Big shout-out to pharmacists Dean and Krista Stone in Metter, Georgia, who this week signed-up their entire pharmacy team to be GPhA members – five technicians and one staff pharmacist (in addition to Dean and Krista themselves).

Did you know that the GPhA dues amount for your technicians is only $25…and that as GPhA members, those technicians get the member rate on all GPhA courses and events…all of which are ACPE-approved for technician CPE? (Including our upcoming webinar on changes to Georgia’s PDMP and how technicians are affected!)

If you didn’t, now you do.  So, like, sign them up…here.

(And thanks, Dean and Krista!)

The Drug Enforcement Administration (DEA) will be hosting a Pharmacy Diversion Awareness Conference (PDAC) in Hilton Head Island, S.C., on August 15 & 16, 2016.

It will be open to registered pharmacists, pharmacy technicians, and pharmacy loss prevention personnel who work for DEA-registered pharmacies in the states of Georgia and South Carolina.

The one-day conference is scheduled for Monday, August 15, 2016, from 8:30 a.m. to 5:00 p.m. and will be held again on Tuesday, August 16, 2016.

There is no fee for this conference, and CE credit is tied to this course.

Click here for a one-page flyer with more info.

Former West Point mayor and local dentist Drew Ferguson scored a convincing win over State Senator Mike Crane in yesterday’s Georgia’s third congressional district Republican primary run-off. GPhA had identified Ferguson as the most pharmacy-friendly candidate in the race.

“Last night was a great night for Drew Ferguson, for pharmacists and for Georgia,” said GPhA immediate past president Tommy Whitworth of LaGrange. “In Drew, we’ll have another member of our congressional delegation who understands the pressures on healthcare professions, and who’ll listen to our concerns.”

Republican Ferguson will face Grantville Democrat Angela Pendley in the November general election. The demographics of the west-central Georgia district have made it a stronghold for Republicans in recent congressional elections.

Here’s what the AJC had to say this morning about Ferguson’s victory.

In a public-comment letter to State Insurance Commissioner Ralph Hudgens today, GPhA urged the commissioner to oppose the proposed merger of health insurance titans Humana and Aetna.

This is the final day to submit written comments to the Insurance Commissioner. A public hearing on the proposed merger is scheduled for this coming Tuesday, July 26 at the State Insurance Commission in downtown Atlanta. There, among other groups, the Medical Association of Georgia is expected to testify in opposition to the merger.

The entire text of GPhA’s letter to Commissioner Hudgens follows here.

July 21, 2016
 

Commissioner Ralph T. Hudgens
Office of Insurance and Safety Fire Commissioner
Two Martin Luther King, Jr. Drive
West Tower, Suite 704
Atlanta, Georgia 30334

 
Re:  Aetna, Inc./Humana, Inc. proposed merger

Dear Commissioner Hudgens,

Thank you for the opportunity to be heard on this important issue. The Georgia Pharmacy Association (“GPhA”), which represents the interests of Georgia pharmacists in all practice settings, is extremely concerned that this proposed merger will have a negative impact on Georgia patients as well as Georgia healthcare providers.

Specifically, based upon the information submitted, there appears to be strong evidence that “the effect of the acquisition may be substantially to lessen competition” with regard to individual, small group, large group, and Medicare insurance. These concerns have been raised in Medical Association of Georgia CEO Donald Palmisano’s March 1, 2016, written correspondence to your office.  GPhA shares the concerns raised in that letter and urges its consideration prior to any decision regarding the proposed merger.

Consolidation in the insurance industry, including health insurers and pharmacy benefit managers with whom health insurers contract (PBMs), leaves Georgia patients and Georgia pharmacies particularly vulnerable.  As a result of little to no bargaining power, pharmacies find themselves in the position of entering into take-it-or-leave-it provider agreements which often, among other things:

• Force participating pharmacies to charge patients more than a drug actually costs and pass along the excess to the PBMs;
• Prevent participating pharmacies from informing patients of lower-cost alternatives;
• Force participating pharmacies to accept negative reimbursements on prescriptions;
• Force participating pharmacies to offer pharmacy services beyond the filling of prescriptions without reimbursement;
• Withhold money from pharmacies in connection with unattainable metrics;
• Charge pharmacies different types of fees, including direct and indirect remuneration fees, often undisclosed at the time of claim processing (these can amount to thousands and thousands of dollars per year);
• Prevent participating pharmacies from being reimbursed for compounded products; and
• Prevent participating pharmacies from being reimbursed for refills or prescriptions beyond a thirty (30) day fill.

