APhA Advocacy Issues

Health Care Reform - Implementation of the Affordable Care Act

In March 2010, President Obama signed into law the Affordable Care Act (P.L. 111-148; ACA), also referred to as health care reform. Beyond provisions impacting patients and insurance companies, numerous provisions within the final law either impact directly or could impact pharmacists. ACA issues of importance to APhA, pharmacists, and the pharmacy profession include:

• CMS Innovation Center
• Accountable Care Organizations
• Essential Health Benefits
• Medical Loss Ratio
• Integrated Care Models
• Transitional Care Models
• Improvements to Medicare Part D MTM
• Litigation to Determine the Constitutionality of the New Law

Revisions to FDA Drug Paradigm (OTC+)

In 2012, FDA announced it is looking at ways to make the distinction between prescription and over-the-counter (OTC) drugs more flexible through "conditions of safe use" including interventions by a pharmacist or innovative technologies (OTC+).
APhA supports the concept and believes that this is an exciting opportunity for pharmacists to help improve public health, much like what pharmacists have done with immunizations.

Read more about the revisions to the FDA Drug Paradigm (OTC+).

Fraud, Waste, and Abuse

The Centers for Medicare & Medicaid Services (CMS) established the Center for Program Integrity (CPI) to ensure the integrity of Medicare and Medicaid. Within CPI, the Division of Plan Oversight and Accountability (DPOA) safeguards Medicare Advantage (Part C) and Medicare Part D (Prescription Drug Program).  DPOA carries out its mission with an experienced anti-fraud team, of which the Medicare Drug Integrity Contractors (MEDICs) are members.   The MEDICs are comprised of the CMS National Benefit Integrity (NBI) MEDIC and the CMS Outreach and Education (O&E) MEDIC.  

Learn more about the CMS Outreach and Education (O&E) MEDIC.