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Legislative Update February 19, 2008
Author: Kathy Lynch
Legislative Update
By Kathy Lynch, Vice President of Government Affairs
February 19, 2008
Monday, February 18th was a Legislative Holiday. Last Friday, the Senate and Assembly approved legislation that would impose a 10% reduction in all state programs including Medi-Cal provider reimbursement. The Governor, as expected, signed the series of bills that achieve the majority of the cuts he proposed in early January when he declared a Fiscal State of Emergency in California. The cut 10% to providers is currently scheduled to go into effect on July 1, 2008. CPhA, our pharmacy partners and other provider allies are putting plans in place to fight these disastrous cuts.
Over the next few weeks CPhA will be sending out information on how each of you can assist in the fight against the implementation of the 10% cut to providers. Last week, you received a Legislative Alert regarding the Senate Budget Committee's approval for these cuts and the significant impact they will have on pharmacy. If you did not have an opportunity to read it, please do so now by clicking here.
As many of you know, there are many substantive issues facing pharmacy at both the state and the federal level. It is an important time for you to get involved with CPhA and our legislative efforts. One way for you to get involved is to attend CPhA's Legislative Day in Sacramento on Wednesday, April 16th. In order to guarantee an appointment with your legislator, you need to register by March 7th. Registration opened on Friday, February 15th. Please go to www.cpha.com/legday to register!
On April 16th the event will start at 10:00 a.m. (registration will be from 8:00 - 10:00). The day will conclude with a cocktail reception from 3:30 – 5:30. I look forward to seeing you in Sacramento! Don't forget to book your flight now to get the best prices available.
If you have any questions or comments, please contact me at klynch@cpha.com or (916) 779-1400.
Thank you very much for your continued support!
Kathy
Tamper Resistant Prescriptions
The Centers for Medicare and Medicaid Services (CMS) have reviewed our policy with respect to tamper-resistant prescriptions and are providing two updates to that policy. All other guidance included in the State Medicaid Directors Letter and the Frequently Asked Questions continues to be in effect. For more information on the tamper resistant prescription pad policy, please visit www.cms.hhs.gov/DeficitReductionAct/30_GovtInfo.asp. This notification will be posted to the website early next week.
Provider Additions to Otherwise Non-Tamper-Resistant Paper
Several States have had specific questions about whether a provider can add a feature to a prescription to make it compliant with the requirements. States have proposed various features, including particular kinds of ink to write the prescription (gel or indelible); writing out the drug quantities rather than just the number (i.e. “thirty” vs. “30”); and embossed logos. The statute states that all written prescriptions must be “executed on a tamper-resistant pad.” As a result, features added to the prescription after they are printed do not meet the requirement of the statute. Features that would make the prescription tamper-resistant include certain types of paper as well as certain items that can be pre-printed on the paper.
The National Council for Prescription Drug Programs (NCPDP) has convened a focus group to identify consensus best practices and make a recommendation to State Medicaid programs on a standard approach to this requirement. Representatives from provider groups, pharmacy groups, prescription pad vendors, the National Governors Association, the National Association of State Medicaid Directors, the National Conference of State Legislators and several State Medicaid programs are participating. This group is developing a document for State Medicaid programs that identifies a minimum set of features that satisfy the requirements for April 1, 2008 and October 1, 2008. CMS will share the clarification provided above with the NCPDP group so that no recommendations are included in the document that conflict with the requirement.
Computer Generated Prescriptions
CMS is also clarifying that during the period between April 1, 2008 and October 1, 2008, computer generated prescriptions printed by a provider on plain paper, including Electronic Medical Record (EMR) computer generated prescriptions, may meet CMS guidance by containing one or more industry-recognized features designed either to prevent the erasure or modification of information contained on the prescription, or to prevent the use of counterfeit prescription forms.
However, based on its understanding of current prescription security technology, CMS does not believe that computer generated prescriptions printed by a prescriber on plain paper will be able to meet the first baseline requirement that prescriptions contain one or more industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form. In other words, prescriptions printed on plain paper will not be able to meet all three baseline characteristics outlined by CMS. Therefore, beginning October 1, computer generated prescriptions must be printed on paper that meets that requirement. The NCPDP focus group has developed a list of examples of industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form which include, but are not limited to: watermarks, micro-printing, and paper on which the word “void” appears when copied.
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