These contracts typically contain arbitration clauses, confidentiality clauses, and the ability of the health insurer/PBM to terminate pharmacies from networks without cause. These provisions have a silencing effect, as pharmacies often fear retaliation and network termination.

Interestingly, Humana Pharmacy Solutions recently promulgated a proposed contract amendment that has garnered the attention and concern of U.S. Congressmen Doug Collins and Buddy Carter. In a press release on the issue, Rep. Collins stated:

Humana, one of the largest insurance providers in the country, currently has a proposal th[at] would require these small pharmacies to lose $5.00 per prescription, up front, with the hope that they will be reimbursed if they meet certain metrics. However, meeting all of the criteria is not a guarantee that the pharmacy will get reimbursed because there are only spots in the top rankings for a few pharmacies. Under this proposal, a pharmacy could meet most of the CMS benchmarks, provide quality customer care, and still not be reimbursed by Humana. Humana’s criteria has little to do with patient care, and everything to do increasing their profit and driving community pharmacies out of the market. Some of these metrics, including “patient adherence” are beyond the control of the pharmacists. Pharmacies already compete for customers and business, let’s not set a precedent to make them compete for reimbursement by insurance companies as well.”

While Humana Pharmacy Solutions does not appear to be actively registered with your office as a pharmacy benefit manager, the company appears to operate in that capacity within the state. The notice addressed by Congressman Collins was sent to participating Georgia pharmacies. In light of actions such as the one described by Rep. Collins, there is real concern amongst Georgia pharmacists that further consolidation will result in even more onerous contractual practices.

Contractual provisions aside, industry consolidation in the health insurance industry has resulted in health care providers being excluded from networks and patients being divested of their choice in healthcare providers.   With regard to pharmacy in particular, pharmacies are often excluded from networks, and patients are often forced to use mail-order pharmacies or steered to mail-order pharmacies via incentives such as reduced copays.  Indeed, on a daily basis, Georgia pharmacies are unable to fill certain prescriptions for patients with insurance coverage because when they attempt to process the claim, they get a reject code specifying mail-order is required. This, despite the fact that Georgia has an anti-mandatory mail-order statute which provides, among other things, that insurers cannot force insureds to use mail-order; and that “[i]nsureds who do not utilize a mail-order pharmaceutical distributor shall not be required to pay a different copayment fee . . .”  See O.C.G.A 33-30-4.3.

The foregoing problems are a result of an already highly concentrated market. GPhA believes this proposed merger, should it move forward, will exacerbate these problems. Unequal bargaining power is a bad thing for Georgia providers and consequently, a bad thing for Georgia patients.  Moreover, lack of patient choice does not improve healthcare, it undermines it.  As such, GPhA encourages you to exercise your authority under the law and issue an order blocking the proposed merger on the grounds that “the effect of the acquisition may be substantially to lessen competition.”

Sincerely,

Greg Reybold

Vice President of Public Policy & Association Counsel

cc:  GPhA Board of Directors

GPhA CEO Scott Brunner, CAE

“…and if you pay your GPhA dues on time, we promise to stop pestering you to pay your GPhA dues on time.”

It’s (almost) that time again: Time to renew your GPhA membership for 2016-17.  We’ll be mailing your dues invoice to you in early August, and you’ll have a variety of options for remitting payment, including monthly via credit card charge. We want you back as a member, so PLEASE RENEW YOUR MEMBERSHIP BY SEPTEMBER 1…and help us continue to provide essential support and protection for your profession.

[ Cartoon credit: Originally appeared in The New Yorker, but we fiddled a bit with the caption for our purposes.  Can you tell? ]

According to the Washington Post, the Department of Justice is reportedly preparing to sue to block two mega-mergers that could transform the health insurance landscape by consolidating the big five insurers into just three companies.  GPhA opposes those mergers.  Here’s the full story.

