LTC Pharmacy News
June 2016
Long Term Care Pharmacy, like the rest of the healthcare industry, experiences constant change, from new legislation to changes in existing regulation, it's hard to keep up. Make your life a little easier by keeping in touch through
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Administration to Publish Major Rules Before the End of Year
The Obama Administration is preparing to leave office, but not before finishing up its ambitious regulatory agenda. According to the Office of Information and Regulatory Affairs (OIRA), we can expect a final rule on the Reform of Requirements for Long-Term Care Facilities to be published in September of this year. The proposed rule was published in July of 2015 and represents a major overhaul of conditions of participation for LTC facilities under the Medicare and Medicaid programs.

OIRA also anticipates the publication of the EPA's final rule on Management Standards for Hazardous Waste Pharmaceuticals, a year after publication of the proposed rule. We should see this final rule sometime in October.

Both rules have the potential to impose significant change on the nation's long-term care facilities.

MedPAC June Report Released; Drug Pricing Focus
The  Medicare Payment Advisory Commission released its June Report to Congress.
The report's Medicare Part D section includes recommendations on eliminating immunosuppressives and antidepressants from protected status on formularies, eliminating or reducing cost sharing for generic drugs for low-income enrollees and streamlining the process for formulary changes.

Morning Consult reports on other pricing changes in the report.

AHRQ: H-CUP Reports on Discharge to Post-Acute Care
The Agency for Healthcare Research and Quality announces the release of a statistical brief from the Healthcare Cost and Utilization Project (HCUP). The brief provides an analysis of all-payer discharges to post-acute care during 2013.

NQF Releases Third Interim Report for Comment
The National Quality Forum’s interim report, Addressing Performance Measure Gaps in Home and Community-Based Services to Support Community Living: Priorities for Measure Development, is now available for public and member comment through July 15 at 6:00 pm ET.

You will need to log in to the NQF website to submit comments.
Pharmacist Provider Status
The legislation (HR 592) that would allow pharmacists to directly bill Medicare for certain services under certain conditions, now claims 288 co-sponsors, roughly 60 percent of the membership of the House of Representatives.

The companion bill in the Senate (S 314) has 46 co-sponsors, nearly half the membership. 

The legislation has not been scored (official cost estimate) but is reported being reviewed by the Congressional Budget Office. 

So far, no committee of jurisdiction has scheduled hearings on the legislation as the end of this Congress approaches. Being an election year, there are only a few weeks left for Congress to consider and approve this legislation. 

While pharmacy groups continue to press for action, there doesn't appear to be much movement on this issue.

Federal Agency News
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
Report Suggests Chronic Conditions will Drive SNF Growth
McKnight's reports on a market research document predicting that increases in chronic conditions will be a catalyst for growth for skilled nursing services. The report, from Transparency Market Research, targets increased prevalence of Alzheimer's disease and dementia as major drivers of growth.

HIPAA Audits to Target Pharmacies
Drug Topics: The HHS Office of Civil Rights formally began Phase II of its HIPAA audit program and has indicated that pharmacies will be included among the provider and service groups that will be subject to audit scrutiny.

CMS Releases 2016/17 Nursing Home Action Plan (Reed Smith)
Reed Smith reports that CMS Survey and Certification Group has released its Nursing Home Action Plan for 2016-17. The plan focuses on improving survey process, increasing consumer awareness and creating strategic partnerships. 

On-demand Drug Manufacturing?
Kaiser Health News and NPR report on a project at MIT, funded by the Defense Department, that seeks to create a machine that could be set up to manufacture critical drugs on demand. The benefits seem obvious, as are the objections raised by branded manufacturers.

Kaiser: Summary of Major Provisions of Medicaid Managed Care Rule
The Kaiser Family Foundation publishes a summary of the major provision of the recent final rule from CMS on Medicaid Managed Care

Will the Internet of Things be a Healthcare Disruptor?
Health Data Management:  The increasing ability of internet-connected apps and devices to aggregate meaningful data may be one of the biggest boons to large-scale disruption in the $3 trillion healthcare industry.

Maybe Drug Prices Aren't High Enough: Although it sounds like heresy, there is a good argument to be made that artificially low prices for generic drugs, and the increased regulatory risk associated with producing them, are one of the causes of chronic drug shortages. Perhaps the law of supply and demand continues to have consequences. NY Times

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