August/September 2018 Inside: 7 BIG PROTECTIONS FOR GEORGIA PHARMACISTS FAREWELL TO RUTH ANN
Check it out! Expanded convention coverage inside C
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15 OUR NASHVILLE SENSATION You won’t want to miss this expanded photo coverage of the 2018 Georgia Pharmacy Convention in Nashville!
3 26 prescript contact us Rockin’ Nashville Who does what at GPhA — CEO Bob Coleman looks back at and how to reach us the Nashville convention — and what members had to say about it. 27 postscript 4 You asked quick hits Incoming president Tim Short What’s happening in the 28 tackles your questions and Georgia pharmacy world concerns We bid adieu to Ruth Ann, 24 plus meth makes a comeback 8 12 in Georgia, ACA marketplace shout outs GPhA by the chances, and much more New members, plus the latest numbers entries into GPhA’s 100% Club What we saw in our 2018 and President’s Circle member satisfaction survey
10 20 legal injection PharmPAC 28 A reference for your rights Investors in the future of 28 Why Georgia pharmacists pharmacy in Georgia the back page enjoy some of the country’s The lighter side of pharmacy 4 best legal protections 3 and healthcare news
SUBSCRIPTIONS Georgia Pharmacy is distributed as a regular membership service, paid for with membership Georgia Pharmacy magazine Chief Executive Officer Editor dues. Single issues are $10 per issue domestic and $20 international. Practicing Georgia pharmacists is the official publication of the Bob Coleman Andrew Kantor who are not members of GPhA are not eligible for Georgia Pharmacy Association. Director of Communication President and Chair of the Board subscriptions. [email protected] Tim Short Unless otherwise noted, the entire Art Director POSTAL contents of this publication is licensed President-Elect Carole Erger-Fass Georgia Pharmacy (ISSN 1075-6965) is published under a Creative Commons Attribution- Chris Thurmond bi-monthly by GPhA, 6065 Barfield Road NE, Suite NonCommercial-ShareAlike 4.0 International 100 Sandy Springs, GA, 30328. Periodicals postage Immediate Past President license. Direct any questions to the editor at paid at Atlanta, GA and at additional mailing offices. Liza Chapman ADVERTISING POSTMASTER: Send address changes to Georgia [email protected]. All advertising inquiries should be directed to Pharmacy magazine, 6065 Barfield Road NE, Suite Dianne Jones at [email protected] or 100, Sandy Springs, GA 30328. (404) 419-8129. Media kit and rates available upon request.
August/September 2018 Georgia Pharmacy 1 We all know the challenges — but we also see opportunity Health Mart believes in the bright future of independent pharmacy, and we’d like you to be a part of it with us.
With Health Mart® you can count on: • The power and savings of the largest independent pharmacy network • Flexible programs and services that Ready to hear grow your business more? Let’s talk. • Access to the tools that can improve Call 855.458.4678 or visit your pharmacy’s performance join.healthmart.com and profitability
Health Mart is proud to be a member of the McKesson family, sharing in the collective industry knowledge and experience residing within all of the McKesson corporate affiliates. Since 1833, McKesson has been committed to the success of independent pharmacies through the delivery of innovative programs and reliable distribution services. Learn more at mckesson.com. ©2018 Health Mart Systems, Inc. All rights reserved. HM-224545-06-18 PRESCRIPT
From the CEO By the numbers, convention edition
In my last Prescript, I said I On to membership would provide some of the We’re happy to report that as of June, total results of our latest Member active membership has grown 5.8 percent over Satisfaction Survey and mem- the same period last year. And total members bership information. I promise (includes affiliates, academicians, technicians, I’ll get to that, but before I do, and students) has grown more than 12.4 percent. I just wanted to thank ev- In fact, GPhA is up over last year in every mem- eryone who came to the 2018 ber category, with the lone exception of three BOB COLEMAN Georgia Pharmacy Convention affiliate members! in Nashville. What a great con- Comparing the results of the 2015 member vention, great members, and a GREAT TIME! survey to the 2018 survey results, we find that Over and over again members expressed some things remain the same, or very close — what a fantastic location Nashville was and how like