Eight California Pharmacies File Lawsuit Against Department of Health Care Services to Stop 10 Percent Medi-Cal Provider Cuts

Eight retail community pharmacies filed a lawsuit June 9 against the California Department of Health Care Services and its director Sandra Shewry to stop the ten percent Medi-Cal provider cuts to pharmacies from going into effect on July 1, 2008.

The action claims that the state Department of Health Care Services (DHCS) has not met all the requirements of the statute that imposes the ten percent cuts, which was passed by the California Legislature and signed into law in February 2008. DHCS must meet all of those requirements before the cuts can be implemented. The pharmacies are filing this action because of their concern about the drastic impact these cuts will have on California’s network of pharmacies as well as the consequences to Medi-Cal patients. 

California law requires DHCS to “promptly seek any necessary federal approvals for implementation of the 10 percent cut,” which, in turn, requires California to file with the federal Centers for Medicare and Medicaid Services (CMS) a state plan amendment to implement the 10 percent cuts. The state plan is a comprehensive written statement prepared by DHCS, which both describes the nature and scope of the Medi-Cal program and gives assurances that DHCS will administer the plan properly. DHCS cannot show that they have obtained “all necessary federal approvals” including the state plan amendment nor can they show that they have received approval to implement the cuts from CMS, according to a news release issued by the California Pharmacists Association (CPA).

“This lawsuit was carefully drafted to include only issues of state law in order to avoid the fate of two other provider lawsuits that have been filed with the state only to be removed to the federal court at the request of DHCS,” said Lynn Rolston, chief executive officer of CPA, which is a plaintiff in one of the provider lawsuits and supporter of the new pharmacy action. “Moving these cases to federal court is nothing more than a delay tactic that will cause the cuts to go into effect before the providers’ legal claims can be heard by a judge.”

If these cuts go into effect on July 1, 2008, pharmacists may have to turn away new Medi-Cal beneficiaries, stop serving Medi-Cal altogether or be forced to close their doors. The impact of the cuts on access to life saving medications for Medi-Cal beneficiaries and the impact on pharmacies in California are detailed in the report from Stephen Schondelmeyer and the declarations of the individual pharmacies that are part of the complaint filing.

06/25/08

A Landmark Day: Board Votes to Sell HQ & Relocate

(Editor’s Note: the following letter was written by Jim Martin, RPh, Executive Director/CEO, Texas Pharmacy Association (TPA) and appeared in their newsletter April 18, 2008. It is being reprinted with written permission.)

Yesterday was one of those memorable days that happens only once in a long while. The TPA Board of Directors voted to sell our current headquarters building and relocate to a more convenient location in Austin.

So why is this decision such a landmark event? The significance is twofold. First, the sale will allow us to capture significant gains on a valuable asset we have had since 1969, gains that may have peaked. It will also allow us to plan for a future home that will reflect the changing needs of our profession -- a home that better supports our mission to unify pharmacy in a new patient-centered focus.

I previously reported that the board had authorized the staff to explore a relocation, possibly to the downtown area. We were directed to conduct a cost analysis to determine if such a move makes sense at this time. The analysis proved that selling and relocating is indeed advantageous, so we put the property on the market to test the waters. What has since happened is truly surprising. In only 30 days, we have received three offers to buy our property at or above our full asking price. It is quite unusual to find three such buyers in a weakened market with falling property values.

The sale of the building will improve our long- and short-term financial situation by enabling us to pay off debt and by freeing us from the costs of significant repairs and renovations that are long overdue for our building. The improved cash flow will provide more resources for membership growth and our Smart, Healthy Living initiative.

What happens during the interim? We will lease office space in a more modern and conveniently located building that will serve us until the time is right for establishing a long term home for the association. 

Our predecessors at TPA had a vision during the 1960s to move the organization to another level. They found the land we occupy and built an association headquarters that has served Texas pharmacy well for 40 years. Many of those leaders are now retired, and they deserve our thanks for their vision and resolve in providing our current home! I also want to tip my hat to our current leaders for likewise having the resolve to keep us moving forward.