GPhA’s Immediate Past President Tommy Whitworth of LaGrange served as chauffeur and host this past Friday when Third Congressional District candidate Drew Ferguson visited a handful of pharmacies in the district to urge support for his campaign. Among the pharmacies Ferguson visited were Franklin Pharmacy, owned by Kerry and Cathy Griffin in Franklin, GA; Brad Lipham’s Bowdon Pharmacy in Bowdon; Turner Pharmacy in Carollton, owned by Randy Turner; Bobby Lee’s Lee-King Pharmacy in Newnan; and Drew Miller’s Wynn’s Pharmacy in Griffin.

Ferguson, a former West Point mayor and a dentist by profession, is in the Republican primary run-off election on July 26 for Georgia’s Third District seat in the U.S. Congress.  The Third District is solidly Republican, so it’s almost certain the winner of the July 26 run-off will win the seat in November.

At a stop at Wynn’s Pharmacy in Griffin on Friday afternoon, GPhA leaders met with Ferguson and found him to be well-informed on issues impacting healthcare providers and sympathetic to the challenges facing pharmacists.  He indicated a strong willingness to work across the aisle on bipartisan legislative issues impacting pharmacy, including provider status, any willing provider, MAC transparency and DIR fees.

At that meeting, pharmacist Drew Miller presented Ferguson with a personal campaign contribution. “I’m proud to support you,” said Miller, “And I urge my fellow pharmacists to support you as well.”

Says Whitworth: “I urge my fellow Third District pharmacists to do three things: Take a look at Drew’s website at fergusonforgeorgia.com. Then talk to your family and friends and customers about the run-off election and  Make sure it’s on their radar. And then mark your calendar and plan to go vote on July 26.”  Whitworth adds that the outcome of the election will hinge on turnout, “which is why pharmacists need to be sure to go vote.”

Pharmacist Lance Boles of Hartwell was installed as 2016-17 GPhA president during the Georgia Pharmacy Convention last week in Hilton Head, SC. Hartwell is a graduate of the University of Georgia School of Pharmacy. He also earned his MBA at UGA. Boles owns independent pharmacies in Hartwell, Georgia, and Iva, SC.

Kroger pharmacist Liza Chapman of Dawsonville was installed as president-elect, and independent pharmacist Tim Short of Cumming was installed as first vice president. Pharmacist Tommy Whitworth of LaGrange will remain on the board as immediate past president.

In addition, the following Georgia pharmacists were elected to serve on the 2016-17 GPhA Board of Directors: Michael Azzolin of Watkinsville; Sharon Deason of Newnan; Amy Miller of Lula; Fred Sharpe of Albany; Jonathan Sinyard of Cordele; Renee Adamson Smith of Manchester; and Chris Thurmond of Athens.

Also recognized at the convention were 2016-17 region presidents, as follows:

The 2016-17 GPhA Board of Directors and region presidents are installed by outgoing president Tommy Whitworth

Pharmacist Lance Boles of Hartwell is installed as GPhA’s 2016-17 president.

Immediate past president Bobby Moody of Macon recognizes outgoing president Tommy Whitworth and his wife Susan of LaGrange for their service to GPhA.

Members of the 2015-16 GPhA Board of Directors are recognized for their service to the association

Rep. Buddy Carter (R-Ga.), the only pharmacist currently serving in the U.S. Congress, this week was appointed to serve on the conference committee created to resolve differences between the House and Senate versions of the Comprehensive Addiction and Recovery Act.

Carter’s experience as a community pharmacist and his previous work in the Georgia General Assembly to create a prescription drug monitoring program in that state will provide a unique perspective to the committee’s deliberations. As previously reported, provisions relating to partial filling of Schedule II controlled substances as well as Part D lock-in programs will be part of the discussions.

About two dozen local pharmacists attended a Monday evening reception in Gainesville honoring Congressman Doug Collins, a pharmacy champion who faces a challenger in Georgia’s May 24 primary election. The event was hosted by Congressman Buddy Carter, who urged the assembled pharmacists to display Collins signs in their pharmacies and to encourage friends and neighbors to vote for Collins. “Our profession needs more men like Doug Collins in Congress,” said Congressman Carter.

Congressman Collins thanked GPhA, NCPA and the assembled pharmacists for their strong support. He noted that the key to his race will be voter turnout on May 24. “You going to the polls May 24 will make a difference in whether I can win outright or have to go to a primary run-off,” Collins said.

GPhA and the Georgia Society of Health System Pharmacists were also honorary hosts for the event.