the type of pharmacy organizations GPhA impressed they were with the Omni Nashville members work for. Hotel. I even had several tell me that they had In 2015, 37 percent of the members reported We all know the challenges — considered not attending because of the location working for independent pharmacies versus (translation: “It wasn’t the beach!”), but how hap- 39 percent in 2018; 25 percent reported working py they were they made the decision to come. for retail chains in 2015 versus 22 percent in but we also see opportunity Keynote speakers Brad Montgomery, Randy 2018. (Hospitals and health-system employees McDonough, and Brian Crabtree delivered pow- remained about the same.) Health Mart believes in the bright future of erful presentations whose real-world message Overall member satisfaction with GPhA mem- resonated with the audience. About 1,200 hours bership remains very high: 89 percent, which independent pharmacy, and we’d like you of CPE credits were registered, with members ex- appears to be an improvement over the results to be a part of it with us. pressing their appreciation for the quality, topics, in 2015 when 80 percent of the membership and presenters of the courses offered. responded their GPhA membership was of high And attendees rated the Expo Hall the second value to them. highest event, with vendors manning 67 booths In what some researchers consider the most and aisles packed with attendees. important measure of an association’s success or Yes, I also heard about the food. There was too failure, the net promoter score, i.e., the likelihood With Health Mart® you can count on: much, and it was too good. Sorry, you’re going to that a member would recommend membership have to take some personal responsibility and to a non-member, 91 percent of GPhA members • The power and savings of the largest lose those pounds you gained yourself! would recommend GPhA membership, with 69 independent pharmacy network Finally, the President’s Bash! The Downtown percent of those strongly recommending it. Ready to hear Band rocked it like never before. Members GPhA remains strong financially and in mem- • Flexible programs and services that commented, “That’s the best band we’ve ever had, bership numbers thanks to you. Programs like grow your business more? Let’s talk. and I’ve been coming to this event for decades!” the President’s Circle and the 100 Percent Club Call 855.458.4678 or visit and “The Downtown Band was incredible” on the are excellent ways to bring in new members. • Access to the tools that can improve convention survey. Again, our congratulations to Joe Ed Holt, the your pharmacy’s performance join.healthmart.com I also express my personal thanks to the GPhA charter member of the President’s Gold Circle!
Georgia Pharmacy and profitability staff. They tirelessly work to make sure members As always, if there is anything you think weASSOCIATION have a great time at convention and all survey should be doing or things we could be doing BLACK & WHITE OPEN
results so far say they exceeded your expecta- better, please don’t hesitate to let us know.GLOSS/GRADIENT FLAT COLOR tions once again! 1 We hope you notice and enjoy the expanded Bob Coleman is chief executive officer of the Health Mart is proud to be a member of the McKesson family, sharing in the collective industry convention coverage in this issue as well. Georgia Pharmacy Association. knowledge and experience residing within all of the McKesson corporate affiliates. Since 1833, McKesson has been committed to the success of independent pharmacies through the delivery of innovative programs and reliable distribution services. Learn more at mckesson.com. August/September 2018 Georgia Pharmacy 3 ©2018 Health Mart Systems, Inc. All rights reserved. HM-224545-06-18 QUICK HITS
