What About Improving Medication Use?
ACCP believes that the goals of the Senate Finance Committee working group are perfectly aligned with the College’s efforts to advance a quality-focused, patient-centered, team-based approach to health care delivery that helps ensure the safety of medication use by patients and that achieves medication-related outcomes aligned with patients’ overall care plans and goals of therapy through the provision of comprehensive medication management (CMM).
Over the past 2 years, ACCP staff in Washington have worked closely with leaders on the Senate Finance Committee working group to educate them on the importance of “getting the medications right” as part of this chronic care reform process and have urged the committee to include coverage for CMM in the legislation. Despite these efforts—and despite the acknowledgment by the Centers for Medicare & Medicaid Services that medications are the fundamental treatment intervention in each of the eight most prevalent chronic conditions affecting Medicare patients—S. 870 almost entirely ignored the medication use component. The legislation only included a proposal for a very limited Government Accountability Office study on improving medication synchronization.
Next Steps
More encouragingly, at a recent Senate Finance Committee hearing to mark up the legislation, Sen. Pat Roberts (R-KS) highlighted the importance of expanding access to medication management services within the Medicare program and acknowledged that medications are the most prevalent means by which chronic disease is prevented and controlled. During the hearing, Roberts, together with Sen. Tom Carper (D-DE), introduced an amendment requiring the Secretary of Health and Human Services (HHS) to establish a process, beginning in plan year 2020, by which a Medicare Part D plan sponsor can submit a request to HHS for claims data under Medicare Parts A and B.
In its comments to the committee, ACCP thanked these senators for acknowledging the limitations of the current Part D medication therapy management (MTM) program and for recognizing that meaningful medication management services cannot be delivered solely on the basis of Part D claims data. ACCP’s comments also highlighted that Part D MTM programs are, by law, administrative in purpose and scope and that Part D plan administrators—not patients or clinicians—determine who can access an MTM program. ACCP’s comments urged Congress to cover CMM services provided by qualified clinical pharmacists as members of the patient’s health care team among its broader payment reform efforts.
ACCP staff in Washington are due to meet with the offices of Roberts and Carper to continue urging them to consider opportunities to integrate and provide coverage for CMM across all settings of care that serve Medicare beneficiaries.
We recognize the ongoing challenges we face in helping Congress fully understand how clinical pharmacists, practicing collaboratively with physicians and other members of the patient’s health care team, can bring enhanced quality and safety, improved clinical outcomes, and better managed health care costs to the Medicare program and its beneficiaries.
However, we are encouraged that, despite the often politically fractured debate over health policy reform, the Senate Finance Committee remains focused on working in a bipartisan manner to improve care for chronically ill beneficiaries. We are confident that “getting the medications right” through providing CMM is central to achieving this goal.
For more information on any of ACCP’s advocacy efforts, please contact:
John K. McGlew
Director, Government Affairs
American College of Clinical Pharmacy
1455 Pennsylvania Ave. Northwest
Suite 400
Washington, DC 20004-1017
(202) 621-1820
[email protected]