Florida Medicaid Managed Care Legislation

Florida Medicaid Managed Care Legislation:

The Medicaid Managed Care Networks legislation has been filed in both chambers of the Florida Legislature. The House version is HB 625 and is sponsored by Representative Heather Fitzenhagen. The Senate version, SB 670 was filed by Senator Aaron Bean. It is important to note that neither bill has been referred to any committees yet. Yet this is a major step toward reform of the both Florida Statutes (409.975 and 409.967) that govern the Medicaid Managed Care Networks in Florida. It signifies that actions taken by independent community retail Pharmacists can make an impact and that their “voice” and opinions can be heard and make a difference. Through such organizations as The Florida Independent Pharmacy Network and others, the slow gears of legislative change have been set into motion. If passed by both Florida Chambers, the Act shall take effect July 1, 2017.

The heart of the Act relating to the Florida Medicaid Managed Care Networks is amending  Florida Statute 409.975 in prohibiting a managed care plan from excluding a pharmacy that meets the credentialing requirements and standards established by the Agency for Health Care Administration and that accepts the terms of the plan. Additionally, the amendment requires a managed care plan to offer the same rate of reimbursement to all pharmacies in the plan network. There are other additional modifications to Florida Statute 409.975 (both additions and deletions) and we recommend that you read both in their entirety as listed above.

This is a major victory for the independent community retail Pharmacies operating in Florida. It also shows that through a united and continuous effort the system works for both the small Pharmacy business entrepreneur as well as the large national Pharmacy chain stores.

As always, please contact us here at HCC if you have any questions regarding how these changes to the Florida Statutes affect your Pharmacy business. With over 27 years in the Pharmacy Consulting business, HCC can assist with expert advice in any area of your Pharmacy business or practice. We urge you to contact us today to see how our Pharmacy Consulting services can help. With a full-time staff of in-house Pharmacy Consultant specialists, HCC can answer any questions that you may have in all Pharmacy settings. Contact us online or call us today at 800-642-1652 for a free consultation.


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Pharmacy Medication Drug Take-Back Program

Pharmacy Medication Drug Take-Back Program:

As most of us know, Drug Enforcement Administration (DEA) regulations now allow retail pharmacies, among others, to collect controlled and non-controlled pharmaceutical drugs and medications from consumers by using take-back programs. The DEA even has a great tool on it’s website that allows visitors to search for the nearest participating Pharmacy by using their zip-code:
https://apps.deadiversion.usdoj.gov/pubdispsearch/spring/main?execution=e1s1

Deaths due to drug overdoses are now the leading cause of “non-disease” deaths  in the United States according to 2015 statistics released by the DEA. This places drug overdose deaths ahead of car accidents, guns and firearms and all other “injury deaths”. It is, however, important to note that alcoholism and drug addiction are recognized as a disease by the American Medical Association since 1956, therefor eliminating the controversial topic of addiction being a “moral” issue. According to statistics (http://www.aafp.org/afp/2003/0401/p1529.html), 10% of Americans abuse drugs/alcohol and up to 20% of all patients treated by doctors have some sort of substance abuse problem (not counting caffiene or nicotine). The National Institute on Alcohol Abuse and Alcoholism (NIAAA) estimates that alcohol and drug abuse cause 100,000 deaths annually with an associated cost of over $100 billion to the US economy (https://www.niaaa.nih.gov/).

Pennsylvania State Board of Pharmacy Asks For Help
In December the Pennsylvania State Board of Pharmacy sent an email to all Registered Pharmacists in their state that is worth talking about. It was noted (again from the DEA statistics released in 2015) that over 3,500 Pennsylvanians died of drug overdoses. To fight this opioid crisis, the Board made a strong case that all healthcare professionals need to increase our efforts on informing the public on how to prevent and treat the disease of addiction. Additionally, it was duly noted that the installation of drug take-back boxes is one way Pharmacies in particular can fight against the opioid crisis.