DONT MISS IMMUNIZE GEORGIA THIS A farewell to Ruth Ann SEPTEMBER She’s been a much-loved fixture of heck of a dancer. Registration is opening soon Georgia’s pharmacy community for Ruth Ann’s first order of busi- for the 2018 Immunize Georgia more than 27 years, but now GPhA’s ness upon retirement is to take a Conference. It’s being held at the Ruth Ann McGehee is retiring. long-awaited trip to France. And so Columbus Convention and Trade Ruth Ann has served GPhA we wish her a bittersweet bon voy- Center on Friday, September through 27 presidents and five age ... and many happy years ahead. 14, and as always will cover the CEOs (or EVPs as they latest recommendations and were once known). best practices in immunization She has been an or- services. Get more info at ganizer, liaison, calming immunizegeorgia.com. voice, detailed plan- ner, office expert, cat herder, voice of reason, GEORGIA spark of life — and AND METH worn many other hats over the years, always The Georgia Bureau of Inves- with grace, humor, and Left: The Georgia House of Representatives passed a resolution tigation says meth-related professionalism. Her honoring Ruth Ann; she was presented with a copy by Representative deaths in Georgia saw a spike communication skills Buddy Harden. Right: On June 23, a surprised and tearful Ruth Ann last year (from 243 in 2016 are without par — ask was presented with the Larry L. Braden Meritorious Service Award — to 343 in 2017.) The reason? the highest honor bestowed by the Georgia Pharmacy Association. It anyone who’s had the is given to those those people who have, over their careers rendered Price. Demand has pushed up pleasure of speaking similar invaluable service to GPhA and has made extraordinary the price of heroin, so Mexican with her. And she’s a contributions to the practice of pharmacy in our state. meth is a lot cheaper. In fact, for the seventh straight year meth won the ti- tle of Most Confiscated Drug in Georgia the GBI said. Cocaine TWO DRUG COMPANIES SUE PRISONERS takes the #2 spot, followed by Xanax, oxycodone, heroin, and Endo International and Mallinckrodt claim that — contrary to what a hydrocodone. group of Tennessee counties and towns has said— it’s not the drug com- And where are opioids hot? panies that are responsible for the opioid crisis, but illegal drug dealers. According to the GBI’s figures, They’re putting their lawyers where their mouths are and suing several Cobb County tops the list with convicted drug dealers (e.g., a man serving 10 years for possessing fen- the most samples confiscated, tanyl with an intent to distribute) as well as Internet sites they say are followed by Gwinnett, Fulton, illegally offering opioids. DeKalb, and Chatham.
4 Georgia Pharmacy August/September 2018 REMINDER: ITS RENEWAL TIME
It’s time to renew your GPhA mem- Pharmacy Convention, and bership! You should have received events throughout the year your renewal notice by e-mail and • Live classes, certifications, and THE ACA in your (paper) mailbox as well. training Your renewed membership • The latest state and national MARKETPLACE helps GPhA continue to do our news affecting pharmacy and important work for all Georgia’s medicine 2019 premium changes pharmacists. So please be sure to • Professional insurance and pay- (Georgia edition) renew soon if you havent already roll services, including liability Georgia’s health insurance — just go to GPhA.org/renew and coverage (for individuals), group companies are asking for do it right now! health (for pharmacy owners), rate hikes of two to about 15 While we continue our legisla- HR services, and more percent for their exchange tive efforts on your behalf, we also policies — much less than the hope you’re taking advantage of Important: Save time in the future 50+ percent increases of 2018. your other member benefits. by opting for annual auto renewal The good news is that these so you dont have to think about it increases won’t have much ef- • A large and growing library of every year. And don’t forget to sup- fect on consumers, because the on-demand CPE courses on cur- port PharmPAC; that investment ACA caps the amount they’re rent topics like opioids, diabetes, helps us elect legislators who un- required to pay for coverage. and pharmacy management derstand and appreciate the value (especially important in a dues- of pharmacists across the state. It looks like more insur- renewal year) ers will be entering the • Great networking opportunities: Please renew by August 31 to avoid marketplace region meetings, the Georgia cancellation of your membership. A preliminary look at the over- all ACA marketplace for 2019 has some good news: We’re on track to add more insurance Georgia leads with patient protection carriers. (In 2018 a lot of car- riers exited the marketplaces.) Something like 26 states have taken And Georgia goes even further That’s based on preliminary Georgia’s lead and enacted laws simi- — we not only prohibit copay rate filings in 12 states and the lar to what we did in 2017 — laws that clawbacks, gag clauses, and District of Columbia. protect patients from PBM abuses. For