March 14, 2014

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March 14, 2014 

United States Congress

Medicare payment bill introduced: On Tuesday, March 11, 2014 sponsor Congressman Brett Guthrie (R-KY) and cosponsors Congressman G.K. Butterfield (D-NC) and Congressman Todd Young (R- IN) introduced legislation authorizing the payment of pharmacist services through Medicare Part B. The legislation, HR 4190, would amend the Social Security Act by:

1. Adding language at 42 USC 1395 x(s)(2) which defines “Medical and other health services.” The amending language states:

Pharmacist services furnished by a pharmacist, as licensed by State law, individually or on behalf of a pharmacy provider—(i) which the pharmacist is legally authorized to perform in the State in which the individual performs such services; (ii) as would otherwise be covered under this part if furnished by a physician, or as an incident to a physician’s service; and (iii) in a setting located in a health professional shortage area (as defined in section 332(a)(1)(A) of the Public Health Service Act), medically underserved area, or medically underserved population (as defined in section 330(b)(3) of such Act).

2. Adding language at 42 USC 1395l(a)(1) which defines “Payment of benefits.” The amending language states:

(AA) with respect to pharmacist services (as defined in section 1861(s)(2)(GG)), the amounts paid shall be equal to 80 percent of the lesser of the actual charge or 85 percent of the fee schedule amount provided under section 1848 if such services had been furnished by a physician’’.

The effective date for payment of services would be on or after January 1, 2015.

Over the next weeks AACP will provide AACP members with additional advocacy tools to build congressional support for HR 4190.

Administration

Another try at gainful employment regulations: On Friday March 14, 2014 the U.S. Department made available a pre-publication copy of its proposed rules on gainful employment. The newly proposed rules include two metrics: student cohort default rate and debt to income ratio. As you may recall a court ruling struck down certain provisions of the 2010 were struck down certain provision 2012. The court did not challenge the department’s authority to develop rules related to gainful employment.

The department, through the negotiated rule making process that ended December 2013, was unable to gain consensus around the draft rules it presented the panel. During the negotiation process the department removed the loan repayment metric that had been part of the draft rule package. Since there was no consensus among the members of its negotiated rule making panel, the department proceeded with drafting proposed rules that take into consideration the input of the panel. The loan repayment metric does not reappear in the rules proposed by the department on Friday.

According to the Dear Colleague Letter published by the department on April 20, 2011 institutions with programs that lead to the Doctor of Pharmacy as the first-professional-degree and any certificate programs a student successfully completes within the time of their professional education are not subject to the gainful employment rules.

Members of the House Committee on Education and Workforce immediately denounced the departments actions. In a news release on Friday the committee chair and other committee leaders stated that department should be working with them to develop a comprehensive approach to higher education reform through reauthorization of the Higher Education Act. Members also expressed concern that the department’s proposed rule would have a negative impact on minority students that comprise a large percentage of participants in programs subject to gainful employment rules.

Agencies discuss FY15 budgets: Following last week’s release of the President’s FY15 budget request to Congress federal agencies are providing additional detailed resources. These resources include documents referred to as congressional justifications. These “CJ”s include information about the programs and services administered by the agency and comparisons of current funding requests and the past fiscal year. This week both the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) discussed their FY15 budget requests with members of their respective coalitions.

CDC Director Tom Frieden, speaking to the CDC Coalition remarked that the FY14 Omnibus restored nearly all the funding reductions the agency suffered as a result of sequestration. The FY15 budget request is slightly less than the enacted amount for FY14. New programs that the Director would like Congress to fund include: global health security; antibiotic resistance and prescription drug abuse. Specific funding and program information is available in the CDC FY 15 congressional justification.

HRSA Deputy Administrator Marcia Brand was joined by a number of Bureau leaders to discuss the HRSA FY15 budget request with the Friends of HRSA. Provision of high quality care within the HRSA administered community health centers program will remain a priority for FY15. Health professions workforce is an important focus of HRSA. The recruitment and retention of primary care providers through the National Health Service Corps is a presidential priority. HRSA, while required to work within the siloed categories of the health professions legislation, is attempting to improve the team-based, collaborative care delivered by health professionals through the creation of a new competitive clinical training and interprofessional grant program. Health professions bureau staff indicated that this proposed grant program would assist health professions educators develop and improve their capacity to provide learning environments, across the healthcare spectrum, in which team-based care is already the model of delivery so students will learn and benefit from that increasingly important environment. Specific funding and program information is available in the HRSA FY15 congressional justification.

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Founded in 1900, the American Association of Colleges of Pharmacy (AACP) is a national organization representing the interests of pharmacy education and educators. Comprising all accredited colleges and schools of pharmacy including more than 6,400 faculty, 57,000 students enrolled in professional programs and 5,700 individuals pursuing graduate study, AACP is committed to excellence in pharmacy education.

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