MPARX

Maine Pharmacy Association

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”. […]

LD6 and LD44 Are Successfully Moving Through the Legislative Process

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 […]

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

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

Maine’s new opioid prescribing and PMP law takes effect July 29th, though some provisions have other timeframes specified in the law.  The impact of this law will significantly affect prescribers, pharmacists and patients.  Here’s an essential update:

Penalties

Individuals who violate this law (prescribers and pharmacists) may be subject to civil penalties of $250 per violation, not to exceed $5000 per calendar year.

 

Limits on Prescribing

Effective 7/29/16 – Limits new opioid prescriptions, or an aggregate of multiple opioids prescriptions, to no more than 100 morphine mg equivalents (MMEs) per day.  Visit the Maine Quality Counts Caring for ME webpage for information on compassionate tapering of opioids.

 

Effective 7/29/16 until 7/1/17 – For patients who already have active prescriptions that exceed 100 MMEs per day, opioids prescriptions must be limited to 300 MMEs per day, in aggregate.

 

Effective 7/1/17 – New and existing prescriptions for opioid medications are limited to 100 MMEs per day.

 

Exceptions

  • Medical necessity that is documented in the patient’s record.  This expires 1/1/17.
  • Cancer pain
  • Palliative care associated with a serious illness or injury.
  • End of life and hospice care
  • Medication-assisted treatment for substance abuse disorder
  • Opioids directly ordered or administered in an emergency room, hospital, long-term care or residential treatment facility.
  • Or other circumstances to be defined in rule by 1/1/2017.

 

Effective 1/1/17 – Opioid prescriptions for acute pain limited to 7 day supply within a 7 day period (renewable).  Opioid prescriptions for chronic pain limited to a 30 day supply within a 30 day period (renewable).

 

Prescription Monitoring Program

Effective 1/1/17 – Prescribers must check the PMP upon initial prescription of a benzodiazepine or an opioids, and every 90 days thereafter for as long as the prescription is renewed.  This provision does not apply when a benzodiazepine or opioids is ordered or administered in an emergency room, a hospital, a long term care facility or a residential care facility.

 

Effective 1/1/17 – Pharmacists must check the PMP prior to dispensing a benzodiazepine or opioids under the following circumstances:

  1. A person is not a resident of Maine
  2. The prescription is from a prescriber with an address outside Maine
  3. The person is paying cash when the person has a prescription insurance on file
  4. According to the pharmacy record, the person has not had a prescription for a benzodiazepine or an opioids medication in the previous 12 months.

 

o   Requires that pharmacists notify the program and withhold a prescription until the pharmacist is able to contact the prescriber if the pharmacist has reason to believe that the prescription is fraudulent or duplicative.

o   Allows on-duty pharmacists to authorize staff to access the PMP for customers filling prescriptions.

 

The Maine PMP is making efforts to automatically register pharmacists into the system in conjunction with annual license renewal.  However, there’s no guarantee this will be done in time for January 2017.   As of July 2016, only half of Maine pharmacists are registered with the PMP.  Don’t wait, register now.

 

Pharmacists, register with the PMP here.

 

Pharmacy Technicians, register as a sub-account here.

 

Electronic Prescribing

Effective 7/1/17 – All prescribers must prescribe opioids electronically.  A waiver from DHHS must be requested if compliance cannot be met.

Of note – New York was the first state to require electronic prescribing of controlled substances.  Maine will be the second state.  As of July 2016, 94% of pharmacies and 4% of physician practices in Maine are equipped to electronically transmit controlled substance prescriptions.  If you are uncertain if your pharmacy is equipped, contact your pharmacy operating system vendor.  Arrange with your vendor for a demo, timeframe for installation, training and pricing.

 

Education

Effective 12/31/17 – All prescribers of opioid medications must complete 3 hours of CME on opioids every 2 years.

 

 

Best regards,

Mac

Maine Attorney General, Janet Mills, has requested the assistance of the Maine Pharmacy Association in regards to the heroin and opioid abuse crisis in the State of Maine.  Please read the Letter from AG Mills and the accompanying Narcotic Drugs Warning and take action to be part of the solution. Read the rest of this entry »

We’re one step closer to advancing pharmacy practice in Maine!  The proposed rule-making for Collaborative Drug Therapy Management is now available.    Please review the Proposed Rule-making CDTM Document and share your thoughts to MPARXinfo@gmail.com by December 31, 2015.   MPA will collate all comments into a letter to the Board by the comment deadline of January 4th.