The board wants to put $1 million+ in gains from the building sale into carefully chosen investments as an endowment for a future home for TPA. This endowment will likely be housed within the Texas Pharmacy Foundation. There will be many opportunities to participate in the growth of the endowment fund and many ways in which contributors will one day be honored in the new building. I can't predict what our eventual new home will look like or when it might become a reality. I do know that an endowment of more than $1 million is a great start toward that goal.

There will be considerable discussion about the endowment fund at our Conference & Expo in July, where the House of Delegates will consider a resolution to make it happen. I want to encourage all members to attend the delegates meeting to learn more about our plans and to be a part of creating the endowment.

I am excited about the direction of our organization during these challenging times. We are reviewing TPA's governance structure with the goal of creating a strategically focused board of directors whose activities are policy-driven. We are reviewing our staffing and budgetary needs to streamline the association, maximize efficiencies and improve our ability to drive membership growth and patient-focused initiatives. (In fact, our Smart, Healthy Living campaign and Rxperts brand is drawing national interest.) You should be proud of our staff and leaders for their focus and energy on our new mission.

06/15/08

UCD Breaks Ground on Seven Education

Buildings at Fitzsimons Campus

The University of Colorado Denver (UCD) held a commemorative groundbreaking ceremony in June to mark the beginning of the final phase of planned construction at the Fitzsimons campus. Seven new education buildings - including a new library and classroom facilities - will start going up this month as part of efforts to complete the vision of a premier research, academic and patient care center in Colorado.

Once completed, the new facilities will flank the University of Colorado Hospital, including the Anschutz Inpatient and Outpatient Pavilions, the CU School of Dentistry, the Barbara Davis Center for Childhood Diabetes, the Ben Nighthorse Campbell Native Health Building and other established structures on the Fitzsimons campus.

The new facilities will enable hundreds of students in CU's medical, nursing, pharmacy and graduate schools to complete their higher education goals in state-of-the-art surroundings. With the new Children's Hospital, a planned Veterans Administration Medical Center and the adjacent Colorado Bioscience Park Aurora, the Fitzsimons campus will heighten its reputation as a powerhouse economic hub and top Colorado employer.

"Fitzsimons will be a major job growth engine for Colorado, bringing in tens of thousands of new jobs. It is already home to some of the top clinics in the state staffed by some of the best physicians, nurses and health care professionals," said CU president Hank Brown. "Add to that our medical research and what we have is a state teaching and research institution that not only cares for the health and well-being of Coloradans, but trains the next generation of health care providers."

The new buildings under construction at Fitzsimons include:

u  Academic Office West, a 204,974-square-foot academic facility with conference rooms and offices for faculty, staff and campus programs.

u  Library, a 113,005-square-foot hub of knowledge and home to administration, circulation, research, general use, a learning resource center, reference and resource services, systems databases, material storage, education and health informatics, information access and study space, a drug information center, and the History of Medicine collection.

u  Education Facility 1B, a 115,980-square-foot building that will provide a setting for the integration of nursing, pharmacy, dental and medical students. It will include lecture halls, classrooms, laboratories and other academic amenities.

u  Education 2/Education Bridge/Academic Office East, a 265,081-square-foot building designed to bring together faculty, students and programs in two interconnected structures.

u  Facility Support Building, a 68,078 building that will house facilities operations programs, including maintenance shops, mail services, engineering and building safety, grounds maintenance, parking and transportation services.

u  Environmental Health and Safety 2, a 7,356-square-foot structure that will provide waste handling to support UCDHSC.

The University of Colorado Denver is one of three campuses in the University of Colorado system. Located in Denver and Aurora, Colo., the center includes schools of medicine, nursing, pharmacy, and dentistry, a graduate school and a teaching hospital.

06/15/08

CPhA Joins Coalition of Health Care Providers Suing

The State of California Over Cuts in Medi-Cal Payments

The California Pharmacists Association (CPhA) has joined a wide range of health care organizations in filing a lawsuit against the State of California to stop the 10 percent Medi-Cal provider cuts from going into effect on July 1, 2008. The class action lawsuit, filed in Los Angeles County Superior Court, contends that the planned payment cuts violate state and federal laws (42 C.F.R. §447.204) that require that Medicaid (Medi-Cal) payments "must be sufficient to enlist enough providers so that services under the (state's Medicaid) plan are available to recipients at least to the extent that those services are available to the general public."