adjudication fees, we also ban example: recoupment outside of the audit read more process, delivery, and retaliation. @gphabuzz • Arizona, Arkansas, Colorado, Florida, For more about this, check out Indiana, Kansas, Kentucky, Louisiana, Greg Reybolds “Legal Injection” Maryland, Minnesota, Mississippi, New on page 10. York, South Carolina, South Dakota, Utah, Virginia, and West Virginia passed legislation allowing a pharmacist to pro- vide patients with info about alternative For those tasked with navigating medications and/or alternative pur- the complexities of healthcare, chasing options that can save patients Cardinal Health brings scaled solutions that help our customers money. thrive in a changing world. • Arizona, Colorado, Florida, Indiana, For more information, visit Kansas, Kentucky, Louisiana, Maryland, cardinalhealth.com New York, South Carolina, Utah, and Virginia passed legislation prohibiting © 2017 Cardinal Health. All Rights Reserved. CARDINAL HEALTH, the Cardinal Health LOGO fees related to claim adjudication un- and ESSENTIAL TO CARE are trademarks of Cardinal Health and may be registered in the US and/or less certain conditions are met. in other countries. Lit. No. 1RI17-721139 (10/2017)
August/September 2018 Georgia Pharmacy 5 1RI17-721139 Georgia Pharmacy Sponsorship Ad_FINAL.indd 1 10/6/17 4:17 PM DRUG SHORTAGES QUICK HITS Worldwide supply of antibiotics is in trouble
The Amsterdam-based Access to to receive newer and stronger drugs. ASPIRIN: ONE Medicine Foundation published a This issue of excess now has the LOW DOSE white paper in which it explained political attention it so desperately DOESNT FIT ALL that there is little investment in the deserves, the group wrote, but there supply chain for antibiotics because is less attention being paid to another You know that a daily low-dose of the low profit they generate for vital component, namely access. aspirin is supposed to help drug companies. That means the This comes on the heels of a study prevent cardiovascular disease. supply is patchy, complex, and at in Nature Climate Change that found But a new study in the Lancet risk of collapsing, which adds to the Patients in warmer climates face finds that the typical 81mg dose danger of resistant bacteria and higher risk of drug-resistant infec- is not effective for 80 percent of superbugs. tions.” As the co-author explained, patients over 154 lbs. The irony, the group points out, Places in the South tend to show People who weigh more is that while the issue of antibiotic more [drug] resistance than places than about 154 pounds saw no overuse has received a lot of at- in the North, and a good chunk of benefit to the 81-mg. dose, but tention, the rise of drug-resistant that variability can be explained by higher doses (say, 325 mg) are bacteria means more people will need temperature. effective for heavier patients. Thinner folks can and should continue that low-dose regimen. Drug shortage is “serious concern”
Besides the issue of antibiotic access, the U.S. is facing more traditional shortages — significant in some cases — of at least 100 drugs, the FDA acknowledged. According to the agency’s deputy commissioner, “It’s a serious concern not just in routine, everyday clinical care, but also in the context of a shortage of life-saving Representing pharmacists products at a time of a public health and pharmacies before the emergency.” Georgia Pharmacy Board, That’s not a surprise to the Amer- GDNA and DEA. ican Medical Association, which AREAS OF PRACTICE issued a formal declaration that the shortage of some critical drugs in the Professional Licensing U.S. is both a public health crisis and Medicare and Medicaid a national security issue. Fraud and Reimbursement For example, due to some seri- Criminal Defense ous problems at a Pfizer factory in Administrative Law Kansas — a factory that makes 60 Healthcare Law percent of the country’s injectable opioids — a whopping 98 percent Legal Advice for Licensed of hospitals now report ‘moderate Professionals or severe’ shortages of morphine, fentanyl, and hydromorphone, as WWW.FRANCULLEN.COM well as locally injected anesthesia, (404) 806-6771 • [email protected] according to the American Society of Health-System Pharmacists.
6 Georgia Pharmacy August/September 2018 Committed to providing you the Workers’ Compensation Coverage You Deserve!
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Contact Dianne Jones at GPhA today to get started.
