SCPC Hails Senate Passage of CARA, Thanks Lawmakers in Both Chambers for Recognizing Key Role Played by LTC Pharmacies in Seniors’ Medication Management

DATE: July 13, 2016

Landmark Opioid Abuse Prevention Legislation Recognizes Essential Difference Between LTC and Retail Pharmacies

Washington, DC – Characterizing Senate passage of the Comprehensive Addiction and Recovery Act (CARA) as “a major victory for the nation’s long term care (LTC) pharmacy sector and the patients under their care,” the Senior Care Pharmacy Coalition (SCPC) today thanked key U.S. Senate and House leaders who helped shepherd-through a lengthy, complex legislative process, a vital provision that recognizes the key role played by LTC pharmacies in seniors’ medication management.

“The SCPC thanks U.S. Senators Pat Toomey (R-PA), Rob Portman (R-OH), Tim Kaine (D-VA) and Sherrod Brown (D-OH), and U.S. Reps. Fred Upton (R-MI), Frank Pallone (D-NJ), Gus Bilirakis (R-FL) and Ben Ray Lujan (D-NM) for their leadership and foresight in recognizing that LTC pharmacies are a unique sector within the broader pharmacy space,” said Alan G. Rosenbloom, President and CEO of SCPC. “CARA strikes the right balance between protecting our citizens and communities on the one hand, and protecting the ability of LTC pharmacies to meet and manage the medication needs of LTC residents on the other.”

Specifically, CARA exempts Medicare Part D beneficiaries in skilled nursing facilities (SNFs) and other settings from a proposed medication management “lock-in” provision under Medicare Part D. Over the past year as legislative language advanced through both chambers, SCPC has repeatedly made the case that beneficiaries in SNFs and other long-term care settings already have sufficient protections from drug abuse and diversion, and should be exempted.

Said Rosenbloom: “The exemption is a vital provision that specifically recognizes the unique characteristics of the long-term care patient population and the distinctions between specialized long-term care pharmacies and more well-known retail pharmacies — particularly the additional requirements already imposed on LTC pharmacies under Medicare and Medicaid Requirements of Participation and Medicare Part D rules.”

The SCPC leader pointed out the nation’s LTC pharmacies already provide stringent oversight of prescription drug dispensing and usage — including even greater oversight of opioids and other Schedule II drugs dispensed to LTC patients — and are in a unique position to ensure the ongoing integrity of the Medicare Part D program. “As contracted pharmacies servicing LTC facilities, our LTC pharmacies maintain stringent oversight of patients’ entire drug regimens. The methods of packaging, dispensing, and tracking medications — and monitoring usage in LTC facilities — results in LTC pharmacies satisfying extraordinarily high safety and compliance standards.”

Rosenbloom said Medicare and Medicaid Conditions of Participation for LTC facilities require the pharmacy to provide oversight and management of all medications for each patient receiving care and services in the facility. Of particular note with respect to narcotics:

  • LTC pharmacists and licensed LTC facility staff employ count sheets to track every dose of narcotics prescribed and administered;
  • LTC pharmacists and licensed LTC facility staff conduct regular narcotic audits to ensure compliance; and,
  • Orders and reorders of narcotics are handled by LTC pharmacists and licensed facility staff — not Medicare beneficiaries themselves.

“CARA’s passage with the ‘lock-in’ provision and exemption intact demonstrates major progress by SCPC in terms of educating lawmakers and their staffs about the unique nature of LTC pharmacies and their patients — and we will continue to shed light on how we differ significantly from the retail pharmacy sector,” Rosenbloom concluded.

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