LTC Pharmacy News
May 2022
Collaborate with Customers to Retain Staff
One of the biggest challenges in all of healthcare right now is keeping qualified staff on board and engaged. Your customers in long-term care are having the same problem as you. Does it make sense to work together to solve this one?

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Federal Updates
CMS Publishes Final MA and Part D Rule for 2023
The final rule, scheduled for publication in the federal register on May 9, finalizes CMS' proposal to address the DIR issue, where pharmacies are subject to PBM claw back after the prescription has been addressed, but CMS has delayed implementation until January 2024.

CMS also addressed MA provider network adequacy as well as marketing communications and other issues.

CDC Updates LTC Facility Vaccination Forms
The Center for Disease Control announced updated forms for LTC facilities to report vaccination status for their facilities. The new revisions are intended to simplify reporting and make it easier for facilities to comply.

Inspector General Raises Concerns about MA Prior Authorization
The HHA Inspector General released a report raising concerns that some Medicare Advantage organizations had inappropriately denied prior authorization requests from beneficiaries. 

The plans denied coverage in some cases when the request would have been covered under fee-for-service Medicare.

FDA Approves Test for Alzheimer's Disease
The Food and Drug Administration approved an in vitro test for early detection of amyloid plaques associated with Alzheimer’s disease. The intention is to use the test in persons over the age of 55 who have exhibited cognitive signs that may indicate Alzheimer's disease.

CDC on Effectiveness of Boosters on COVID in Nursing Homes
The question being asked was whether a booster shot of COVID-19 vaccine during an omicron breakout was effective in protecting nursing home residents from infection.

FDA Restricts Use of J&J COVID-19 Vaccine
FDA updated its guidance for the use of the Johnson and Johnson COVID-19 vaccine. The new guidance limits use to individuals 18 years of age and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate, and to individuals 18 years of age and older who elect to receive the Janssen COVID-19 Vaccine because they would otherwise not receive a COVID-19 vaccine.

Everything Else
Pharmacy Critics Speak Out

Docs Complain About Pharmacy Automation
Doctors affiliated with Physicians for Patient Protection complain that chain pharmacies that rely on pharmacy automation are putting patient safety at risk. However, there appears to be some underlying concern that pharmacists are looking to expand their scope of practice at physician expense.

AMA Pans Test-to-Treat: Pharmacists not Ready
The American Medical Association has criticized the Biden Administration's test-to-treat program which authorizes pharmacists to test for COVID-19 and, if positive, dispense medication immediately.

The physician lobby claims pharmacists are not qualified to perform this duty.

LTCAlliance to Form: Fix Long-Term Care
The Green House Project and Pioneer Network have agreed to band together to form an alliance aimed at changing long-term care in light of the National Academies Report which focused on the major deficiencies of the current LTC system.

PillPack Pays Fine for Early Insulin Refills
The US Attorney for Southern NY announced that Amazon company PillPack had agreed to pay $5.79 million to settle charges of fraud related to early refills of insulin pens.

The settlement will be paid to the federal government and to individual states affected by PillPack actions

Pharmacy Cheers End of DIR Fees
The long struggle to prohibit the PBM practice of clawing back pharmacy payments for Medicare Part D drugs appears to have ended successfully with the publication of the CMS final rule for Medicare Advantage and Medicare Part D programs in 2023.