"Chronically ill patients rely on their pharmacists as a means of survival. If these cuts go through as planned, many pharmacies will have no other choice but to close their doors, leaving patients with nowhere to turn to get the prescriptions they need," said Lynn Rolston, chief executive officer of CPhA. "Health care providers and their patients will be devastated by these cuts for years to come."

The lawsuit also contends that, under federal Medicaid law, the secretary of the U.S. Department of Health and Human Services (HHS) must approve the policies and methods used for setting payment rates and that such changes may not be implemented by the state prior to HHS' approval. According to the complaint, California has yet to submit what is known as a State Plan Amendment (SPA) to the federal government, requesting approval of the reduced Medi-Cal rates.  

Additionally, federal regulations require the state to establish Medicaid payment rates for hospitals and other institutional providers through a public process that includes publishing the proposed rates and the methodologies and justifications used to establish those rates. No such process took place before the 10 percent rate reduction was approved, according to the lawsuit. Rather, the rate reductions were based solely on an across-the-board slashing in response to the state's budget deficit. 

When it comes to Medi-Cal payments to physicians and other individual health care providers, the lawsuit charges that "state law requires that Medi-Cal fee-for-service rates be adopted pursuant to the regulatory process and requires the Department (Department of Health Care Services) to annually review Medi-Cal rates for physician and dental services, taking into account Consumer Price Index cost increases, reimbursement levels under Medicare and other third-party payors, prevailing customary charges and other factors." As with the cuts imposed upon hospitals, the lawsuit points out that no such regulatory process occurred before the rate reductions for physicians and other providers were approved.

The Providers intend to seek an injunction to stop the cuts from going into affect before July 1. A court hearing on the request for an injunction is anticipated within the next thirty to forty-five days.

06/09/08

Texas DPS Extends Time Limit on Schedule II Scripts

The Texas Department of Public Safety (DPS) has increased from seven days to 21 days the period of time during which a Texas pharmacy may dispense Schedule II medications after the prescription issue date.

The amendments to Chapter 13, Subchapter D, §13.75, no longer allow a pharmacy to call a physician and change the date on an official prescription for a Schedule II drug. If an official prescription is presented later than 21 days after issuance, a new prescription is required. The amendments became effective March 12, 2008. 

06/09/08

Texas VDP Claims Need NPI Starting 5/23

The Texas Vendor Drug Program (VDP) started rejecting pharmacy drug claims on May 23 if they are submitted without the pharmacy's National Provider Identifier (NPI) number. Updated pharmacy NPI information must be on all electronic transmissions submitted to Texas Medicaid, Children's Health Insurance Program, Children with Special Health Care Needs Services Program, and Kidney Health Care.

VDP has accepted the pharmacy NPI since April 2007 on claim requests, claim reversals, and eligibility verification requests. The NPI number replaces the NCPDP number in the Service Provider ID field. The Service Provider ID qualifier value will be "Ø1" for the NPI number. 

The Texas Vendor Drug Program will accept only the state-issued license number for Prescriber ID as is currently required. Texas will not accept claims submitted with the Prescriber NPI. The Payer Sheets for Claim Requests (B1), Claim Reversals (B2), and Eligibility Verification (E1) can be found in the Pharmacy Procedures Manual. 

06/09/08

University of Colorado Hospital Selects CytoCare for

IV CompoundingTo Enhance Safety and Efficiency

University of Colorado Hospital (UCH) will become the first health care provider in North America to use its IV chemotherapy compounding robotic technology ¾ CytoCare, Health Robotics recently announced. The robot will automate chemotherapy compounding for syringes and IV bags. Fifty some robots have been sold worldwide.

“We selected CytoCare to efficiently prepare the safest possible medications for our patients,” said Nancy Stolpman, PharmD, PhD, director of pharmacy at UCH. “CytoCare, situated in our new Anschutz Inpatient Pavilion setting, will initially be used to prepare products for our hospital patients and eventually we will add in the IV chemotherapy product needs for the University of Colorado Cancer Center as well. This new technology will significantly enhance the practice of pharmacy and will very likely become standard of care in the future.”

