM practices, including the leverage these companies have over retail pharmacies.

NIC Releases Q4 2017 Skilled Nursing Data Report
The National Investment Center for Seniors Housing & Care (NIC) has published its latest survey of skilled nursing facility occupancy and payer trends. It seems the recent trends continue, with occupancy falling to 81.9 percent, while managed care payments continue their slide and Medicaid continues to account for an increasing percentage of SNF revenue.

Medicaid Directors Issue Brief on Waiver Trends
The National Association of Medicaid Directors has published an issue brief that examines the steps states are taking to bring innovation, cost control and sustainability to their Medicaid programs. Trends include efforts to better manage pharmacy costs, provide a continuum of care for mental illness, as well as better coordination with Medicare and time limits in Medicaid.

Walmart in Talks to Buy Pill Pack
While the big news has been Walmart's offer to buy Humana, the other story is more interesting to us. PillPack, the company that focuses on mail order delivery of medications to patients using multiple drugs, is the next target for Walmart, as reported by CNBC. Will Walmart be your next competitor?

SNFs Track Patients to Avoid Hospitalization
The CMS focus on preventing hospital readmissions has motivated some skilled facilities to begin tracking residents, even after they leave the facility. SNF managers point to the need to demonstrate their value and avoid penalties. See story in Skilled Nursing News

MCBS 2015 Chartbook is now available
The Medicare Current Beneficiary Survey data from 2015 has been made a vailable for download from CMS. This is an invaluable data source for information on one of the nation's largest healthcare programs.

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