MPARX

Maine Pharmacy Association

Celebrating 150 Years – Registration

Friday, October 13th to Sunday, October 15th Holiday Inn By the Bay Maine Pharmacy Association and the Maine Society of Health System Pharmacists  Come join your MPA and MESHP colleagues for an exciting weekend of education and festivities to celebrate the 150th anniversary of MPA, the first state pharmacy association.  The event is sponsored by both organizations […]

DHHS shared guidance documents for e-prescribing and opioid dispensing

DHHS shared guidance documents for e-prescribing and opioid dispensing.  Notably, “A pharmacist is NOT required to verify that a practitioner has a waiver of the requirement to electronically prescribe…” To review the official documents, please click on the links below. Electronic-Prescribing-Clarifications Opioid Dispensing Clarification    

E-Prescribing Grace Period Notice and Chapter 488 User Guide

The deadline for mandatory e-prescribing of opioids was rapidly approaching on July 1st. However, the State sent the following communication announcing a 31 day grace period for enforcement of the penalties for violating the e-prescribing provision.  This is good news and will give prescribers and dispensers a little more time to prepare. DHHS provided material on other provisions in Chapter […]

2017 Scholarship Golf Scramble

Join us for our 2017 Scholarship Golf Scramble ! Where: Val Halla Country Club When: Saturday, August 12, 2017 Shotgun start 1pm Includes 18 holes of golf on a championship course, golf cart, BBQ dinner at Rachel’s on the Green! Cost: Single Golfer: $110.00 Foursome: $400.00 Dinner Only: $35.00 Corporate or personal hole sponsorship: $75 […]

Pharmacists from across Maine convene in Augusta to advocate for profession and patients

Pharmacists and pharmacy students from across the state convened in Augusta on May 30th to advocate for LD 572.   Update: Senate passes LD 572; now on to the House!  LD 572 specifies in statute that the “Practice of Pharmacy” is “the provision of health care services” and that “Pharmacists” are “providers of health care services”. […]

DHHS shared guidance documents for e-prescribing and opioid dispensing.  Notably, “A pharmacist is NOT required to verify that a practitioner has a waiver of the requirement to electronically prescribe…”

To review the official documents, please click on the links below.

Electronic-Prescribing-Clarifications

Opioid Dispensing Clarification

 

 

The deadline for mandatory e-prescribing of opioids was rapidly approaching on July 1st. However, the State sent the following communication announcing a 31 day grace period for enforcement of the penalties for violating the e-prescribing provision.  This is good news and will give prescribers and dispensers a little more time to prepare.

DHHS provided material on other provisions in Chapter 488 which may also be helpful to pharmacists.

Opioid Prescription Requirements – User Guide

 


 

Commissioner Hamilton Logo edit final1 copyDepartment of Health and Human Services Commissioner’s Office 221 State Street 11 State House Station Augusta, Maine 04333-0011 Tel.: (207) 287-3707; Fax: (207) 287-3005 TTY Users: Dial 711 (Maine Relay)

 

 

 

 

 

June 29, 2017

 

Dear Prescribers, Dispensers, Professional Boards and Societies, and other interested parties:

 

The Maine Department of Health and Human Services would like to thank you for your commitment to the people of Maine. Under Public Law Chapter 488, An Act to Prevent Opioid Abuse by Strengthening the Controlled Substances Prescription Monitoring Program (PMP), electronic prescribing becomes mandatory on July, 1, 2017 or individuals would face a penalty.

 

https://legislature.maine.gov/legis/bills/bills_127th/chapters/PUBLIC488.asp

 

5.  Penalties.   An individual who violates this section commits a civil violation for which a fine of $250 per violation, not to exceed $5,000 per calendar year, may be adjudged. The Department of Health and Human Services is responsible for the enforcement of this section.

 

Under the Commissioner’s authority, the Department will be allowing a 31 day grace period regarding the enforcement of the penalties.

 

To be clear, this grace period only applies to the e-prescribing mandate. Chapter 488 Law is still fully in effect.

 

After this grace period, penalties for individuals who violate this section of the law will be enacted. If you need to apply for an e-Rx waiver, please visit the SAMHS PMP website to complete and submit your application: http://www.maine.gov/dhhs/samhs/osa/data/pmp/e-prescribing.htm

 

Additionally, please find an overview of guidance around opioid prescriptions, exemptions, and special information for veterinarians online: http://www.maine.gov/dhhs/samhs/osa/data/pmp/index.htm

 

For any additional questions, please do not hesitate to contact the PMP email at SAMHS.PMP@maine.gov.