The Problem With the Pharmacy Medication Drug Take-Back Program

As most Pharmacists see it, the problem is two-fold:
1. The participation by a Pharmacy is not mandatory in all states. Perhaps it should be, but the issue of cost is a major concern. In those states considering legislation mandating take-back programs in all pharmacies, resistance from state pharmacy organizations point out that the pharmacies should not be responsible for the program costs. One California county actually passed legislation placing the costs on the drug manufacturers. However, the pharmaceutical industry challenged the law and it was struck down by a federal court of appeals. Everyone agrees that the public needs the way to safely dispose of medications, but no-one can agree on who should pay for it. Until this issue is addressed, the number of Pharmacies participating in the program will be very limited.
2. Local police and law enforcement facilities in Pennsylvania also have medication drug take-back boxes. There are more than 500 such drug take-back boxes located in police stations around the state. It is simply more convenient for Pharmacies to direct patients to the local police and law enforcement facilities than to have to handle the return of the unwanted, unused or expired drugs themselves (and the paperwork involved).

What Pennsylvania Asked Pharmacies To Do


– Register with the DEA as an authorized collector and purchase a safe drug take-back box for your location.
– Stock and/or supply drug deactivation packets such as the Deterra Drug Deactivation System or Disposa-Script to make available to your customers.

Whatever the obstacles, the intent of the Pharmacy Medication Drug Take-Back Program is to provide a safe, convenient, and responsible way for consumers to get rid of  their unwanted, unused or expired drugs while also educating the general public about the potential for abuse of medications. It is the responsibility of all Healthcare professionals to participate as best they can in helping fight the “opioid crisis” that is hurting our nation and society.

As always, HCC is here to help you in any way that we can. Contact us online or call us today at 800-642-1652 to discuss how we can help you (or just if you’d like to talk about any idea that you may have regarding Pharmacy!). Healthcare Consultants is a nationally renowned full service Pharmacy staffing and consulting firm that has been in business for over 27 years. Owned, managed and staffed by full-time in-house Pharmacists, HCC offers a full range of Pharmacy Staffing & Placement, plus is noted for our Pharmacy Consulting Services that other firms simply cannot offer.


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2017 Pharmacy Focus, Challenges & Opportunities

Pharmacy Focus, Challenges and Opportunities in 2017:

A new year is here and Pharmacy issues, challenges and opportunities are more abundant and complex than ever before. New Pharmacy advancements and rapid changes in disease treatments, legislation, insurance issues, media attention and a more informed patient have certainly resulted in one significant fact: the roles that Pharmacists play as part of the Healthcare Team are both expanding and becoming more demanding on our skills. The result is that Pharmacists are being challenged now more than ever to be at the “center” regarding total patient care. A Pharmacist’s role is no longer focused only on their expertise regarding a patient’s medications, but as perhaps the central player in ensuring a patient’s well being. This means both increased involvement with all other Healthcare professionals, as well as increased communication with physicians, nurses, ancillary healthcare staff, caretakers, insurance companies and of course, the patient and the patient’s families.

The vitally important role that we at HCC see the Pharmacist playing now (and ever increasing in the future) is one of being both the “communicator” and the “educator”. One of the reasons this is taking place is that if you drew a diagram of all the healthcare roles and functions that are involved in ensuring great patient care, the Pharmacist is in many cases at the center. It is the Pharmacist who must ensure that there is always an accurate flow of information taking place between many of the healthcare team members, and then again it is the Pharmacist who often times is the one communicating directly with the patient and their family members. This not only relates to medications and making sure that factors such as accuracy of dosages, appropriate choice of medication for individual patients, correct administration instructions, checking for adverse drug interactions, adequate counseling and of course compliance all take place. The real focus has become education. After all, who is the real expert on drugs and medications? Once again the most recent Gallup poll shows that Pharmacists are at the top of the list for the most trusted professionals (see Gallup Poll). The public respects a Pharmacist’s knowledge, ethics, expertise and opinions. Add to this that studies have shown that patients are “more likely to be honest when talking to their Pharmacist versus their doctor”. This was related to the fact that most patients interacted with their community Pharmacist much more often than with their physicians or other healthcare providers on a “routine basis”. One example cited was a patient who had a total of 11 different physicians! Additionally, the point can be made that the specialization of physician care has led the public to view doctors as “only focusing on their piece of the overall picture” and leaves the Pharmacist as the “overseer” who manages the entire patient care. This can be especially true when settings such as clinics and large multi-staff physician practices are involved.