Shown here, R to L, GPhA President Tommy Whitworth of LaGrange, Congressman Collins, Congressman Carter, and GPhA CEO Scott Brunner

Shown R to L, pharmacist Dale Coker, Congressman Collins, Congressman Carter, and pharmacists Tim Short and Shawn Hodges

If you know of a Georgia pharmacist who passed away since last June, please let us know so we can acknowledge him or her at the Georgia Pharmacy Convention. Just send a note to Ruth Ann McGehee at rmcgehee@gpha.org. Thank you.

In a ceremony at the Capitol this past Tuesday, Governor Nathan Deal signed into law GPhA priority legislation designed to increase the use and effectiveness of the state’s prescription drug monitoring program (PDMP). The legislation, HB900, was a collaboration between GPhA, GDNA and the Medical Association of Georgia, and was drafted by GDNA director Rick Allen.

The new law, which takes effect July 1, will allow pharmacists and physicians to delegate retrieval & review of PDMP information to “any person licensed, registered or certified” by the Board of Pharmacy or the Medical Composite Board. Under that provision, pharmacists may delegate the checking of PDMP to technicians. In addition, the new law specifically allows communication (related to information found in PDMP) with physicians and/or other pharmacists involved in a patient’s healthcare.

Pictured with the governor at the bill-signing are GPhA President Tommy Whitworth of LaGrange (far right) and Second Vice President Liza Chapman of Dawsonville (second from right). Representatives of the Medical Association of Georgia and the bill’s sponsor, Chairman Sharon Cooper, also attended the signing.

State Medicaid Director Linda Wiant (center, in pink), with the GPhA Board of Directors yesterday at GPhA.

Yesterday, State Medicaid Director Linda Wiant visited with the GPhA Board of Directors to discuss a range of issues impacting GPhA members, from concerns about CMO network adequacy to problems with prior authorizations.

Wiant, a Mercer-trained pharmacist, also commented on recently-passed legislation that will subject Medicaid recoupments to the audit bill of rights, indicating that she had implemented new policies several months ago to address concerns about excessive clawbacks, and that in her opinion the GPhA-supported legislation simply made those policies part of the Code of Georgia. In response, directors alerted Wiant that her policy changes were clearly not being adhered to by some state subcontractors.

The GPhA Board also met with officials from the Health Prevention Division of the State Department of Public Health to discuss partnering opportunities in chronic disease management, immunizations and prescription drug abuse prevention. The officials, Director of Health Protection Dr. Pat O’Neal, Director of Chronic Disease Prevention Dr. Jean O’Connor, and Director of Pharmacy Dr. Kimberley Hazelwood, indicated they welcomed further conversations about how pharmacists and DPH can work together.

The meetings with Wiant and Public Health are the latest in a series of stakeholder visits the Board has undertaken to engage and build relationships with key stakeholders and partners in Georgia pharmacy. The meetings are one result the new policy governance structure GPhA members approved last July. Under that structure, the size of Board of Directors was reduced from 41 to 11 members, and the Board refocused its attention on outreach and policy-setting.

Since last September, in addition to yesterday’s meetings, GPhA board members have met with:

• Deans of the pharmacy schools at Mercer and South
• Pharmacy student leaders from South, Mercer and UGA
• UGA and South pharmacy school faculty
• Leaders of the Georgia Food Industries Association, Georgia Society of Health System Pharmacists and the Georgia Association of Chain Drug Stores
• The president and the CEO of the Medical Association of Georgia
• Leaders of the Georgia Pharmacy Foundation
• The Chairman of the Georgia Board of Pharmacy
• Leaders of GPhA’s practice academies
• The CEO of Alliant Quality, Dennis White

“These meetings are great information-gathering sessions,” said GPhA President Tommy Whitworth of LaGrange. “They not only build relationships, but they are already creating opportunities for us to pool our resources and knowledge with other groups to help our members and the patients we serve.”

GPhA board member Drew Miller of Griffin chats with DPH’s Dr. Jean O’Connor and Dr. Pat O’Neal yesterday at GPhA.