 

 

Sincerely,

 

Christopher J. Pezzullo, DO

State Health Officer

Maine lawmakers are close to wrapping up this legislative session.  Here are updates of bills that will affect the practice of  pharmacy…

 
LD 455: Relating to the provision of tobacco cessation services by pharmacists
Summary: This bill amends the laws governing the practice of pharmacy to expressly include tobacco cessation counseling services and the furnishing of over-the-counter nicotine replacement products approved by the federal Food and Drug Administration. It also requires pharmacists to be reimbursed by the MaineCare program for these products and the corresponding counseling. 
Status: This bill has passed the House and Senate and is on the Governor’s desk.
LD 456: Increased access to adolescent vaccinations.
SummaryThis bill allows the administration of certain vaccines by a pharmacist to a person 11 years of age and older, instead of 18 years of age and older as in current law. 
Status: This bill has passed the House.  Senate has placed the bill on the special appropriations table pending enactment.  (This bill may not make survive appropriations, $$$).
LD 1594: Regarding the prescribing and dispensing of naloxone by pharmacists
SummaryThis bill provides that a pharmacist may prescribe and dispense naloxone hydrochloride to an individual at risk of experiencing an opioid-related drug overdose or to a person in a position to assist such an individual. 
Status: passed in House and Senate.  On the way to the Governor’s desk.
 
LD 572: Amend the laws governing the practice of pharmacy. 
SummaryThis bill specifies that the practice of pharmacy is the provision of health care services.
Status: Passed in Senate.  Defeated in House.  Sent back to House by Senate.  House defeated the “recede and concur” motion from the Senate.  Thus, the bill is defeated in the House by a vote of 76-72 with 3 absences.  

 

The outcome of LD 572 is especially unfortunate because the pharmacy community rallied behind this bill.  On March 7th, 2017, there was standing room only in the LCRED Committee room as pharmacists and pharmacy students from across the state testified in support of this bill.  The public records reflect 32 individuals (pharmacists, physicians and health system administrators) testifying in support.  In May, we had a letter writing campaign with over 100 letters of support sent to Senators and Representatives.  Recently, on May 30th, approximately 50 pharmacists and pharmacy students from across the state convened in Augusta again to advocate for LD 572.  I appreciate everyone’s effort whether you emailed your Representative, wrote your Senator, or advocated in person on March 7th or May 30th.  Unfortunately, our efforts were unsuccessful this time.  We won’t give up!  We’ll be back in the next session (with lessons learned from this year) asking for recognition of pharmacists as providers of health care services.
Best regards,
Mac

Pharmacists and pharmacy students from across the state convened in Augusta on May 30th to advocate for LD 572.

 

Update: Senate passes LD 572; now on to the House!  LD 572 specifies in statute that the “Practice of Pharmacy” is “the provision of health care services” and that “Pharmacists” are “providers of health care services”.  LD 572 puts the profession of pharmacy and the services they provide along with other health care professionals.  This is especially important in rural and underserved areas of the State.

 

The profession of pharmacy was recognized in both the Senate and House which reminded policymakers of our value on healthcare teams.  Pharmacy students from both UNE College of Pharmacy in Portland and Husson University School of Pharmacy in Bangor advocated alongside faculty including Dean Rodney Larson, Dr. George Allen, Dr. Stephanie Nichols, Dr. Alla Fabrikant and Dr. Cassandra Parsons.

Our collective voices were heard as the Senate voted affirmatively for LD 572.

LD 572 will now proceed to the House.

Stay tuned!

Good news!!  Two bills, LD 6, an “An Act to Prohibit Insurance Carriers from Retroactively Reducing Payment on Clean Claims Submitted by Pharmacies” and LD 455, “An Act Relating to the Provision of Smoking Cessation Services by Pharmacists” are moving through the legislature process.

LD 6, an “An Act to Prohibit Insurance Carriers from Retroactively Reducing Payment on Clean Claims Submitted by Pharmacies” has passed the Maine Senate and Maine House and is on the way to the Governor’s desk.   The Maine Pharmacy Association advocated for this bill.

What are Retroactive Payment Reductions?  In theory, calculating the profit from dispensing a prescription should not be difficult.  However, retroactive payment reductions such as Direct and Indirect Remuneration (DIR) fees are complicated charges that are billed to pharmacies often many months after a clean claim for a prescription has been submitted.  These charges may be the difference between the agreed upon reimbursement rate and another contractual variable or these fees may be based on compliance with contractually imposed performance metrics.  These retroactive fees, which began as a component of Medicare Part D plans, have expanded and are now incorporated in many commercial third party plans.
 
