Recently, a group of national pharmacy associations, chain drug stores, and other interested stakeholders announced the launch of a new coalition, the Patient Access to Pharmacists’ Care Coalition (PAPCC), to develop and enact legislation that would grant pharmacists provider status under Medicare Part B.

ACCP published a Washington Report outlining the College’s perspectives regarding the coalition’s efforts and addressing questions raised by ACCP members regarding the College’s absence from this newly established group. Click here to read the Washington Report.

ACCP Medicare Coverage Initiative – PRN Update

Since the formal launch of ACCP’s Medicare Part B Comprehensive Medication Management Coverage Initiative in December 2012, ACCP’s Washington office has made a concerted effort to improve its collaboration with the College’s PRNs to advance our advocacy agenda.

The response from the PRNs has been impressive. PRN chapter officers and leaders have led efforts to raise funds from PRN members for ACCP’s Political Action Committee (PAC) and have used PRN meetings and communications to stimulate discussion and interest in our Medicare Initiative.

As we move forward with our efforts to introduce legislation on Capitol Hill, the leadership of our PRNs is even more important. PRN members collectively possess a depth of clinical knowledge and expertise that contribute directly to ACCP’s success. There are no better advocates for this effort than the clinical leaders who deliver these services to patients across the country.

We appreciate the PRNs’ enthusiasm and leadership in helping to advance our advocacy efforts, and we look forward to a busy 2014.

Medicare Initiative Resources

ACCP recently released some important resources and updates related to the Medicare Initiative. PRN members are especially encouraged to review these documents.

Medicare Initiative One-Page Summary: This document provides a concise summary of the Medicare Initiative, with talking points on why “getting the medications right” is an essential objective for a modernized, cost-effective, and quality-focused Medicare program.

Medicare Initiative Update. Part B Comprehensive Medication Management Coverage vs. “Provider Status”: Examining the Difference: This document thoroughly examines why ACCP is seeking to establish a new Medicare Part B benefit for comprehensive medication management (CMM) services delivered by qualified clinical pharmacists, rather than “provider status” for pharmacists. The document explains why simply adding pharmacists to the list of eligible Part B providers will not guarantee that Medicare will pay pharmacists for their services. It highlights examples at the state level in California as well as initiatives at the federal level that show the importance of securing a Medicare benefit that covers services, not providers.

Medicare Initiative Update: 2013 Review: One year after the launch of our Medicare Initiative, this document reviews the progress we have made and the lessons we have learned. These can be summarized as follows:

• The policy of our proposal is fundamentally solid. In a hyper-partisan Congress, Republicans and Democrats agree that a CMM benefit delivered by qualified clinical pharmacists would enhance the quality of care available to seniors and improve overall health outcomes.
• The cost of our proposal remains a major challenge. In a difficult budgetary environment and amid the ongoing debate over sequestration, the challenge of gaining support for an initiative that will be an upfront cost to the Medicare program money is considerable.
• Support from other health professions is critical. Because our Medicare Initiative calls for CMM services delivered by qualified clinical pharmacists working as formal members of the patient’s health care team under collaborative practice agreements, lawmakers may reasonably expect that other members of the health care team will support our initiative. ACCP has been resolute in its outreach to other health care professions and stakeholders, particularly the physician community.
• Delivery of care must be compatible with evolving delivery and payment models. Health policy discussions on Capitol Hill are dominated by the issue of reforming Medicare payment policies and moving away from the fee-for-service model that rewards volume over outcomes and quality. As a result, a new Medicare benefit, such as ACCP’s Medicare Initiative, must be compatible with evolving payment models already being tested, such as accountable care organizations (ACOs) and patient-centered medical homes.
• Our success will require the participation of all ACCP members. No legislative initiative can move forward purely on the strength of its own merits – grassroots advocacy and financial contributions are key to showing support for an initiative from districts and states well beyond the Beltway. ACCP calls on every member of the College to participate in our grassroots program and support our PAC.

