Actually, it's not that they don't understand the concepts so much as they have been convinced by the PBMs that there is no savings to be made that way. PBM testimony and testimony from TRS and ERS, as well as their actuary, all said the end result will be the same.

 

Yes, that's the case, at least the way the RFP was written. A transparent contract simply would not fit the parameters of the state's RFP. One of our experts, Gerry Purcell of Pharmacy Partners, told committee members that he has seen numerous contracts, even contracts for many fewer lives than the state of Texas plan, that save significant money for both employers and the beneficiaries.

 

One the many PBMs that operate with the transparent mode, Catalyst, testified he could save approximately $20 million on one of the state's contracts. More importantly, he offered to pay for an auditor of the committee's choosing to review the savings that Catalyst believes its plan could offer.

 

One interesting tidbit from the hearing: Committee members learned the same actuary has been advising ERS for 30 years without having to submit a competitive bid for the work! Look for that oversight to be remedied the next time around.

 

In the meantime, we, along with our colleagues from the other pharmacy organizations, have a few actions in mind.

 

Stay tuned!

 

P.S. As you can see, I'm back. And I've been cleared to drive again! Hooray!! Thanks so much for everyone's continued good wishes. I can tell you the world is a much brighter place this side of the operation than it was during the 10 days I waited for it. 

 

In discussions with Sen. Martinez and his staff, NCPA noted that  many independent pharmacies, already licensed by the state, would be forced out of the DMEPOS program because of the added costs of the half million dollar bond. At the same time, unscrupulous and unregulated fly-by-night operatives would be undeterred by the additional cost. Sen. Martinez agreed to drop his surety bond amendment, while increasing civil and criminal penalties for those who defraud Medicare and expelling them from the program. NCPA strongly supports that effort.

 

The Centers for Medicare & Medicaid Services has proposed a $65,000 surety bond, which NCPA strongly opposes for the same cost and patient access reasons. NCPA looks forward to continuing to work with Sen. Martinez's office to fight fraud in this important Medicare program while protecting small pharmacies and their patients.

While the Bush Administration has dealt pharmacy small business owners a tough hand over the last several years, especially with a severely flawed definition of AMP, the $150 billion economic stimulus package the president signed into law last week has several features that are of significant benefit to small businesses.

Please talk to your accountant about these and other provisions in the new law. If you are able to make some new investments in your business, check out the Community Pharmacy Supplier Guide on the National Community Pharmacists Association Website.

 

 

Lynn Everett, RPh