Dianne Jones | Georgia Pharmacy Association | P (404) 419-8129 F (404) 237-8435
Edition Date: 07/2018 Georgia Pharmacy SHOUT-OUTSASSOCIATION
UGA APPLAUDS TWO NT S E D R
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P Congrats to GPhA pharma- 8 cist members Ben Ross of 1 Statesboro and Rhondo- These are the newest members lyn Smith of Winterville GP.Logos.Final.indd 1 3/21/18 1:02 PM of the GPhA’s President’s Circle — — they were named as GPhA members who recruit their two of UGA’s “40 Under fellow pharmacists, technicians, 40” for 2018. W00t! academics, and others to become part of the association. Recruit a member and join! Gold Level: Joe Ed Holt, Valdosta NEW MEMBERS Silver Level: PHARMACISTS Corine Ferebee; Fairburn Catherine Akin; Atlanta (AEP) Michael Ferguson; Valdosta Ashley London, Evans Monica Arbogast; Niceville, Fla. Dana Flores; Madison, Ala. (ACHP) Mike Forehand, Vienna Kiah Baker; Bossier City, La. (AEP) David Freeman; Savannah Pedro Valentin, Columbus Ajay Banga; Atlanta Haylee Gamblin; Evans (AEP) Rob Dykes, Cochran Candace Barnett; Atlanta Emad Gharavi; Monroe (AEP) William Hussey, Eastman Kimberly Barwick; Dexter (AEP) Sheena Ghorbani; Cumming (AEP) Jessica Bearden; Albany (ACHP) Mounika Godavarthi; Cumming Leonard Bennett; Jacksonville, Fla. Brian Gosa; Selma, Ala. La-Kasia Best; Ocala, Fla. Lakisha Hamilton; Marietta Jessica Blackburn; Auburn, Ala. Hayley Hardin; Kathleen Brittany Blain; Bonaire (AEP) Robin Helmstadter; Dacula (AEP) Club Camron Boyd; Pooler (AEP) Stephen Henken; Montgomery, Ala. Georgia Pharmacy Georgia PharmacyASSOCIATION Pamela Boyd; Pooler (AEP) (ACHP) ASSOCIATION Brandon Brooks; Marietta Donna Higdon; Lafayette (ACHP) These are the newest members Jordan Brown; Odum Charity Holt; Douglas (AIP) GP.Logos.Final.indd 5 3/21/18 1:02 PM of GPhA’s 100% Club — Georgia Harry Burg; Newnan (AEP) Leslie Hornsby; Iron City pharmacies where 100 percent of Craig Burks; Smyrna (AIP) Brittany Horton; Daphne, Ala. employees are GPhA members. Matthew Burnette; Dublin (AEP) Jessica Horton; Ooltewah, Tenn. Find out more at Jennifer Campbell; Alabaster, Ala. Jihan Howard; Atlanta GPhA.org/100percent. John Mark Carter; Savannah (AEP) Ramonda Howard; Conyers Rebecca Cash; Columbus, MS (AEP) Amitie Hussey; Eastman (AEP) John Chafin; Jonesboro (AIP) Sara Ivanov; Atlanta Barnes Pharmacy, Baxley 1 Stephanie Chang; Alpharetta Amreen Jivani; Lawrenceville Owner: Mark Barnes 1 Ryan Chavers; Kennesaw Kimberly Kaminski; Cornelia (AIP) Blake Cheek; Cumming (AEP) Maggie Kavanaugh; Bloomington, Ind. Dublin Drug Company, Dublin Mark Cifelli; Jacksonville, Fla. Tammi Knight; Reynolds (AIP) Owner: Trent McDaniel Brian Clark; Chapin, S.C. (AIP) Mary Kunyiha-Shelton; Bowdon Lynn Clavo; Atlanta (ACHP) Shayroz Ladhani; Mareitta Pineview Pharmacy, Pineview Quwanna Clemons; Atlanta Margaret Leech; Newnan (AEP) Owner: Forehand Robert Mike Anna Coggins; Valdosta (AEP) Austin Lively; Newnan (AEP) Marshall Curtis; Augusta (AIP) Suleena Mahajan; Sterling Heights, Mich. Senoia Drug, Senoia Hardave Deol; Fresno, Calif. (ACHP) Monica Masters; Covington Owner: Chad Daniels Frederique Dunham; Valdosta (AEP) Rashada McGhee; Perry Anat Eshed; Alpharetta Julie McLeod; Valdosta (AEP)