For complete information on ACCP’s advocacy effort, visit our Medicare Coverage Initiative page at www.accp.com/govt/medicare.aspx.

To find out how you can get more involved in our grassroots effort, visit our Legislative Action Center at capwiz.com/accp/home/.

ACCP Comments on the CMS Contract Year 2015 Proposed Rule

On January 10, 2014, the Centers for Medicare & Medicaid Services (CMS) issued proposed recommendations for the Medicare program titled “Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs” and requested that interested stakeholders submit comments on the regulatory changes.

ACCP responded, applauding the agency for its efforts to expand beneficiary access to the Part D medication therapy management (MTM) program. However, ACCP expressed concern that Part D MTM – as currently structured – delivered primarily through prescription drug plans and detached from the patient’s health care team and medical records, fails to support a team-based approach to patient care and will fall short of realizing the full potential of effective team-based medication management in terms of improved outcomes and lower costs.

Click here to read the CMS Proposed Regulation.

Click here to read ACCP’s Comment Letter.

ACCP Endorses a Medicare Reform Proposal – The Better Care, Lower Cost Act

A recently introduced piece of legislation would establish an integrated chronic care delivery program (Better Care Program or BCP) that promotes accountability and better care management for chronically ill Medicare patients while encouraging investment in infrastructure and redesigned care processes that result in high-quality, efficient service delivery for the most vulnerable and costly population.

This bipartisan, bicameral initiative, introduced by Senators Wyden (D-OR) and Isakson (R-GA) (S. 1932) and Reps. Paulsen (R-MN) and Welch (D-VT) (H.R. 3890), would allow groups of providers to establish “better care practices,” which would in turn receive newly calculated, risk-adjusted, capitated payments rewarding better health outcomes for enrolled beneficiaries.

Of importance, pharmacists were included on the list of BCP-eligible professionals, an indication of the growing awareness among lawmakers of the need to incorporate pharmacists as fully integrated members of the health care team responsible for managing complex medication regimens.

ACCP wrote to the original sponsors of this legislation to thank them for their leadership in working to develop a modernized Medicare program that rewards quality, value, and outcomes over volume and process. In our letter, we cautioned that the absence of Part B coverage for CMM services remains a significant barrier to beneficiaries’ access to these services.

Click here to learn more about the Better Care, Lower Cost Act.
Click here to read ACCP’s letter of support.

Tracy Rupp Named 2014–2015 ACCP-ASHP-VCU Congressional Healthcare Policy Fellow

Tracy Rupp, Pharm.D., RD, MPH, BCPS, of Durham, North Carolina, has been named the 2014–2015 ACCP-ASHP-VCU Congressional Healthcare Policy Fellow.

The fellow program, now in its eighth year, provides pharmacists with unique insights into health care policy analysis and development, under the auspices of the Virginia Commonwealth University (VCU) School of Pharmacy in collaboration with the American College of Clinical Pharmacy (ACCP) and the American Society of Health-System Pharmacists (ASHP).

The current fellow, Daniel Nam, BSPharm, J.D., is a Legislative Fellow for Sen. Michael Bennet (D-CO), who serves on the Senate Committee on Health, Education, Labor, and Pensions and the Committee on Finance.

Click here to read the press announcing Dr. Rupp’s appointment.

Click here to learn more about the ACCP-ASHP-VCU Congressional Healthcare Policy Fellow Program.

Advancing Our Medicare Initiative Through Grassroots Action

We believe that our investment in our Washington office and advocacy activities during the past 12 years leaves us well placed to advance our Medicare Coverage Initiative. However, our success ultimately lies in the engagement of ACCP members to help their elected officials understand the importance of “getting the medications right” as part of patient-centered, team-based models of care delivery.

With more than 15,000 members, not to mention their professional colleagues and patients, ACCP has the potential to exert considerable influence on Capitol Hill. Yet to realize this potential, we need the active participation of all of our members as grassroots advocates.

