| TPA members can access the following articles and more on our
BREAKING NEWS,
TENNCARE News,
MEDICARE News and
LEGISLATIVE Information pages. You may also wish to view
current News at a Glance,
as well as
News at a Glance 2006 and
News at a Glance
2005.
12.21.04 TennCare Drops Aggrenox from PDL
The Bureau of TennCare has asked the Tennessee Pharmacists Association to notify
members that Aggrenox® will be removed from the PDL effective January 1st, 2005.
Alternative products available on the PDL include: Dipyridamole, Persantine®,
Ticlopidine, Ticlid®, and Plavix®. Complete article and link to First Health...
12.20.04 Medicare Part B Payment Rates
The Centers for Medicare & Medicaid Services (CMS) has released the payment rates
for Medicare Part B covered drugs and biologics for the first quarter of 2005. For the
majority of Part B drugs, the payment amounts are based on 106% of the Average Sales Price (ASP). The ASP was calculated based on data submitted by drug
manufacturers for the third quarter of 2004. Complete article and payment rates...
12.20.04 Cariten Switches to ProCare PBM - New Info
On December 15, 2004, the Tennessee Pharmacists Association disseminated a notice (see below) about Cariten Healthcare's switch to ProCare PBM. Cariten
Healthcare has asked that we provide additional information. Complete article...
12.15.04 Cariten Switches to ProCare PBM on January 1
The Tennessee Pharmacists Association learned today that Cariten Healthcare has
changed its Pharmacy Benefit Manager. Effective January 1, 2005, ProCare PBM will
begin processing claims for Cariten. Pharmacies should be set up to process all Cariten Healthcare claims to ProCare PBM by that date. Complete article, ANSI BIN #,
samples of new cards, ProCare PBM Help Desk number, Cariten Healthcare's new NCPDP Version 5 Response Payer Sheet Template, NCPDP Version 5 Request
Payer Sheet Template...
12.15.04 Caremark Branding Changes The Tennessee Pharmacists Association received word today that effective
December 1, 2004, Caremark began producing ID cards with the Caremark logo,
both for new cards and for ID cards on existing plans. While many names have been
used to refer to the company (AdvancePCS, A Caremark company; Caremark;
CaremarkPCS), "Caremark" is the adopted brand name going forward. A new
BlueCross BlueShield of Tennessee ID card with the Caremark logo will also be
used, however, this change does not impact the way pharmacies submit claims for BCBST members. Complete article, new cards, processing information, Help Desk numbers.
12.14.04 TennCare Compound Segment Change: January 3
The Bureau of TennCare has requested the assistance of the Tennessee Pharmacists Association in advising pharmacists of an important change that will
impact the Point-of-Sale (POS) system used for processing TennCare pharmacy claims: On January 3, 2005, First Health Services Corporation, at the request of
TennCare, will begin to accept and process the NCPDP Version 5.1 Compound Segment in order to provide electronic submission of multi-ingredient compounds.
To facilitate pharmacists' efforts, TennCare has provided an updated Payer Specifications Sheet which includes the Compound Segment. This change will
require changes to your software. You are urged to contact your software vendor
immediately to ensure that you will be able to submit claims utilizing the Compound
Segment without interruption. For important details, TPA members should read TennCare's complete 3-page notice. Members may contact TPA to request a fax
copy: 615.256.3023 or tpa@tnpharm.org. A conference call for providers' questions
is scheduled for December 16, 2004, from 1 p.m. to 3 p.m. CST. Complete article, TennCare's 3-page notice...
12.13.04 Take Advantage of CCRx Program to Pay Pharmacists for Services
For perhaps the first time, the pharmacy profession has a nationwide payor - Community Care Rx (CCRx) - who recognizes the value of professional pharmacy
services and is offering payment for the provision of a wide array of care-based services: Comprehensive Medication Review, Medication Cost Management, Drug
and Dose Verification, Drug Information, OTC Medication Consult, and more. As a provider of Outcomes through Medication Therapy Management Services (MTMS), you
will enhance your professional satisfaction, build patient loyalty, generate new
revenue for your pharmacy, and demonstrate the value of community pharmacists to Medicare.
Very soon, CCRx will be promoting this service to its members, and patients will be
coming to your pharmacy to take advantage of this benefit. You need to be prepared! Here's how: Complete article, Fee Schedule, Glossary of MTMS Terms
12.9.04 Immunization Certification Program to be Held in January
The TPA, in conjuntion with the UT College of Pharmacy, is offering its annual two-day
Immunization Certification Program for Tennessee pharmacists, January 27-28, 2005
. Held in the fall in previous years, this program has been moved to January this year
as a result of changes in didactic portion of U.T.'s curricula. This may be the only
opportunity for pharmacists to obtain Immunization Certification in 2005 - it is not yet known whether a one-day program will be offered later in the year.