How does this affect pharmacy?
“DIR fees have wreaked havoc on independent community pharmacies and their ability to continue serving patients. These fees, typically assessed by PBMs well after prescriptions are dispensed to patients, blow a hole in community pharmacy operating budgets that is difficult to mend,” Doug Hoey, CEO of NCPA January 20, 2017
 
The growth in DIR fees is outpacing the growth of part-D drug costs and DIR fees have expanded to many commercial third party plans.  DIR fees have yet to show that they improve performance and specifically patient outcomes.  DIR fees do not reduce the cost of drugs for beneficiaries at the point-of-sale and in fact push seniors (especially vulnerable patients who use the prescription drug benefit the most) into the ‘donut hole’ and even further into the catastrophic phase of the Part D benefit.  As implemented, DIR fees are shifting the burden of drug costs away from the private insurance companies and onto the backs of local pharmacies.   LD 6 is a win for the profession because it requires fair reimbursement for clean pharmacy claims.

LD 455, “An Act Relating to the Provision of Smoking Cessation Services by Pharmacists” received a unanimous ‘ought to pass’ as amended from the Health and Human Services Committee.  The amended bill would add the following to the definition of “Practice of Pharmacy”… “the provision of tobacco cessation, ordering and dispensing of over-the-counter tobacco cessation products approved by the United States Food and Drug Administration”.

This bill is good public health policy because it increases access to smoking cessation products and services. A unanimous ought-to-pass from the committee is a significant step forward in the legislative process.  We’ll continue to monitor this bill through the legislature and to the Governor’s desk.

NOW is the time to advocate for your profession!  Details about how YOU can get involved are outlined below.

I’m delighted to report that a date for a public hearing has been set for LD 572, An Act to Amend the Laws Governing the Practice of Pharmacy, and LD 456, An Act to Increase Access to Vaccinations.  
 
JOINT STANDING COMMITTEE ON LABOR, COMMERCE, RESEARCH AND ECONOMIC DEVELOPMENT
Sen. Amy Volk, Senate Chair & Rep. Ryan Fecteau, House Chair 
PUBLIC HEARING: Tuesday, March 07, 2017, 1:00 PM, Cross Building, Room 208
 
NOW is the time to recognize pharmacists as Providers of Health Care Services!
 

LD 572 amends the definitions of “Pharmacist” and “Practice of Pharmacy” to specify that our profession provides health care services.  Every day, pharmacists across our state educate patients on the safe use of medications, immunize against vaccine-preventable diseases, provide comprehensive medication reviews to seniors, and reduce the risks of medication adverse events thereby lowering total healthcare costs.  LD 572 recognizes the role of pharmacists in today’s healthcare systems.  LD 572 formally defines what is already a fact; pharmacists are “Providers of Health Care Services” and members of the healthcare team.  LD 572 has bipartisan support; sponsored by Senator Volk  of Scarborough and co-sponsored by Representative Fecteau of Biddeford, Senator Brakey of Androscoggin, Senator Katz of Kennebec, Representative Perry of Calais, and Representative Chace of Durham.  With both accredited colleges of pharmacy in Maine training Doctor of Pharmacy graduates, now is the time to recognize the contribution of pharmacists to patient careMaine 128_LD 572 Practice of Pharmacy       

 
LD 456 expands access to vaccination services for teens and preteens by allowing the administration of certain vaccines by a pharmacist to a person 11 years of age and older, instead of 18 years of age and older as in current law.  The CDC routinely recommends the HPV vaccine to prevent certain cancers, the Tdap booster, and the meningococcal vaccine to persons in this age group.  LD 456 is good public health policy for 3 reasons.  1) Maine has the lowest vaccination rate of Tdap (87.7%), meningococcal (77.7%), and HPV (53.9%, >2 doses) of all New England states(1).  The recent pertussis outbreak in Maine with a peak of 557 cases in 2014 is a powerful reminder that infectious diseases can gain ground at any time, unless we remain vigilant(2).  2) Pharmacists are the most accessible healthcare professionals.  Over 1,000 pharmacists have been trained and registered as immunizers in Maine.  Pharmacist immunizers are located in every county of our state and offer vaccination services in underserved, rural communities.  Many pharmacies offer vaccination services on a walk-in basis during days, evenings, and weekends.  3) Lastly, LD 456 ensures pharmacists work in collaboration with the child’s physician.  LD 456 and existing regulations require a prescription or standing order for Tdap, Meningococcal or HPV vaccines prior to pharmacist administration.  LD 456 and existing regulations also require the pharmacist to notify the authorizing practitioner (of the vaccine administration) who issues the prescription or standing order within 3 business days.  This bill ensures that pharmacists work collaboratively on healthcare teams to ensure appropriate immunizations. Maine 128_LD 456 Access to Vaccinations
 
What can YOU do to advocate for pharmacy?
1) Attend the public hearing on March 7th.  Bring a patient advocate, bring a medical colleague, bring your APPE students (in their white coats).  
2) If you can’t attend in person, send me your testimony of support (template letter attached) and I’ll submit your testimony on your behalf at the public hearing.
 