The point is that a Pharmacist’s role is no longer viewed as simply as being a “pill counter, placing a label on the bottle and then being a cashier”. As a profession we are now responsible for counseling patients and increased communication with an expanding number of other healthcare team members. This direction is a “must’ for each of us to undertake in order to ensure increased patient medication compliance and build the best healthcare aviabale. This means expanding our own skills and education to perform tasks that perhaps many of us never did before (Pharmacogenetic testing is a great example as discussed in one of our recent posts – Pharmacogenetic Testing in Community Pharmacies. Physicians, related healthcare practitioners, insurance providers and especially patients are demanding this of us. It is interesting to note that of the 10 “Top-Read Health-System Articles in 2016” on Pharmacy Times , over half were about patient and/or physician counseling and communication regarding specific diseases and the Pharmacists role as a “team member”.

2017 is an exciting time to be practicing Pharmacy! The opportunities for us as both individuals and as a profession are almost limitless. Plus they are increasing at a rate never seen before. It is our choice to each participate and play a major role in this “revolution” in US healthcare, or to “sit on the sidelines” as an observer. I hope we all choose wisely.

As always, HCC is here to help you in any way that we can. Contact us online or call us today at 800-642-1652 to discuss how we can help you (or just if you’d like to talk about any idea that you may have regarding Pharmacy!). Healthcare Consultants is a nationally renowned full service Pharmacy staffing and consulting firm that has been in business for over 27 years. Owned, managed and staffed by full-time in-house Pharmacists, HCC offers a full range of Pharmacy Staffing & Placement, plus is noted for our Pharmacy Consulting Services that other firms simply cannot offer.


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Emergency Room Pharmacists

Emergency Room Pharmacists in Hospitals:

Emergency Room Pharmacists on staff are a new and exciting trend in the practice of hospital pharmacy across the nation! The pharmacist’s role as an integral member of an Emergency Health Team reflects a rising consensus among national healthcare providers in hospitals and health care systems across the country that such pharmacy positions are a must. Studies are showing that the end result of having a dedicated ER pharmacist as a team member are leading to improved patient care, decreases in medication errors and an overall improvement in patient satisfaction and care. According to a 2009 study conducted at the University of New Mexico, the presence of pharmacists in the university hospital’s emergency room reduced the incidence of medication errors by 27.5 percent. Mindful of these and other similar studies, many hospitals are establishing positions for emergency room pharmacists. “I don’t think you can provide appropriate emergency care without pharmacists present”, states Dr. Meehan, who practices primarily at the University of Illinois Hospital in Chicago. “I find them to be an indispensable team member”. Although pharmacists have long provided medication consultations to ER healthcare teams, the push for dedicated pharmacist positions within the setting itself is a growing trend.

The benefits of having pharmacists in the ER  can be as individual as the care setting and as dynamic as the healthcare problem that a patient is presenting. For example, Dr. Meehan at the University of Illinois Hospital in Chicago values many of the contributions of his ER pharmacist, including:

  • Quickly performing accurate dose calculations and expediting delivery of essential drugs from the central pharmacy during the treatment of stroke or cardiac arrest patients who may need thrombolytic therapy
  • The ability to prepare medication doses quickly and accurately during code situation
  • The fact that for polypharmacy patients, pharmacists are naturally on heightened alert for the threat of dangerous drug interactions as well as complementary drug combinations. “Those considerations aren’t at the forefront for physicians, but pharmacists are intimately aware of them and able to intervene when necessary,” said Dr. Meehan.

The expansion of ER pharmacy services is just beginning, added Dr. Musselman (who works with the North Kansas City Hospital ER team)  “It’s becoming a necessity, and we’ll see the trend accelerate. Accrediting bodies will start asking why a hospital doesn’t have ER pharmacists rather than why they do.”

If you represent a hospital or healthcare system that is considering establishing an in-house Emergency Room Pharmacist position, Healthcare Consultants can help. In the business of Pharmacy Staffing and Pharmacy Consulting for over 25 years now, HCC has been the nation’s leader in the following areas:

  • Developing policies and procedures for implementing and maintaining ER Pharmacy positions and duties
  • Developing ER Pharmacist job descriptions
  • Onsite training and startup of Hospital ER Pharmacies
  • Pharmacist Staffing (both permanent and part-time positions)

We offer you the support of an experienced staff who have been through the process many times and know the business inside and out! Call us today at 800-642-1652 for a free consultation.

Bob Miller
9/5/2014


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