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 2004.

12.30.05 TennCare: Benzodiazepine and Barbiturate Clarification (TPA username and password required)       12.30.05 Update Medicare Rx:  "Final Preparations are Underway" Provides descriptions of (and directions for accessing) several documents that will assist pharmacists with the January 1 implementation of the Medicare Part D Prescription Drug Benefit. (TPA username and password required) 12.23.05 Update MedicareRx: "Medicare Rx Enrollment Numbers Are In" Includes: Dedicated CMS phone number for pharmacists' use on January 1-2; Pharmacy Notice Required by CMS Part D Grievances, Coverage Determinations, Exceptions and Appeals; PDP Transition Policies by Plan; and more. (TPA username and password required)       12.22.05 Pharmacy Cuts in Medicaid Retained in Final Budget Package The compromise budget package approved December 21 in the Senate by a vote of 51-50 (with Vice President Dick Cheney casting the deciding vote) retains cuts in pharmacy reimbursement that will curtail Medicaid patients' access to critical services. Complete article and summary of bill as it related to pharmacy reimbursement (TPA username and password required)       12.21.05 Budget Passes Senate (House will need to vote again) This morning, the Senate passed the budget by a vote of 51-50, with Cheney casting the tie-breaking vote. The budget, projected to produce billions of dollars in savings from the Medicaid pharmacy program, was altered slightly so that the House now will have to vote on it again before it is sent to President Bush for approval. Complete article (TPA username and password required)       12.19.05 Medicaid Reform Update Early this morning, the U.S. House of Representatives passed, on a vote of 212 to 206, the Budget Reconciliation Conference report containing yet another approach to Medicaid Reform. The new approach was unveiled at about 3:00 this morning and voted on just after 5:00 a.m.  Complete article (TPA username and password required)       12.19.05 First Health Premier for Medicare Part D First Health Services Corporation has asked the Tennessee  Pharmacists Association to provide members with information related to the  First Health Premier Medicare Part D Pharmacy Program.  Complete article (TPA username and password required)       12.16.05 Kendall Lynch Moves Onward and Upward It is with very mixed emotions that we at the Tennessee Pharmacists Association inform you that, at the end of this month, Kendall Lynch will be stepping down from his position as Executive Director of the Tennessee Board of Pharmacy. We are losing an experienced, ethical, insightful, knowledgeable, strong leader -- it is, of course, these same qualities that influenced Secure Pharmacy Plus to hire Kendall as its President and Chief Executive Officer. We are happy for Kendall and wish him the very best of luck, and we look forward to working with him in his new position!  Secure Pharmacy Plus press release       12.16.05 Update MedicareRx: Find Out Now if Dual-Eligible Beneficiaries Are in a Plan You Accept (TPA username and password required) Medicare Part D for Hurricane Katrina Evacuees (TPA username and password required)         12.15.05 Medicaid Action Alert - Contact Your Representatives!       12.15.05 TennCare: Tapering Prescription for Benzos and Barbs After numerous discussions with TennCare regarding the discontinuation of coverage of benzodiazepines and barbiturates for adult enrollees, the Tennessee Pharmacists Association is very pleased to announce that the State is offering to reimburse pharmacies for a one-time prescription to help enrollees who need to be tapered off these medications. To obtain this prescription, the prescriber must call and get a PA.  Certain other criteria must also be met. View details in today's TennCare notice. (TPA username and password required)       12.15.05 TennCare:  Changes Related to Grier Require New Form on 1/1/06 New "Prior Authorization Required Form" (TPA username and password required)         12.15.05 NCPDP: National Provider Identifier Bulk Enumeration Process Delayed by CMS (TPA username and password required)         12.7.05 TennCare Notice Major Changes to Grier Consent Decree Process; Benzodiazepine and Barbiturate Classes of Drugs Discontinued for Adults; Provider Education Conference Calls on December 14 and 20; more (TPA username and password required)         12.7.05 Update MedicareRx: "Countdown to Implementation" Announces and includes a link to NDCHealth's Part D Eligibility solution, now available live online, free of charge, providing test cases for pharmacists to submit NCPDP 5.1 E1 transactions. Also includes link to instructions for obtaining Medicare Prescription Drug Plan formularies. (TPA username and password required)         12.6.05 TennCare:  Governor Opens Medicaid Category Earlier, with More Generous Eligibility Criteria (TPA username and password required)         12.6.05 TennCare PDL - New Format (TPA username and password required)       11.29.05 TennCare Workshops Begin TONIGHT in Knoxville (TPA username and password required)       11.23.05 Medicare Part D: National Day of Conversation (TPA username and password required)       11.18.05 House Enacts Cuts to Pharmacy Reimbursement in Medicaid       11.18.05 Pharmacies Must Register to Dispense Isotretinoin: iPledge Program (TPA username and password required)         11.18.05 Immunizers:  1) Survey - Response Needed by 11/21;  2) Flu Season Q&A       11.18.05 Update MedicareRx: "Enrollment is Here..." (TPA username and password required) "Medicare Rx: A National Conversation" will air on TV Saturday, November 19, and Sunday, November 20, 6:30 - 7:00 p.m. EST. Download flyer to post in pharmacies. (TPA username and password required)         11.17.05 TennCare Safety-Net Program Update Today, Governor Bredesen reviewed budgetary information for the TennCare program and the TennCare Safety-Net Program.  TPA was contacted late this afternoon regarding some decisions that have been made based on the budget review process for the TennCare Safety-Net Program. Basically the benefits that were scheduled to end on December 31, 2005, have been extended. Complete article (TPA username and password required)       11.17.05 ALERT: Medicaid Cuts Coming to a Vote       11.17.05 TennCare Notice: "Drug to Inferred Disease" Edit & More (TPA username and password required)         11.16.05 URGENT: Respond Today by 4:00 CST regarding uncompensated care costs for medically necessary services and supplies for Hurricane Katrina evacuees (TPA username and password required)         11.11.05 Medicaid: Vote Postponed to Monday - Contact Representatives! (TPA username and password required)         11.11.05 TennCare:  Holiday Check Schedule, Withdrawal of Pemoline, PDL, Grandfathering Schedule and More (TPA username and password required):     Holiday Check Schedule for Pharmacy Providers Pemoline and Its Withdrawal by the FDA Changes to the Preferred Drug List for December 1, Grandfathering Schedule for Remainder of 2005, etc.       11.10.05 Contact Representatives IMMEDIATELY about Medicaid Reform Proposal       11.10.05 Webcast Demonstration of Medicare Prescription Drug Plan Finder tool: www.cms.hhs.gov/partnerships/mma/webcasts.asp         11.8.05 Medicare Prescription Drug Plan Finder Tool is Now Live (TPA username and password required)       11.3.05 Medicaid Reform - Take Action NOW!       11.3.05 Update MedicareRx: "Auto-Enrollment Forms Are in the Mail" (TPA username and password required)       11.2.05 Action Alert: Senate Proposes Medicaid Cuts       11.1.05 Bettie Wilson, D.Ph., Appointed to Board of Pharmacy The Tennessee Pharmacists Association is pleased to announce the appointment by Governor Bredesen of Bettie K. Wilson, D.Ph., to a five-year term on the Tennessee Board of Pharmacy. Dr. Wilson, Director of Johnson City Medical Center Pharmacy, fills the seat vacated by Dr. Bob Shutt upon the completion of his term. Watch for more information in the upcoming Tennessee Pharmacist! TPA appreciates Dr. Wilson's willingness to serve and thanks Dr. Shutt for his dedication and hard work for the last five years.       10.31.05 Contact Your Members of Congress NOW about Medicaid Reform! On Friday [10/28/05], the Tennessee Pharmacists Association notified you that Committees in the House and Senate had adopted Medicaid Reforms that largely rely on cuts from the pharmacy program. We have received additional information from APhA and NCPA. According to the few TPA members who have been in contact with their legislators, Tennessee's members of Congress indicate that, for the most part, they are not hearing from pharmacists. If you are not ready to give up your Medicaid patients, please review the APhA and NCPA material carefully and contact your members of Congress NOW, by entering your zip code in the black and yellow "Write Your Legislators" box below the menu on the left.       10.28.05 Federal Legislative Alert - Congress to Act on Medicaid Reform - Call to Action       10.28.05  Medicare Outreach by Pharmacists - Report Outreach Activities TPA is working in conjunction with other state pharmacy associations through the National Council of State Pharmacy Association Executives (NCSPAE) to assure that pharmacists get the important recognition and credit they deserve for all the work being done by pharmacists throughout the U.S. regarding Medicare Part D. In order to get appropriate acknowledgement of the work being done, NCSPAE has established a site for pharmacists to report all Medicare outreach education being done. Pharmacists throughout the country are being asked to go to this site - http://www.ncspae.org/medicare/form.html - and report ALL outreach activities that have been conducted in the past and that will be conducted in the future. It is critically important for all pharmacists to report. Remember, if you do not document it, you did not do it. Pharmacists need to document