Pharmacy needs to STAND UNITED for this hearing and show our commitment to public policy solutions that optimize care for patients.  We need at least 30 pharmacy students in white coats at this hearing.  We need pharmacists from a variety of practice settings to testify their support.  We need at least 100 letters of support from pharmacists across the state.
 
 
Thank you for your commitment!  Please feel free to contact me with questions.
 
 
Best regards,
 
Mac

Opioids can have serious risks and side effects, and CDC developed the CDC Guideline for Prescribing Opioids for Chronic Pain to encourage safer, more effective chronic pain management. CDC’s new Opioid Guideline App makes it easier to apply the recommendations into clinical practice by putting the entire guideline, tools, and resources in the palm of your hand.

Since 1999, the amount of prescription opioids sold in the U.S. has nearly quadrupled.

FEATURES INCLUDE:

  • Patients prescribed higher opioid dosages are at higher risk of overdose death. Use the app to quickly calculate the total daily opioid dose (MME) to identify patients who may need closer monitoring, tapering, or other measures to reduce risk.
  • Access summaries of key recommendations or link to the full Guideline to make informed clinical decisions and protect your patients.
  • To provide safer, more effective pain management, talk to your patients about the risks and benefits of opioids and work together towards treatment goals. Use the interactive MI feature to practice effective communication skills and prescribe with confidence.

MANAGING CHRONIC PAIN IS COMPLEX, BUT ACCESSING PRESCRIBING GUIDANCE HAS NEVER BEEN EASIER.

Download the free Opioid Guideline App today!  CDC Drug Overdose Prescribing APP

This App, including the calculator, is not intended to replace clinical judgment. Always consider the individual clinical circumstances of each patient.

LEARN MORE
www.cdc.gov/drugoverdose/prescribing/guideline.html |

The Department of Health and Human Services has released a communication concerning the implementation of DHHS rule to carry out the requirements of PL 488.  DHHS has collaborated with stakeholders to assist the department to improve the program and policy regarding opioid medication practices here in Maine. It is the hope that this communication will serve to calm some of the apprehensions around the DHHS rule.  The Maine Pharmacy Association will continue to communicate information as it becomes available.

 

Click Here for Letter

Please verify your PMP account information by end of business November 30, 2016 to ensure a smooth transition to the new software system in mid December.  Please read the letter from Sheldon Wheeler outlining the new system requirements and transition plan.


 

Dear Account Holder:

The Maine Prescription Monitoring Program (PMP) will be upgrading software systems to meet the required PMP enhancements identified in Chapter 488 Public Law. The Department will be moving to the new software on Tuesday, December 20, 2016. Please find important information about the upcoming transition below.

In the new system, only one user account is allowed per email address. All accounts that share an email address MUST provide a unique email address for each user moving forward, or they will NOT be transferred to the new system. If your account is not transferred, you will have to submit a new registration application and wait for your account to be approved by the state administrator.

To ensure your account is successfully transferred to the new system, please verify that the email address listed on your account is unique. Log in to your existing account at

https://mepdm-ph.hidinc.com/melogappl/bdmepdmqlog/pmqhome.html to review and update your profile.

Please complete all account updates by the end of business on Wednesday, November 30, 2016.    

Additional login information and the user guide will be forthcoming. 

Please be aware that there will be a delay in prescription history of up to 2 weeks during the transition. We appreciate your understanding and patience during this time.

Should you have any questions at this time, you may contact the Maine Prescription Monitoring Program at (207) 287-2595 or by email at SAMHS.PMP@maine.gov.

Best Regards,

Sheldon Wheeler

Director, Office of Substance Abuse and Mental Health Services

 

CC:

Evelyn Sharkey, PMP Coordinator

Jessica Bates, PharmD,  shared a summary document regarding the new opioid prescribing laws in Maine.  It is a document created for providers with suggestions for compliance.

Please click here for the summary.

Thank you Jessica.