MTM, health care reform discussed at high-level meeting of APhA, CMS

Menighan, Frizzera discuss roles for pharmacists.

A high-level meeting between CMS and APhA staff provided an opportunity to discuss key issues of mutual concern.

CMS Acting Administrator Charlene Frizzera and her staff hosted a get-acquainted session on October 23 with recently installed APhA Executive Vice President and CEO Tom Menighan, BPharm, MBA; Anne Burns, BPharm, Vice President, Professional Affairs; Kristina Lunner, Vice President, Government Affairs; and Marcie Bough, PharmD, Director, Federal Regulatory Affairs. APhAintroduced Frizzera to key topics that are important to pharmacists and the Association, explored how pharmacists can help CMS meet the needs of Medicare beneficiaries, and discussed opportunities for continued collaboration with CMS.

Top of the agenda was medication therapy management (MTM)—highlights of APhA’s MTM resources, APhA’s statement of support for CMS’s expanded MTM provisions for Medicare Part D plans in 2010 and in CMS’s recently proposed regulations, as well as ways to work together to address MTM implementation barriers.

APhA emphasized pharmacy successes with immunization rates and asked CMS to consider ways in which pharmacists could similarly help expand patient access to and utilization of other preventive services, such as diabetes screening. Also discussed were ongoing Part D implementation challenges and the need for pharmacists to be included in Special Needs Plans’ provider networks in order to meet the MTM needs of this patient population.

APhA expressed support for efforts to reduce medication waste and highlighted the need for error prevention and quality improvement for e-prescriptions and prescriber and pharmacist user interfaces as e-prescribing expands. APhA also pointed out the limited clinical role that pharmacists can play because of the lack of Medicare Part B status.

APhA concluded the meeting with a discussion on pharmacists’ role in the anticipated health care reform (HCR) package. Looking ahead to the likely CMS regulatory activity that would follow passage of HCR legislatioin, APhA promoted the importance of pharmacist involvement in integrated care models, transition of care, and grant/pilot programs that test new delivery models such as MTM.

The meeting was a success in APhA’s view. Blogging about the meeting, Menighan wrote, “We’re staying close to CMS and working hard to be there when regulators begin to focus on whatever bill the White House ultimately signs regarding health care reform.”

For more information Medicare and HCR, go to www.pharmacist.com/GA and the APhA Health Care Reform Hub on www.pharmacist.com.

Posted October 28, 2009