8 Georgia Pharmacy August/September 2018 Laura Miller; Dublin Regina Bonner; Colbert Juli Moore; Griffin Marla Mitcham; Augusta (AEP) Brandy Carr; Tifton Lauren O’Neal; Williamson Corinne Mueller; Fairborn, Ohio Brenda Clark; Pineview Lisa Perkins; Griffin Lan Namgoong; Marietta Holly Collins; Pineview Nikki Pike; Griffin Hali O’Malley; North Salt Lake, Utah (AEP) Kimberly Cornelius; Doerun Kristin Pitts; Reynolds John Ostrander; Woodstock (AEP) Desiree Cross; Stone Mountain Dianne Posey; Moultrie Abigail Otumi; Midland, Tex. Chad Daniel; Hapeville Rhonda Priest; Cordele Michelle Pennington; Evans Brittany Disharoon; Axson Keri Radney; Dudley David Pope; Evans (ACHP) Melissa Ann Ellington; Jackson Jennifer Roberson; Moultrie Ronnie Rael; Gallup, N.M. Miiah Eubanks; Reynolds Katy Roberts; Milner Elizabeth Reynolds; Opelika, Ala. (AEP) Kissa Floyd; Phenix City, Ala. Lyntrell Robinson; Dublin David Schoenbaechler; Louisville, Ky. Kayla Foster; Griffin Marcelle Robinson-King; Cadwell Karl Simon; Sugar Hill Mathew Fowler; Cochran Cathy Sheffield; Locust Grove Natalie Smith; Dayton, Ohio (AEP) Brenda Frasier; Tifton Jack Shepherd; Dublin Cortlan Smith; Snellville Abigail Gentry; Douglas Pam Sightler; Macon Shawn Spencer; Suwanee (AEP) Andrew Green; Auburn, Ala. Kenneth Smith; Kathleen Joseph Thomas; Dunwoody (ACHP) Tammy Griffin; Commerce Tina Smith; Senoia Dominic Torchia; Power Springs Shannon Hester; Tifton Lauren Smithline; Athens Matthew Turner; San Antonio, Tex. Xavier Hill; Atlanta Martina Snead; Lenox Nina Weidle; Atlanta (AEP) Harold Hodgson; Bishop Amy Tinsley; Warner Robbns John White; Dalton Nancy Holcomb; Sugaqr Valley Cardizia Turner; Tifton Ericka Wilkins; Bellport, N.Y. Jimmy Huckaby; Griffin Sarah Turner; Perry Erica Womble; Newnan (AEP) Jennifer James; Griffin Brittany Webb; Donalsonville Melissa Wood; Cummings (AEP) Melissa Jewell; Douglas Cora Williams; Adrian Shari Woods; Atlanta (AEP) Shonda Jordan; Douglas LaTerrell Williams; Newnan Matthew Wrigley; Villa Rica Amanda Langley; Senoia Ashley Williams; Senoia Karen Wyman; Williston, Vt. Monik Lawson; Dublin April Worley; Griffin Tsion Yohannes; Buford Breanna Lowery; Dublin Victoria Young; Griffin Shauntrice Loyd; Dublin Katherine Zellner; Culloden TECHNICIANS Carley Loyd; Tennille Matthew Beck; Decatur Kristin Marvin; Atlanta AFFILIATE Ariel Bennett; Griffin Deborah Mathews; Griffin Bobby Melnick; Allied Pharmacy Exchange
For details, registration, and more info visit calendar GPhA.org/calendar.
All CPEasy courses are APhA’s Pharmacy-Based Pharmacy Abbreviations and Basic Training: 30 Medications conducted by webinar Immunization Delivery: Calculations for Technicians and Classifications Pharmacy from the comfort of your A Certificate Program for (CPEasy) Technicians Need to Know Pharmacists October 4; 7:30 – 9:00 p.m. (CPEasy) home, office, or wherever August 12; 8:00 a.m. – 5:00 p.m. 1.5 Hours CE October 18; 7:30 – 9:00 p.m. you have an Internet Georgia Pharmacy Association HQ, Free to all 1.5 Hours CPE connection. Visit GPhA. Sandy Springs 2018 NCPA Annual Convention 2018 AIP Fall Meeting org/cpeasy for more The Dreaded OSHA Update Saturday, October 6, 1:00 AM Sunday, October 21, 8:00 AM information. (CPEasy) Laws and Regulations in Georgia: APhA’s Pharmacy-Based August 14; 7:30 – 8:30 p.m. What Pharmacy Technicians Immunization Delivery: Visit GPhA.org/education August 23; 7:30 – 8:30 p.m. for all our education Must Know (CPEasy) A Certificate Program for September 6; 7:30 – 8:30 p.m. October 11; 7:30 – 9:00 p.m. Pharmacists offerings. 1 Hour CE 1.5 Hours CE December 2; 8:00 a.m. – 5:00 p.m. 2018 New Laws Update (CPEasy) Georgia Pharmacy Association HQ, September 13; 7:30 – 9:00 p.m. Sandy Springs 1.5 Hours CE
All CPEasy courses are given live via our free Learning Express software; you just need a computer and and Internet connection (headphones recommended; a microphone if you want to ask questions of the instructors). Visit GPhA.org/cpeasy for more info.