Identifying Political Champions

In seeking to identify potential champions to advance our initiative in Congress, we need to determine the elected officials who share our vision of a more patient-centered, team-based, and quality-focused approach to Medicare who also sit on the congressional committees of jurisdiction over the Medicare program itself.

In the House of Representatives, jurisdiction over Medicare is shared between the Energy and Commerce Committee and the Committee on Ways and Means. In the Senate, the Finance Committee oversees Medicare issues. Members who sit on these committees are best placed to introduce legislation on behalf of ACCP and work to ensure its passage into law.

Click here to view the members of the Senate Finance Committee
Click here to view the members of the House Energy and Commerce Committee
Click here to view the members of the House Ways and Means Committee

In addition, legislation would ideally be introduced in a bipartisan manner, meaning that a Republican and a Democrat from a committee of jurisdiction would work together to cosponsor a bill on our behalf. Although we acknowledge the challenge of identifying bipartisan cosponsors from the key committees of jurisdiction, we have taken care to ensure our legislative proposal is entirely nonpartisan and focused on issues that members from both parties can agree on – improving quality and lowering costs in the Medicare program.

To determine whether your elected officials sit on a committee of jurisdiction, visit our Legislative Action Center and enter your zip code to view your congressional delegation. Check your work zip codes as well as your home address – especially if you practice in multiple sites. Members of Congress will be interested in learning about innovative, cost-saving care delivery going on in their district, even if you are not a constituent residing in that district.

ACCP’s Guide to Hosting a Visit of Elected Officials to Your Practice

A key element in the internal ACCP discussion leading up to the launch of our legislative initiative was the need to develop a consistent, standardized process of patient care – and the recognition that clinical pharmacists’ contributions to patient care are often difficult to define could act as a barrier to achieving recognition and payment for those services.

If this definitional question persists even within the health care community, it is understandable that lawmakers in Congress may struggle to grasp what we are proposing when we call for Medicare Part B coverage of CMM services delivered by qualified clinical pharmacists.

Hosting a visit of your elected officials to your practice is perhaps the single most important thing you can do to help lawmakers understand what team-based, patient-centered clinical practice is all about – and to generate their support for recognition of and payment for clinical pharmacists’ services.

A visit also serves as a means of establishing an ongoing constructive dialogue with your congressional representative or senator, and their staff, on issues important to the delivery of team-based, patient-centered care.

A comprehensive guide to inviting a member of Congress to tour your practice site is available on our Legislative Action Center. If you would like to discuss the process of hosting a lawmaker at your practice site, please contact John McGlew at (202) 621-1820 or [email protected].

All ACCP members are urged to consider inviting their elected officials to learn more about their practice through a tour of their practice site.

Advancing Our Medicare Initiative Through the ACCP Political Action Committee (ACCP-PAC)

Political contributions are an essential component of our grassroots advocacy toolkit, helping to raise our profile on Capitol Hill and show our support for members of Congress who share our vision for clinical pharmacists in an evolving Medicare program.

A well-funded PAC can be used to show the support within the profession for our legislative initiative and the importance ACCP members attach to moving it forward in Congress.

ACCP-PAC depends entirely on the support of ACCP members. Although numerous PACs represent various segments of the pharmacy profession, ACCP has the only PAC dedicated to advancing the practice of clinical pharmacy.

We call on the PRNs to encourage their members to participate in the PAC.

All ACCP members should consider donating at least $25 to ACCP-PAC. If each ACCP member were to contribute just $25, ACCP-PAC would raise $300,000. CLICK HERE to support your PAC today!

Contact Us! For more information on any of ACCP’s advocacy efforts, please contact:

John K. McGlew
Associate Director, Government Affairs
American College of Clinical Pharmacy
1455 Pennsylvania Ave. NW
Suite 400
Washington, DC 20004-1017
(202) 621-1820
[email protected]