HR 592/S314 “Pharmacy and Medically Underserved Areas Enhancement Act” is one of the most important legislative initiatives for the profession of pharmacy. HR 592 and the Senate companion bill S314 would amend Title XVIII of the Social Security Act to include pharmacists as providers thereby enabling patient access to, and payment for pharmacy services.  Currently, there are 185 cosponsors in the House of Representatives for HR 592 and 28 cosponsors of S314 in the Senate. Representative Pingree and Senator Collins have already pledged their support to the bill.

 

Recently, a delegation from Maine Pharmacy Association met with legislative staff at Representative Poliquin’s office in Lewiston to advocate for this important legislation. The visit concluded by asking Representative Poliquin to support patient access to cost-effective pharmacy services and to cosponsor HR 592. The MPA delegation will be meeting with Senator King’s office later this month.

 

Poliquin

From left to right: Kenneth McCall, PharmD, Associate Professor UNE, Cassandra White, PharmD, Assistant Professor, Husson University, Amelia Arnold, PharmD, Manager of Retail and Clinical Operations, Community Pharmacies, Erin Kany, UNE Class of 2017, Stephanie Lewis, PharmD, UNE-Hannaford Pharmacy-Martin’s Point Healthcare PGY1 Resident, Jacob Turmel, Husson Class of 2016, and Minh Pham, UNE Class of 2016.

The pharmacist and student pharmacist contingent who attended the joint House/Senate hearing at the Cross State Office Building in Augusta (2/24) on LD 141 “An Act to Amend the Definition of ‘Health Care Practitioner’ in the Maine Health Security Act to Include Pharmacists” which was introduced by Representative Paul Chace. 

 
Many individuals testified in favor of the bill including Dr. Ken McCall from UNE, Dr. Dan Robinson from HUSOP and Whitney Jandreau (HUSOP P4 and the only student pharmacist speaking). There was no testimony against the proposed act.Students and Pharmacists at LD141 Hearing with Representative Chace

For Immediate Release, February 24, 2015

On Monday, February 23, 2015, Judge Nancy Torresen ruled in favor of our case against the State of Maine (Ouellette, et al vs. Mills) regarding the importation of medications from specific foreign countries. Judge Torresen ruled definitively in our favor that the Maine law passed in 2012 (LD 171, Public Law chapter 373) violates federal laws which were established to protect the public from unsafe medications.

 

From the beginning, we raised significant concerns about threats to public safety by the illegal importation of prescription drugs into Maine through foreign-based brokers and other entities. The federal government strictly limits importation of pharmaceuticals for personal use, yet the Maine law looked to circumvent this secure drug-supply system.

 

“Maine pharmacists are relieved that Judge Torresen’s ruling ensures the safety of prescription drugs for Mainers by upholding federal laws that are designed to prevent unapproved and substandard drugs from coming into the United States,” stated Kenneth McCall of the Maine Pharmacy Association, one of the plaintiffs in the case.

 

“We believe the Court ruled correctly. All along, we warned that the law violated federal laws and this ruling proves that. Maine people can be assured that the prescriptions that are filled by Maine pharmacists are approved medications,” stated Curtis Picard of the Retail Association of Maine, a plaintiff in the case. “We expect foreign companies to abide by this ruling and federal law and to cease illegally importing drugs into Maine.”

 

CONTACTS
Curtis Picard                                                                          Kenneth McCall, PharmD, RPh

Executive Director, Retail Association of Maine                      Maine Pharmacy Association

207.240.7377 (cell), Curtis@retailmaine.org                          207.205.7327 (cell),mparx.president@gmail.com

 

 

###

On January 28th, 2015​, the federal provider status legislation was reintroduced in the House of Representatives. The bill – introduced by Reps. Brett Guthrie (R-KY), G.K. Butterfield (D-NC), Todd Young (R-IN), and Ron Kind (D-WI) – is called the Pharmacy and Medically Underserved Areas Enhancement Act H.R. 592. Similar to 2014’s, H.R. 4190, the provisions will provide access to pharmacist provided patient care services to patients in medically underserved communities. This bill and its forthcoming companion bill in the Senate is the key priority for the Patient Access to Pharmacists’ Care Coalition (PAPCC), which Maine Pharmacy Association, participates in through the National Alliance of State Pharmacy Associations. Click here to view the press release from the American Pharmacists Association.​