Here’s a shout-out to GPhA’s Nominating Committee members, who met yesterday at GPhA to evaluate candidates and choose a slate of names to recommend for election to the 2016-17 GPhA Board of Directors. Voting in that election will commence next month.  We’ll be releasing the slate shortly, after all candidates have been notified.  For now, THANK YOU to Nominating Committee members (L to R in the photo below) Bobby Moody (chairman), Drew Miller, Sharon Sherrer, Carolyn Florence, Hannah Head, Ted Hunt and Mahlon Davidson. Thanks to the great number of highly qualified candidates who applied, the Nominating Committee had a tough job to do. We appreciate their service!

Scott Brunner, CAE, Chief Executive Officer

GPhA had a strong turn-out for its Pharmacy Advocacy Event this past Friday, with pharmacists speaking to their senators as well as senators on the Senate Health and Human Services Committee to advocate for HB 900 (PDMP) and HB 916 (DCH audits).

Three events remain and it’s vital that we have good turnout so pharmacists are both seen and heard in the final weeks of the session. Please sign up for one of our four remaining Pharmacy Advocacy Team events at GPhA.org/atthecapitol:

• March 10; 10:00 a.m. – 1:00 p.m.
• March 15; 10:00 a.m. – 1:00 p.m.
• March 22; 10:00 a.m. – 1:00 p.m.

This week in the legislature

Week eight began with cross-over day, February 29, and legislators worked through the day and well into the night in order to pass bills out their respective chambers.

Pharmacy-related bills that passed the House on cross-over day include…

• HB 1043 (creating certain carve outs for hospitals in connection with immunizations)
• HB 722 (now consisting of expanding eligible conditions for use of cannabis oil)
• HB 1058 (amongst other things, defines harm reduction agencies that provide services to individuals at risk of HIV and allows these agencies to distribute syringes, which can currently only be done by pharmacists and practitioners)
• SB 402 (establishment of the State Commission on Narcotic Treatment Programs and a temporary moratorium on the issuance of new licenses to narcotic treatment programs)

GPhA is also monitoring other bills that previously passed their respective chambers:

Bills we SUPPORT

• HB 900: PDMP reform
• HB 916: DCH audits
• HB 926: Drug law (GPhA supports with revision)
• HB 952: State oversight in connection with state board anti-trust immunity (GPhA supports with revision)
• HB 783: Drug update
• HB 588: Pseudoephedrine ID requirements (GPhA supports with revision)

Bills we’re NEUTRAL on

• SB 115: Allowing PAs to prescribe hydrocodone compound products
• SB 230: Uniform Emergency Volunteer Health Practitioners Act
• HB 813: Expedited partner therapy for STDs
• HB 886: Mail order — see below
• HB 897: Drug repository program

No bills that GPhA opposes survived crossover.

Bills that did NOT make crossover

Some of the bills GPhA was following with varying degrees of interest that did not make crossover are set forth below.

• HB 1000: Audits of PBMs contracted with the state (GPhA supported)
• SB 381: Dealing with stem cells (GPhA neutral)
• SB 382: Surprise billing (GPhA neutral)
• SB 418: Copying and maintaining of government photo id of people who are presenting prescriptions for Schedule IIs (GPhA opposed)
• HB 875: Patient Access to Specialty Tier Drugs Act (GPhA neutral)
• HB 1077: state-wide referendum on cultivation/sale of cannabis (GPhA neutral)
• HB 1088: adding post-traumatic stress disorder to the conditions authorized for cannabis oil (GPhA neutral)
• HB 1091: establishment of the State Commission on Narcotic Treatment Programs (GPhA neutral)
• SB 291: Affordable Free Mkt Healthcare Act (GPhA neutral)
• SB 299: GA Health Care Transparency Initiative (GPhA neutral)

Other Activity in Week 8

HB 588

HB 588 was considered by the Senate Health and Human Services Committee and passed. GPhA is supportive of this bill, although we’re in conversations regarding a few limited revisions we’d like to see. GPhA would like to thank Representative Clark, who presented the bill in committee, for taking the time to meet with GPhA to discuss it.

HB 886

HB 886 (mail order) also passed the Senate Health and Human Services Committee. House Health and Human Services Committee Chair Sharon Cooper presented the bill in committee prior to its passage. GPhA will continue to monitor this bill as it makes its way through the Senate.

HR 1576

Introduced in Week 8 by Representative Price, it would create a study committee on the pricing of prescription drugs, consisting of five members of the House. GPhA will seek to offer input to this committee should the resolution pass.