| LTC Pharmacy News
January 2025 |
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| A New Year! New hopes and new dreams. We've been here before. Sometimes it works out, and sometimes not. Let's choose optimism and vow to learn from our mistakes. I plan on experiencing many of these over the coming months.
Lots going on in the healthcare world, and the slightly smaller world of pharmacy and LTC pharmacy. One of my resolutions is to publish more content more frequently. The early months of the year have state legislatures in session and a new administration is moving in, so the world will move quickly. I will try not to miss anything that might be important to you.
Now, let's all take a deep breath and imagine how great we will feel this time next year if we give it our best this year.
Keep in touch
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TheMedicare Drug Benefit: An Update and Refresher for LTC Pharmacy
Medicare Part D was created more than 20 years ago. This post gives a bit of history on how the benefit was passed and how the regulatory process produced the system we have today. It also provides an update on the Medicare drug benefit as it has evolved over the past decades. More |
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| | | | Biden Administration Releases Draft 2026 MA and Part D Payment Policies The Administration released the advanced notice of proposed changes to the Part C (Medicare Advantage) capitation methodology and discusses annual changes to the Part D standard benefit parameters for 2026. CMS proposes to increase MA payments by 4.3 percent ($21 billion), much to the irritation of physician groups.
FDA Issues Final Rule on Non-Prescription Drug Approval An FDA final rule has been published that allows some non-prescription drugs to be used for additional conditions for non-prescription use (ACNU). The FDA implemented this rule to increase the options to use non-prescription drugs, subject to a self-qualification questionnaire.
CMS Offers Nursing Home Nursing Incentives CMS will offer registered nurses and incentive to put their talents to use in nursing homes and will streamline training for non-nurses to qualify for Certified Nursing Assistant status. More
CMS Memo on 2025 Nursing Home Survey Priorities The 2025 mission and priorities document lays out this year's priorities for state survey agencies. Among them, the inappropriate use of antipsychotic medications, staffing, and involuntary discharges. More
FTC Issues 2nd Report on PBMs, Suggesting Excessive Markups The Federal Trade Commission issued a second staff report comparing cost of acquisition of select drugs to prices charged by affiliated pharmacies. Many of these comparisons demonstrate price inflation of more than 1,000 percent. More
Medicare Current Beneficiary Survey: Women's Health Data Book CMS announces the first Women's Health Data Book, based on data from 2022. Highlights include prevalence of women with four or more chronic conditions, pulmonary issues, and disability.
HHS Strategic Plan for Artificial Intelligence The HHS has developed a strategic plan for the use of AI in Health, Human Services, and Public Health. The plan includes the support of models that are ethical, appropriate, and effective. coming at the end of the Biden Administration, we will watch to see what the incoming Trump Administration will do.
NIH Publishes Policy on Drug Access The National Institutes of Health released a updated policy document requiring companies seeking to license NIH patents to submit an Access Plan outlining steps they intend to take to promote patient access to licensed products. |
| | What's Happening in the States |
| | PBM Reform: How States are Trying to Control Drug Spending
An article published by Multistate Associates surveys the issues state legislatures will face in the regulation of PBMs. Among the most urgent are spread pricing, 340B pharmacies, PBM reporting, and patient steering by PBMs. More
McKesson to Support State Pharmacy Associations for Advocacy McKesson Amplify, a project from the drug wholesaler to support the preservation of pharmacy services, announced that it would be providing financial support to selected state pharmacy associations to encourage advocacy and engagement. Associations have been encouraged to apply for these grants. More |
| | | | Will PBM Reform Save Pharmacies From Closing? The pharmacy industry has focused on the negative impact of aggressive actions by PBMs as a major factor in the closure of pharmacies in the US. Indeed, the evidence is strong that there is such a correlation. However, the author of this article suggests that other factors are at play. More
Aetna Sues Drug Companies Over Generic Drug Price Fixing Aetna, the insurance arm of CVS, has filed suit against several drug manufacturers, alleging the companies conspired to selectively bid with health plans to maintain market share and increase prices. More
CVS Layoffs Continue CVS will eliminate 164 corporate positions as a result of the loss of the Kansas Medicaid contract. The company informed Connecticut, under the Worker Adjustment and Retraining Act (WARN) requirements of the layoffs. The company announced in October that it would reduce headcount by 2900 positions.
Walgreens Beats Expectations Despite Loss The drug retailer saw its stock jump despite losing $265 million in the quarter. The company reports that it plan to close 1200 retail locations is proceeding, with 70 stores shut down in the first quarter.
RiteAid Survey on Public Relationships With Pharmacists Chain drug retailer Rite Aid reports on a survey showing consumers are not fully aware of the capabilities of community pharmacists. While the profession is well regarded, there is relatively low awareness of how much pharmacists can do to provide valuable services.
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