Successful completion of the program will certify pharmacists to provide
immunization services in Tennessee. All participants must be CPR-certified and
must prepare for the course using a homestudy CD that will be shipped to registrants
in advance. The fee for the two-day Certification program is $325 for APhA and/or TPA
members and $450 for non-APhA/non-TPA members. Interested individuals may download the form or contact the TPA office (615-256-3023). Registrations and
payment should be received by December 31, 2004, in order to have time to receive and review the homestudy CD.
12.7.04 Medicare Regions Announced The Medicare Modernization Act (MMA) requires a number of changes to the Medicare
program, including the addition of Medicare prescription drug plans (PDPs), as well
as the addition of regional Medicare Advantage (MA) plans under the new Medicare
Advantage program. To implement both new programs, the Centers for Medicare and Medicaid Services (CMS) and Department of Health and Human Services (HHS)
announced on December 6 the establishment of 26 MA regions and 34 PDP regions,
beginning in 2006. Complete article, HHS press release, and link to CMS information...
11.30.04 Post ACS Cancer Screening Guidelines in Your Pharmacy
The American Cancer Society has provided Cancer Screening Guidelines in a poster
(8.5" x 11") for TPA members to hang in their pharmacies. Entitled "The Power to
Change a Life," the poster can be printed in color or black and white and provides
specific cancer screening guidelines for men and women and varying ages. The poster displays the Tennessee Pharmacists Association logo as well as the
American Cancer Society logo.
11.19.04 First Health Announces Holiday Mailing Schedule
TPA has received a memo regarding the First Health holiday schedule for pharmacy check mailings. TPA Executive Director Baeteena Black has been contact
with representatives from TennCare about the possibility of getting this changed, but it appears this will not occur.
11.16.04 Influenza Vaccine Distribution Update
The Tennessee Pharmacists Association received two documents late yesterday from the Tennessee Department of Health (TDH). They provide important updated
information about Tennessee's plans to distribute 137,000 doses of influenza vaccine made available to TDH through the Centers for Disease Control and
Prevention (CDC). One document is a letter to physicians concerning the new
influenza vaccine allocation plan for the state of Tennessee; the other is a copy of Monday's press release announcing TDH plans and Tennessee's new influenza
vaccine information hotline. Complete article, letter to physicians, press release...
11.15.04 Bonnyman Agrees to Give Bredesen Chance to Reform TennCare
The Tennessee Justice Center (TJC) has today filed four motions to suspend the
consent decrees governing TennCare. The motions ask the Court to modify the
orders for a period of two years as necessary, to permit the state to implement any
new waiver amendment that is properly approved by the Centers for Medicare and Medicaid Services (CMS). These motions came after a weekend of intense
negotiations with state officials after Governor Bredesen's announcement that the
TennCare program would likely end. TJC director Gordon Bonnyman said that the
nonprofit group agreed to file the motions on the following conditions... Complete article and "Remarks of Gordon Bonnyman"...
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11.10.04 TennCare Likely to End; State Moves Toward Medicaid
This morning, Governor Phil Bredesen announced the State of Tennessee has set in motion a process to dissolve TennCare, pending final discussions with public
-interest attorneys. The process will replace TennCare with a traditional Medicaid
program similar to that currently offered in more than 40 states. The Governor has
instructed the Bureau of TennCare and the Department of Human Services to prepare
a plan for orderly transition to Medicaid. The process of notifying TennCare enrollees
of changes will begin in early January, and the conversion to Medicaid is expected to
be completed in mid-2005. Of TennCare's 1.3 million enrollees, as many as 430,000 could lose health coverage. Complete article...
11.10.04 CCRx Conference Call TONIGHT: Open Enrollment Begins Nov. 15
Community Care Rx (CCRx) will host a conference call tonight at 7 p.m. Eastern to discuss the upcoming Annual Coordinated Election Period. November 15 through
December 31, 2004, will be the only open enrollment opportunity for beneficiaries to
switch from one Medicare-approved prescription drug discount card to another. Complete article...
11.9.04 PDL & Processing Updates from TennCare/First Health
The Tennessee Pharmacists Association has disseminated updates to members at
the request of TennCare and First Health. Included are updates concerning new POS
edits, new compounding standards, PDL changes as a result of CDC guidelines for the current flu season, and problems with incorrect claims processing.
11.5.04 FluMist update - important information for providers
On November 4, 2004, the Tennessee Pharmacists Association received a letter by
MedImmune from the Tennessee Department of Health. FluMist, the live, intranasally
-administered influenza vaccine, is approved for use this year in anyone who is healthy, not pregnant, and between the ages of 5-49 years. The CDC has not
restricted its use to high priority groups. However, one barrier to acceptability has
been the requirement that it be stored in a manual defrost freezer or in a special freezer box provided by the company. On November 4, the FDA and MedImmune
announced that FluMist shipped after November 2, 2004, may be stored in an
ordinary, frost-free freezer without the special freezer box. Stored like this, the new expiration date will be February 8, 2005. Complete article and letter...
