Proposed CMS Rule Must Change to Take Into Account Interests and Concerns of America’s Independent Long Term Care (LTC) Pharmacies

DATE: October 14, 2015

Washington, DC – In the interest of protecting the concerns of America’s independent Long Term Care (LTC) pharmacies, the Senior Care Pharmacy Coalition (SCPC) has submitted formal comments and proposed revisions to the Centers for Medicare and Medicaid Services’ (CMS) “Medicare and Medicaid Conditions of Participation for Long Term Care Facilities” Proposed Rule, 80 Fed. Reg. 42168 (July 16, 2015).

Alan G. Rosenbloom, President and CEO of SCPC, said the organization has carefully analyzed the Proposed Rule and considered the implications of the Agency’s proposal for LTC pharmacies, LTC facilities, and the patients that they serve, and suggests it should be modified by CMS to:

• Address long term care pharmacy payment and reimbursement issues as it mandates, through regulation, enhanced levels of pharmacist care;

• Introduce flexibility into the proposed pharmacist chart review requirements to recognize that patient charts are not always available to a pharmacist, particularly in rural areas;

• Clarify the definition of “psychotropic drugs” by direct reference to the therapeutic categories the Agency seeks to regulate; and,

• Introduce flexibility into its proposed 48-hour limit on PRN orders for certain drugs.

“The SCPC thanks CMS for the opportunity to comment on its proposed revisions to Medicare and Medicaid Conditions of Participation for skilled nursing and nursing facilities, particularly those regarding the provision of pharmacy services,” Rosenbloom stated. “Many of the proposed elements are consistent with current State Operations Manual (SOM) guidance or otherwise improve the provision of pharmacy services in facilities. In several areas, however, the proposed regulations are too broad, inconsistent with federal definitions regarding classifications of medications, risk unintended interpretations that could impose impractical compliance requirements or otherwise create unintended liability for the facility or the pharmacy, or are unnecessary. Thus, the SCPC requests that the Final Rule incorporate the modifications proposed above.”

SCPC member pharmacies provide care and services to patients in long-term care facilities in more than 40 states who occupy approximately 400,000 beds across the country. The SCPC advocates for public policies that protect patients, improve the quality of healthcare across a shifting care continuum, and strengthen the economic viability of independent LTC pharmacies and their ability to serve medically compromised seniors.