Florida Pharmacy Association - STAT News

Thursday, September 02, 2004 Michael Jackson, Editor

A Member Service of the Florida Pharmacy Association

Medicaid to Suspend Early Refill Edits

The Florida Pharmacy Association has been informed that the Agency for Health Care Administration will be changing the edits to allow for early refills due to the hurricane emergency that now exists in Florida. This means that pharmacies should be able to adjudicate prescription claims for Medicaid recipients prior to the regularly scheduled refill date. Pharmacies should continue to see the refill too soon edit but the claim should still pay. The Medicaid claims processor is implementing the change as we go to press. Pharmacists should work with other health plans as patients are now visiting their pharmacies to obtain medications to cover until Hurricane Frances passes over our state. We understand that senior organizations will be sharing with their constituents’ information on how we as pharmacists can help during this crisis.

Governor Bush has already declared a state of emergency in anticipation of the need to move resources to manage our state’s health care system. We anticipate that the state will continue to solicit for pharmacists to volunteer their time in the affected areas of our state. Our friends in neighboring states have already begun to offer assistance.

Below you will find information that should help you understand how you may aid patients during this emergency period. In the meantime with Hurricane Frances moving towards our shores you may want to take special precautions like making sure your pharmacy data systems are backed up and secured prior to the storms landfall. Your staff should be briefed on storm preparation procedures including how to communicate with the prescription department manager after the storm has passed.

Prescriptions that have no refills can be processed by the pharmacist in emergency situations under Florida statutes 465.0275. If the pharmacist is unable to obtain refill authorization from the prescriber the pharmacist can provide a 72 hour supply of medications on a one time basis. There is an exception when there is a declaration of a state of emergency order by the Governor for the affected areas of a disaster. Under those circumstances a pharmacist under executive order may dispense up to a 30 day supply provided that:

(1) The prescription is not for a medicinal drug listed in Schedule II appearing in chapter 893.

(2) The medication is essential to the maintenance of life or to the continuation of therapy in a chronic condition.

(3) In the pharmacist's professional judgment, the interruption of therapy might reasonably produce undesirable health consequences or may cause physical or mental discomfort.

(4) The dispensing pharmacist creates a written order containing all of the prescription information required by Florida statutes 465 and chapters 499 and 893 and signs that order.

(5) The dispensing pharmacist notifies the prescriber of the emergency dispensing within a reasonable time after such dispensing.

Submission of Claims to the Centers for Medicare & Medicaid Services

The Atlanta Regional Office of the Centers for Medicare & Medicaid Services (CMS) has established a response team to assist providers who may be impacted by Hurricane Frances. They wish to inform the provider community that they are ready and available to provide assistance. The regional CMS main contact number is 404-562-7390.

The Regional Office has communicated with CMS contractors who service this area and advised them to provide needed guidance on claims submission as a result of the storm. If necessary, contractors will accept paper claims from the affected area to aide in the relief effort.

CMS has asked the Florida Pharmacy Association to share this information with you.

You may contact the Atlanta team leader who is Colleen Carpenter, 404-562-7242, or Wilma Cooper, 404-562-7361,

L. David Hinson

Centers for Medicare & Medicaid Services Atlanta Regional Office

61 Forsyth Street, S.W., Suite 4T20

Atlanta, GA 30303-8909

(404) 562-7365 Voice

(404) 562-7386 Fax

Florida Board of Pharmacy Meeting Uncertain

The Board of Pharmacy meeting that was scheduled to take place on August 16-18 had been rescheduled for September 8-10, 2004 in Tampa, Florida. This rescheduling was necessary due to Hurricane Charley. With Hurricane Frances approaching Florida the Department has informed us that they will monitor the situation but have not cancelled the September meeting at this time. A decision whether or not to cancel the meeting will be made on Monday, September 6.

CMS to take Comment on Proposed Medicare Drug Benefit Rules

The Centers for Medicare and Medicaid Services (CMS) has prepared proposed regulations to implement the changes associated with the Medicare Modernization Act (MMA). This includes provisions that implement the payment for medication management services. Comments must be submitted to CMS by October 4, 2004. CMS will then review the comments and then submit a final rule version for implementation. As you may recall the discount card program is part of MMA and will continue through the end of next year. Nearly every pharmacy organization is weighing in on this program as it has far reaching effects on the practice of pharmacy in nearly every health care setting. Members are urged to watch this very closely and be prepared to provide comment to CMS. Please visit the American Pharmacists Association Website at and examine the summary. There are a number of issues that we have with the proposed rule that needs to be addressed. The summary articulates many of these concerns. You will want to be prepared to provide comment to CMS as soon as possible. The APhA website will take you to a link where you may file your comments on-line.