10.29.04 Aggrenox WILL NOT be Removed from TennCare PDL
The Tennessee Pharmacists Association today received an announcement from TennCare regarding the prescription medication Aggrenox. Aggrenox will NOT
become a non-preferred medication on November 1 as had been reported in the TennCare memo dated October 22, 2004. View document.
10.27.04 Claims Submissions for Aranesp The Tennessee Pharmacists Association was today asked by Amgen to notify
pharmacists that many claims for Aranesp® SingleJect® prefilled syringes are being
submitted incorrectly. Coding procedures are clarified in their letter.
10.22.04 Aggrenox to be Removed from TennCare PDL
The Tennessee Pharmacists Association today received the attached announcement regarding TennCare and the prescription medication Aggrenox. Complete article...
10.18.04 Influenza Summit Provides Redistribution Plan for Flu Vaccine Shortage
The American Pharmacists Association (APhA) has published the following Redistribution Plan from the AMA/CDC Influenza Summit. Complete article...
10.18.04 BCBST to Waive Copays for Generic Prescriptions
Beginning today (October 18th), BlueCross BlueShield of Tennessee will waive the
copay for any generic prescription obtained by members in selected fully insured accounts. These members will have a zero copay at the pharmacy. Complete article...
10.6.04 Chiron Will Not Supply Flu Vaccine for 2004-05 Season
The United Kingdom (UK) regulatory body, known as the Medicines and Healthcare Products Regulatory Agency (MHRA), has suspended Chiron's license to
manufacture Fluvirin® influenza virus vaccine in its Liverpool facility for 3 months.
This action prevents the company from releasing any of its 48 million anticipated
doses of Fluvirin® during the 2004-2005 influenza season, reducing by approximately
one-half the expected supply of trivalent inactivated vaccine (flu shot) available in the United States for the 2004–05 influenza season. Complete article...
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10.1.04 Merck Withdraws VIOXX (rofecoxib)
Merck &. Co., Inc., yesterday announced an immediate voluntary worldwide withdrawal of VIOXX (rofecoxib), a decision based on new three-year data from a
prospective, randomized, placebo-controlled clinical trial, the APPROVe (Adenomatous Polyp Prevention on VIOXX) trial, which showed an increased risk of
stroke and heart attacks after study participants had used the drug for greater than 18
months. Pharmacists should stop dispensing VIOXX immediately. Complete article...
10.1.04 Todd Bess Appointed to Board of Pharmacy
Governor Bredesen has appointed Todd Bess, Pharm.D., to the Tennessee Board of
Pharmacy position held by Forrest Parmley, D.Ph., of Nashville, whose term on the
Board has expired. Dr. Bess earned the Pharm.D. from U.T. in 1986 and is Director
of Clinical Services for St. Thomas Health Services in Nashville. Watch for more information about Dr. Bess in an upcoming TPA publication.
9.30.04 ASP Launches New Website The U.T. College of Pharmacy chapter of the American Pharmacists Association
Academy of Student Pharmacists has launched its new website. Webmaster Patrick
Duke and all of the students who worked on this project are to be commended for its professionalism. Check it out!
9.21.04 SHARE WITH YOUR PATIENTS: Medicare Prescription Drug Discount Card FAQ.
Member pharmacists are encouraged to print this PDF file and share it with their
patients, to help them understand the ins and outs of the Medicare Prescription Drug Discount Card program. TPA username and password required.
8.19.04 Governor Presents New TennCare Waiver for Public Comment
Governor Bredesen today submitted the new TennCare Waiver for public comment. Click to read Governor Bredesen's letter and/or the new Waiver. (A link to the Waiver
can also found under the letter.)
8.5.04 TennCare Announces Schedule for Implementation of POS Edits
Today at 2:44 PM, TPA received from Shana Bush, Pharm.D., Clinical Manager in Tennessee for FirstHealth Service Corporation, an email with a copy of a Memo to
Pharmacy Providers regarding the timeline for implementation of changes in certain
Point of Service Edits for TennCare. The first of these edit changes went into effect on
July 26, 2004. On Monday, August 9th, the unit of measure edit will go into effect.
Other changes become effective on future dates as outlined in the Memo. Dr. Bush
stated a copy of this Memo is being included in the remittance advice being mailed
tomorrow to arrive in your pharmacies next week. She stated TennCare had already,
at the time of our conversation, faxed a copy of the Memo to chain headquarters. Read more and see the Memo...
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