“Patient and staff safety is of the highest priority in working with chemotherapy agents. CytoCare is an important tool for us to optimize our compounding operations and deliver timely, accurate doses for every patient.” Strode Weaver, MHSA, MBA, executive director of oncology services at the University of Colorado Cancer Center, added.

A huge advantage to CytoCare is that it will help eliminate calculation errors. Chemotherapy dosing, according to Health Robotics and Primus Innovations, a world leader in automated IV admistures preparations, which is collaborating with Health Robotics to distribute the technology which is already in use in Europe, can be in such small amounts that even one decimal point off in calculation can mean a tenfold overdose for a patient.

CytoCare uses its robotic arm to mix the compound and deposit them in IV bags, vials or syringes. The robot then drops any articles, such as used vials and syringes that are no longer needed or contaminated, into a waste container, so persons never touch them.

The robot is designed to do several safety checks. It weighs the drugs before and after they are mixed to confirm the dosage; it checks bar codes on the drug packaging to make sure it has the right drug; it places the drug on a platform and rotates it 360 degrees, taking images of the drug and comparing those to images stored in its database.

05/02/08

Rosauers Opens New Store in Bozeman, Montana

Rosauers Supermarkets Inc. has opened a new combination Rosauers Food & Drug store and Huckleberry’s Natural Market slightly west of Montana State University, in Bozeman, Mont. The store is the anchor tenant for the new Bozeman Gateway project, a 72-acre mixed-use development that will feature Montana’s first lifestyle center. The lifestyle concept integrates retail, restaurant, residential, office and entertainment uses within a pedestrian-friendly, open-air environment, enhanced by open spaces and numerous water features.

“We’re excited about expanding our presence in Montana, and being a part of the Bozeman Gateway project,” said Jeff Philipps, president and CEO of Rosauers. “We believe the residents of Bozeman and the surrounding area will be delighted with the outstanding facility we have planned, as well as our unique offering of item selection, price, quality and service.”

The store, at approximately 60,000 square feet in size, carries a broad selection of grocery and specialty foods including a full assortment of natural and organic items and supplements offered under the “Huckleberry’s Natural Market” banner. A large service deli is included featuring a seating area and cooking school. A drive up pharmacy and a customer service center are added conveniences.

The addition of the Bozeman store brings the total number of Rosauers company locations to 22. Rosauers Supermarkets Inc., is headquartered in Spokane, Wash., and operates stores in Missoula, Kalispell and Libby, Mont., as well as stores in Idaho, Oregon and Washington. It is a wholly owned subsidiary of URM Stores, a wholesale cooperative also located in Spokane.
05/02/08

CPhA Works with Partners to Successfully

Delay California E-Pedigree Requirements

The California Pharmacists Association (CPhA), along with its partners, the National Association of Chain Drug Stores and the California Retailers Association worked closely with the California State Board of Pharmacy to extend the electronic pedigree requirements deadline until January 1, 2011.

"The California Pharmacists Association is pleased that the Board of Pharmacy has delayed the implementation of the electronic pedigree requirements," said Lynn Rolston, CEO for CPhA. "While CPhA wholeheartedly supports the board's desire to ensure the safety of prescription medications to patients, we were concerned that more time was needed for all members of the supply chain to be ready and that pharmacies would not have the appropriate equipment installed by the deadline to read the pedigree. It was our biggest concern that the supply of needed medications for Californian's not be disrupted."

"CPhA worked tirelessly on behalf of patients and its members to help achieve the delay in the electronic pedigree. Today's vote [March 26] will provide more time to ensure a successful implementation for all concerned and especially pharmacies. We applaud the Board of Pharmacy for acknowledging the hurdles that exist and we will continue to work with our partners and the board to find an electronic pedigree standard that will ensure patient safety," said Kathy Lynch, vice president of Government Affairs for CPhA.

05/02/08

Arizona State Board of Pharmacy

Josephine Anne Galindo has been appointed a public member of the Arizona State Board of Pharmacy. He appointment will expire January 16, 2012.

Daniel Milovich, RPh, has been appointed a member of the same board. His appointment will end January 21, 2013.

