LTC Pharmacy News
July 2023
Expand Your Pharmacy Practice-Part Deux!
Frances Nahas and Jim McDonald of RedSail Technologies and Integra were gracious enough to give me an extra inning to talk about the nearly unlimited opportunity awaiting long-term care pharmacy in this, the most exciting time in history to be in healthcare. 

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No August Newsletter
Just as hope triumphs over experience, I will be trying to sort my files, freshen up some content and enjoy some time with the grandkids over the next month. The only goal likely to be accomplished is the one involving grandkids. 

Looking forward to getting back in touch in September. Any ideas for white papers, blog posts, tutorials? Let me know. I don't know much, but I know people who do. Have a great August!
 Federal Updates
CMSProposed Rule Cuts Home Health Reimbursement
CMS has issued a proposed rule that will, if finalized, reduce Medicare Home Health reimbursement by $375 million in calendar year 2024. The payment reduction is intended to account for the impact of the introduction of the Patient-Driven Groupings Model (PDGM)

CMS Updates Medicare Drug Price Negotiation Guidance
The Medicare Director at CMS released a nearly 200-page document detailing the process the agency will use to enter its first round of drug price negotiations with drug companies for certain drugs covered by Medicare. The 10 drugs selected for price negotiation will be determined sometime prior to September 1.

CDC Recommends Seniors Get RSV Vaccine
The Center for Disease Control recommends that persons aged 60 and older receive one of the two vaccines indicated for prevention of respiratory syncytial virus (RSV). Vaccines sponsored by GSK and Pfizer have the indication and are expected to be available sometime this fall.

DEA Adds Second Step in Reporting Controlled Drug Theft or Loss
The rule, which goes into effect on July 24, 2023, adds a follow-up requirement to the initial requirement of all registrants to report the theft or loss in writing to the DEA field office within one business day of discovery. Under the new rule, the formal follow-up notice must be electronically filed with DEA within 45 calendar days of the discovery.

Everything Else
NY Nursing Homes Face Staffing Fines
The state of New York will begin assessing penalties against nursing homes that fail to meet the new staffing mandate as early as July 10. Nursing homes are struggling to find ways to comply with a regulation they complain does not come with any additional state money to help them comply.

Forget BMI, Says AMA
the American Medical Association has come out in favor of abandoning the current method by which we tag people as overweight or obese. The physician association notes that the body mass index (BMI) is flawed because it relies on information derived primarily from white people. Doctors should base their assessment of body weight by a broader view of healthy weight.

Senior Living Occupancy Increases Again
Assisted living and independent living facility occupancy is up by .6%, continuing its long climb from the lows experienced during the pandemic. Despite the good news, total occupancy has yet to recover from pre-COVID levels.

Top10 Drugs Account for 22% of Part D Spend
KFF (formerly the Kaiser Family Foundation) reports that its analysis of drug spending in Medicare Part D reveals that the top-10 drugs account for 22 percent of the total Part D spending in 2021, while accounting for 0.3 percent of all Medicare-covered drugs.

This may be a clue as to which drugs CMS will designate as candidates for price negotiation in 2026.

President's LTC Agenda Faces Headwinds
The Administration's long-awaited nursing home staffing rule is at the Office of Management and Budget, undergoing final review before publication. The tug of war between tougher standards and the difficulty of attracting talent to the industry has proven more difficult to manage than the Biden team imagined.

Will Leqembi Coverage Bankrupt Medicare?
With full FDA approval, Leqembi, an Alzheimer's disease drug developed by Eisai and Biogen, becomes eligible for coverage by Medicare without the restrictions imposed on Aduhelm, Biogen's previous entry into the market. Aduhelm was approved for Medicare coverage for people enrolled in a clinical trial.

At a price of $26,500 per year, the bill for Medicare could run into several billion dollars.

Nearly 800K People Die or are Disabled Due to Wrong Diagnosis
You might expect this to be more rare than it is, but according to a study from Johns Hopkins, death and disability due to misdiagnosis affects 795,000 people in the US every year.

USP Changes go Live in November. Are You Ready?
The US Pharmacopeia standards compounding-related chapters become applicable on November 1. Are you ready for the changes?

The changes that have gotten the most interest relate to classification of hazards.