A group of leading independent long-term care (LTC) pharmacies has joined to form the new Senior Care Pharmacy Coalition (SCPC), dedicated to representing the legislative and regulatory interests of independent LTC pharmacies and those of the vulnerable patients they serve. No other organization in Washington focuses exclusively on the public policy priorities unique to this increasingly important health sector, which provides consultative pharmacy services and medications to seniors in skilled nursing centers and residential care settings across the nation.
The group has elected Michael G. Bronfein, co- founder of Baltimore, MD-based NeighborCare and Remedi SeniorCare, as its first Chairman. Joining Mr. Bronfein on the Executive Committee are: Vice-Chairman Phil Fogg, Jr., Chairman and CEO of Milwaukie, OR-based Marquis Companies and Consonus Health Care; Treasurer Fred Burke, CEO of Atlanta, GA-based Guardian Pharmacy Services; and Secretary Ed Mercadante, CEO of Cranford, NJ-based Partners Pharmacy.
Alan G. Rosenbloom — former chief executive of both the Alliance for Quality Nursing Home Care (AQNHC) and the Pennsylvania Health Care Association (PHCA) — has been named President and CEO of SCPC. AQNHC merged with the American Health Care Association (AHCA) in July 2013.
Stated Bronfein: “The launch of the SCPC is an important milestone for the sector. Independent LTC pharmacies, their patients and business partners require a more robust, persistent, focused advocacy effort to properly address the top tier challenges unique to this growing community. Lawmakers, regulators, and the greater healthcare community must gain a deeper understanding of the value LTC pharmacies offer to patients and payers, as well as the systemic barriers undermining their ability to improve health care quality and reduce hospital readmissions for some of Medicare’s most vulnerable beneficiaries.”
Rosenbloom said that the SCPC plans to help develop and propose pragmatic, bipartisan solutions to address three key issues affecting independent LTC pharmacies and their patients:
Maximum Allowable Cost (MAC) Pricing – Independent LTC pharmacies and the patients they serve must be protected from the debilitating effects of secretive, opaque Medicare Part D drug reimbursement policies. These practices afford no recourse for pharmacies to ensure they are appropriately reimbursed for the drugs they dispense, resulting in inappropriately shifting Medicare dollars from pharmacists providing the actual care to Part D intermediaries, such as Pharmacy Benefit managers (PBMs). The result undermines LTC pharmacies’ ability to innovate and to provide the key consultative services that Medicare requires and seniors deserve as we work to optimize outcomes.
Daily Dispensing Fee – A related practice concerns the shift by the nation’s two largest PBMs from a monthly professional dispensing fee for pharmacies’ professional services to a so-called “daily dispensing fee,” linked solely to the amount of medication dispensed. Once again, scarce Medicare dollars are shifted away from providers to Part D intermediaries – with no regard for the unique professional services that LTC pharmacists provide to nursing home patients. This practice impedes the migration to shorter dispensing cycles in certain LTC settings (required by the Affordable Care Act) and incentivizes medication waste that not just costs tax dollars, but presents environmental risks.
Drug Enforcement Agency (DEA) Relationships – DEA policies governing controlled substances, although well intentioned, adversely impact independent LTC pharmacies’ ability to deliver care to their patients residing in nursing homes. Congress must work with stakeholders to bridge the growing gap between the goals of DEA drug enforcement policies, Centers for Medicare and Medicaid Services (CMS) regulations, high standards of patient care, and market realities. SCPC is committed to working constructively and collegially with the DEA, CMS, and Congress to both protect the public and facilitate high standards of care for nursing home patients.
“Increasingly problematic issues relating specifically to MAC pricing, daily dispensing fees and the sector’s relationship with the DEA are undermining the ability of independent LTC pharmacies to deliver the high quality services their professional commitment demands, seniors deserve, and long-term care regulatory provisions require,” stated Rosenbloom. “More tangible progress in these three key legislative and regulatory areas requires focused, strategically oriented advocacy — and that is why SCPC is now entering the public policy arena.”