06/09/08

California State Board of Pharmacy

Stanley Weisser, RPh, is a new member of the California State Board of Pharmacy. His appointment will expire June 1, 2011.

Shirley Wheat has been appointed a public member of the California board. Her appointment will end on June 1, 2010.

Also appointed a public member of the California board is James Burgard, BSME. His appointment will expire June 1, 2009.

06/09/08

New Mexico Board of Pharmacy

Clarence Pearson, MD, has been appointed a public member of the New Mexico Board of Pharmacy. His appointment will expire July 1, 2012.

Rudolph Nolasco, RPh, has been elected vice chairperson of the New Mexico board.

06/09/08

Alaska Board of Pharmacy

The Alaska Board of Pharmacy has elected Mary Mundell, RPh, chairperson; Richard Holm, RPh, vice chairperson; and Dirk White, RPh, secretary.

06/09/08

Sherman Receives Pacific Alumni

Association Faculty Mentor Award

Ed Sherman, PharmD, of the Thomas J. Long School of Pharmacy and Health Sciences, was a recipient of the Pacific Alumni Association Mentor award. This award recognizes outstanding faculty who have mentored students and alumni through their personal professional relationships. Sherman is a long time California Pharmacists Association (CPhA) member and currently is the Region 2 trustee of the CPhA board of trustees. 

06/09/08

Malik Receives 2008 APhA Award in

Community and Ambulatory Practice

Shah N. Malik, MS (Pharm), RPh, Vancouver, Wash., is the 2008 recipient of the American Pharmacists Association Academy of Pharmacy Practice and Management (APhA-APPM) Distinguished Achievement Award in Community and Ambulatory Practice. Malik was officially recognized at the APhA Annual Meeting and Exposition in March.

The award was established to recognize the achievements of an individual who has made a significant contribution or sustained contributions to the provision of pharmaceutical care within community and ambulatory practice.

Malik was selected in recognition of dedicating his career to developing pharmacy-based immunization programs on the national and regional levels. He has been a role model, mentor, and advisor to countless pharmacists, interns, and student pharmacists, having trained hundreds of community and hospital pharmacists across the country.

Malik immigrated to the United States from Pakistan in 1968, after which he earned BS and MS degrees in pharmacy from the University of Montana. He has published several biopharmaceutical papers in the Journal of Pharmaceutical Sciences. He is a consultant to the Oregon State Pharmacists Association (OSPA) and the Oregon Board of Pharmacy on immunization-related issues. He was the first pharmacist in Oregon authorized to receive a Yellow Fever Stamp. He has received numerous awards, including Pharmacist of the Year from OSPA, Payless Drug Store, and the Professional Society of Pharmacists. His work has also received recognition by the American Diabetes Association and OAIC. He is an active member of APhA, Oregon and Washington State Pharmacist Associations, Washington’s Emergency Preparedness and Response Team, and Sigma Xi.

06/09/08

Longs Drugs Reports New Executive Appointments

Longs Drug Stores Corporation has announced three new executive appointments.

Todd J. Vasos has been named executive vice president and COO. He succeeds Karen Stout who has left the company. Vasos will be responsible for store operations, marketing, merchandising, construction and loss prevention. He joined Longs in 2001 as senior vice president of marketing. He was named senior vice president and chief merchandising officer in March of 2005. Immediately prior to joining Longs, Vasos was with the drug store chains, Phar-Mor Inc. from 1994 to 2001 and Eckerd Drug from 1983 to 1994.

Larry Gatta, group vice president of marketing, is being promoted to senior vice president and chief merchandising officer. He joined Longs in 2002 as vice president of marketing. With more than 25 years of retail marketing and merchandising experience, Gatta had worked for a number of retailers prior to joining Longs including Rite Aid, Phar-Mor and Giant Eagle/Tamco.

Linda Voracek, divisional merchandise manager responsible for cosmetics and toiletries, is being promoted to vice president of marketing and will be responsible for all front-end merchandise categories. Immediately prior to joining Longs in 2003, she was a category manager with Kmart for six years and had worked in product development for Shurfine for five years prior to joining Kmart.

05/02/08