August/September 2018 Georgia Pharmacy 9 LEGAL INJECTION
A reference for your rights
Greg Reybold, GPhA‘s vice president of public policy u Recoupment of funds can occur only after the and association counsel, offers his perspective on issues final internal disposition of audit. specific to pharmacy. As a reminder, nothing in this Pharmacies can complain to the commissioner of column constitutes legal advice. If you have a legal issue insurance, who has enforcement authority. or question, consult your own attorney. MAC PRICING Georgia’s MAC law can be found at O.C.G.A. 33-64-9 Nationally, 2018 has been and requires, amongst other things, the following: an exciting year for PBM u PBMs must identify the sources used to deter- legislation and the federal mine multi-source generic drug pricing; level (in large part thanks to u PBMs must update MAC pricing at least every Georgia’s own congressmen five business days; Buddy Carter and Doug u PBMs must reimburse pharmacies based upon Collins — along with our that updated pricing; friends at the National Com- u There are restrictions on what drugs can be GREG REYBOLD munity Pharmacy Associa- placed on a MAC list; tion) and at the state level. u PBMs must have a MAC-appeal process; Surprisingly, despite several years of legislative u Pharmacies have right to appeal a MAC reim- success, I’ve had numerous pharmacists inquire about bursement within 14 calendar days following gaining protections in Georgia that exist already. reimbursement of the initial claim; Indeed, I am happy to report that Georgia has u Pharmacy appeals must be upheld if the drug was some of the most robust PBM legislation in the na- not reimbursed based on updated pricing or if the tion and that much of what has been accomplished drug should not have been placed on MAC list; in other states this year is based on what Georgia u If the appeal to the PBM is successful, the price has already done. must be adjusted the next day and the pharmacy So here is a refresher for Georgia pharmacists on must be allowed to reverse and rebill the claim the breadth of protections that they enjoy in Geor- giving rise to that appeal; gia. (And no, this is not an all-encompassing list!) u If the appeal is unsuccessful, the PBM must pro- vide reason(s) and the NDC of a drug that can be AUDITS purchased at or below reimbursement. Georgia’s Pharmacy Audit Bill of Rights can be Pharmacies can complain of any violations to the found at O.C.G.A. 26-4-118 (see the box on the oppo- commissioner of insurance, who has enforcement site page). It provides, amongst other provisions, authority. the following: u PBMs must provide 14-day notice on initial on- PHARMACY PATIENT PROTECTION site audits; Georgia’s pharmacy patient protections can be u Pharmacies have 30 days following receipt of found at O.C.G.A. 33-64-11. They prohibit PBMs from: audit report to appeal u Restricting pharmacies from providing patients in- u Pharmacies have right to correct clerical errors; formation regarding less-costly prescription drugs; u PBMs are Prohibited from recouping for cor- u Restricting pharmacies from offering delivery rected clerical errors where no overpayment services to their patients; occurred; u Charging patients copays that are higher than the u Recoupments for clerical errors where overpay- cost of the drug (copay clawbacks); ment occurred are limited to only the amount u Charging pharmacies adjudication (transaction) that was overpayed; fees related to claim processing; u The audit period is limited to two years from date u Recouping money from a pharmacy outside the claim was submitted; audit process;
10 Georgia Pharmacy August/September 2018 DO YOU HAVE AN ISSUE YOU’D LIKE TO SEE ADDRESSED IN THIS COLUMN? LET US KNOW — SUBMIT IT TO GREG AT [email protected].