AHCA Planning to Implement Behavior Health Drug Management Program

The Florida Agency for Health Care Administration (AHCA) has announced that it will be working with the University of South Florida's Louis de la Parte Florida Mental Health Institute (FMHI) to implement a legislatively mandated Behavioral Health Drug Management program. According to AHCA over the last five years, spending for Behavioral Health drugs has grown from $175 million in 1999 to $521 million in Fiscal Year 03-04. The Agency has been working with drug manufacturers in sharing the cost of the savings as well as the cost of the program. Proposed contracts for the program has been prepared and is awaiting action. If agreements are not reached then all behavioral drugs will be subject to prior authorization (PA), four brand limit restrictions and other (preferred drug list) PDL limitations. We do not know at this time when or if the agreements have been reached or when or if the PA program for behavioral drugs will be implemented.

Members will note that significant administrative burdens have been placed on pharmacy providers in the Medicaid program. It will be a challenge for our members to help patients in this category to understand changes in their drug therapy. It is important that you share this with your state legislators prior to their return to Tallahassee next spring.

Florida A&M University and Nova Southeastern Pharmacy Deans to Step Down

It was announced at a meeting of the Executive Committee of the Florida Pharmacy Association that Dean Henry Lewis will be stepping down to take on teaching responsibilities at the Florida A&M University College of Pharmacy and Pharmaceutical Sciences. Dr. Lewis served as Dean of the College for a number of years and was tapped in 2002 to guide the University as Interim President during a transition of leadership. Dr. Robert Thomas has been asked to serve as interim Dean until the search committee is formed and completes its work. During Dean Lewis’ tenure the College experience significant growth and development in research and student enrollment. A number of advanced degree programs were implemented along with the opening of a new pharmacy educational complex.

Dr. Lisa Deziel-Evans was appointed by the Chancellor of the Health Professions Division along with members of the University and College Community as Interim Dean of the College of Pharmacy in the Health Professions Division of Nova Southeastern University effective July 1, 2004. Retiring Dean William Hardigan has decided to spend more time in the classroom and with family. He was honored by friends and associates at the recent 2004 FPA Annual Convention in Orlando this summer. While Dr. Hardigan served as Dean, NOVA Southeastern University College of Pharmacy expanded its off campus programs in Miami, Tampa, Orlando, West Palm Beach and Puerto Rico. Over 190 students had been admitted into the College for this fall. Dr. Hardigan received his BS and MS degrees at the University of Wyoming and his Ph.D. from the University of Arizona.

Public Education Initiative on Prescription Medications to be launched in October

FPA members need to be aware that a pilot public relations program to demonstrate the value of pharmacy services is under development for release this fall. This program was conceived through the efforts of national pharmacy organizations and drug manufacturers forming a coalition called the Sarasota Group. One of the primary focuses of the group was to advance patient health by positively enhancing patients’ perceptions about the value of their neighborhood pharmacist, the value of their medicine, and the value of the pharmaceutical manufacturers' role in developing medicines and providing information. Pharmacies in selected markets nationwide will be receiving a letter of invitation to participate. We understand that Miami is one of those targeted areas. Members in the Miami market need to watch the mail for the invitation letter.

Florida Pharmacy Association
Continuing Education Programs

Expanding Patient Care in: Dementia, Delirium & Depression
Offering 12 hours of General or Consultant Recertification Credit
Also Offering: End of Life Hospice and Palliative Care - Can substitute for HIV/AIDS
Medication Errors / September 18-19, 2004
Hilton Miami Airport
5101 Blue Lagoon Drive
Miami, Florida
(305) 262-1000
Academy of Pharmacy Practice Midyear Clinical Conference / October 16-17, 2004
Hyatt Regency
Orlando International Airport
9300 Airport Blvd
Orlando, Florida
(407) 825-1234
FPA Law and Regulatory Conference
Also Offering: End of Life Hospice and Palliative Care - Can substitute for HIV/AIDS
Medication Errors
Live CE / December 4-5, 2004
Hyatt at Sarasota Bay
1000 Blvd. Of The Arts,
Sarasota, Florida
(941) 953 1234
FPA Consultant Continuing Education Conference
Subject: TBA / February 19-20, 2005
Hilton Sandestin Beach
Golf Resort and Spa
Destin, Florida
FPA Consultant Continuing Education Conference
Subject: TBA / March 12-13, 2005
Tampa, Florida
115th Annual Meeting and Convention / July 6-10, 2005
Marriott Marco Island Resort
Marco Island, Florida
22nd Annual Southeastern
Education Gatherin / August 7-10, 2005
Hilton Sandestin Beach
Golf Resort and Spa
Destin, Florida