u Penalizing or retaliating against a pharmacy for and requiring plan sponsors to: seeking to enforce its rights under the law. u Annually report all pharmacy claims; and Pharmacies can complain of any violations to the u Itemize all administrative fees, rebates, or process- commissioner of insurance, who has enforcement ing charges associated with each claim. authority. DCH will provide a report on these claims utilizing aggregated data to the chairs of the House and MANDATORY MAIL ORDER Senate Appropriation Committees. Georgia’s AMMO law can be found at O.C.G.A. 33- 64-10 and prohibits PBMs from: [BOX] O.C.G.A? u Imposing mandatory mail order for group, blan- Notations such as “O.C.G.A. 33-24-59.21” refer to the ket, and individual accident and sickness policies, Officical Code of the State of Georgia’s title, chapter or violating O.C.G.A. 33-30-4.3 which contains ad- and section, e.g., Title 33, Chapter 24, Section 59.21.
Georgia Pharmacy ditional restrictions. (Large swaths of the market You can look upASSOCIATION the exact wording of the are not impacted.) law on sites such as Justia; our shortcut is BLACK & WHITE OPEN
Pharmacies can complain of any violations to the GPhA.org/ocgaGLOSS/GRADIENT . FLAT COLOR commissioner of insurance, who has enforcement 1 authority. Use of this article, or the information it contains, does not con- stitute any legal advice, does NOT establish any attorney-client MEDICATION SYNCHRONIZATION relationship, and does NOT create any legal duty on the part of Georgia’s med sync law can be found at O.C.G.A. the author or the Georgia Pharmacy Association. When making 33-24-59.21 and provides, amongst other things, the a decision that may have legal consequences, readers should following: consult with qualified legal counsel. u Prescription drug programs must apply a prorated daily cost sharing rate to rescriptions dispensed for fewer than 30 days if the prescriber or pharmacist indicates a fill or refill could be in best interest of a patient, or for purpose of synchronizing medication; u It prohibits plans from denying coverage for filling prescriptions to synchronize refilling of multiple prescriptions in ac- cordance with patient, practitioner, and pharmacist; and u It prohibits plans from prorating dis- pensing fees for partial fills in connec- SOME THINGS WORK tion with med sync. Pharmacies must be REALLY WELL TOGETHER. paid full dispensing fees. Mike Tarrant, CFP® proudly announces PBM REGISTRATION his recogniion as a GPhA Corporate Sponsor PBMs are required to be licensed by the Mike has extensive experience working with commissioner of insurance and are subject pharmacists and pharmacy owners, to oversight by the commissioner, who offering a ‘no generics’ approach has enforcement authority for any PBM to financial planning. violation of the law. Learn more at www.financialplanningrx.com
PBM TRANSPARENCY Georgia’s 2018/2019 budget includes a direc- tive to DCH to collect information related Integrated Financial Group | 200 Ashford Center North, Suite 400 | Atlanta, GA 30338 Securiies offered through LPL Financial, member FINRA/SIPC. Advisory Services to pharmacy claims from state health ben- offered through IFG Advisory, LLC, a registered investment advisor. Integrated Financial Group and IFG Advisory, LLC, are separate ennnes from LPL Financial. efit plan and managed-care organizations
August/September 2018 Georgia Pharmacy 11 MEMBER SURVEY GPhA by the numbers
Every year GPhA does a litmus test — we poll mem- stand what members are looking for and how well bers about various aspects of the work we do. We we’re providing it. want to be sure we’re focusing on what’s important, Finally, we ask for members’ personal feedback and we want members’ feedback. — a chance to write about the specific issues they’re Some of those questions are broad and general, concerned about, and to give more detailed explana- and some focus on specifics of our four pillars: tions and perspectives. advocacy, engagement, education, and information. Here’s a selection of the responses from this year’s After collecting the responses, the GPhA Board of survey, including some of the comments that stood Directors and staff review the answers to under- out to us as we reviewed them.
AGREE OR STRONGLY AGREE NEUTRAL DISAGREE
Overall, I am satisfied with I view GPhA as the leading organization advocating for legislative my GPhA membership. and regulatory matters aecting Georgia pharmacists.