our activities around Medicare education. This is important for us to continue to have a seat at the table with CMS for Medicare. A separate site is available for reporting student outreach activities: http://www.ncspae.org/medicare/student_form.html. Students are also urged to report ALL their activities on this special site.       10.27.05 TennCare Program to Improve Care for Children with ADHD and Depression; UT College of Pharmacy will Measure Success and Outcomes (TPA username and password required)         10.26.05 Medicare Part D Pharmacy Network Contacts The Centers for Medicare and Medicaid Services (CMS) has provided the much-anticipated contact information for Medicare Part D Pharmacy Network Plans approved as of October 21, 2005. An Excel spreadsheet listing the 41 plans approved in Tennessee has been posted on the TPA website. The list can be filtered by Legal Entity Name, Organization Marketing Name, Organization Description, and more, and includes contact names, titles, phone numbers, e-mail address, and mailing addresses.  View spreadsheet (TPA username and password required).       10.26.05 Atypical Antipsychotics Added to PDL, Nov. 1 Effective November 1, 2005, there will be a change in TennCare coverage for the Atypical Antipsychotic drug class.  The Preferred Drug List (PDL)  for the TennCare program will be expanded to include the Atypical Antipsychotic class of medication. Two 4-page notices - one for pharmacy providers and one for prescribers - were made available. Complete article and links to BOTH notices (TPA username and password required)       10.26.05 Reminder: Provider Education Conference Calls Oct. 26 & 27 TennCare Provider Education Conference Calls TODAY AND TOMORROW will address processing questions resulting from the newly implemented PDL and edits. The format of the session will be Question and Answer. Complete article and instructions (TPA username and password required)       10.24.05 "Spanish for Pharmacists" provided by PAAS National PAAS National has created and made available free of charge to TPA members,  "Spanish for Pharmacists," a document designed to help pharmacists communicate  with their Spanish-speaking patients. Included are: Pronunciation Hints Questions to Create Profile Numbers Days of the Week Months of the Year Sample Sigs Medication, etc. Parts of the Body Pains, Illness, Symptoms Other Basic Spanish Phrases   View "Spanish for Pharmacists" (TPA username and password required)         10.24.05 TennCare Pharmacy Short List, Effective November 1 The following information was received from First Health on  Friday, October 21: "On November 1, 2005, the Pharmacy Short List of medications that do not count toward the prescription limit will be expanded to include  select medications for diabetes, asthma, and cardiovascular issues. This is a welcome  addition to providing patient care. As a reminder, medications on the short list may be subject to a copay and are only for patients who still have a pharmacy benefit with the TennCare program." Click here for Short List (TPA username and password required)       10.21.05 Reminder:  Important Info Needed from Pharmacies - BY 10/25 Earlier this month, the Tennessee Pharmacists Association asked for pharmacists' help in resolving the problem of certain NDC numbers for certain generics not being accepted for processing on-line by Express Scripts. We asked you to let us know about each product with which you have experienced this problem. To ensure we have information about all relevant products before we compile the list and send it to the State for reconciliation, we must hear from you BY TUESDAY, OCTOBER 25, if you have not contacted us already.  Complete article (TPA username and password required)       10.21.05 TennCare Checks: Reason for Delay Unclear (TPA username and password required)       10.20.05 Update MedicareRx: "Medicare Enrollment Assistance Is on Its Way" (TPA username and password required)         10.13.05 Update MedicareRx: "How Can You Help Beneficiaries Make the Right Choice?" (TPA username and password required)         10.13.05 TennCare Notice: Changes Effective Before Year-End (TPA username and password required)         10.12.05 TennCare: LTC Pharmacy Transition to Medicare Part D The Tennessee Pharmacists Association has received the following information from First Health: "Please review the attached document regarding TennCare and the Long Term Care pharmacies. TennCare and First Health are working to ease the transition to Medicare Part D by allowing LTC pharmacies that return the form to process their pharmacy claims in a pre-consumption format. Because Medicare Part D will require pharmacies to bill pre-consumption, TennCare has agreed to allow participating LTC pharmacies the chance to convert their post-consumption billing methods to pre-consumption. Complete article and link to form (TPA username and password required)       10.11.05 RxOutreach - Important Info Needed from Pharmacies TPA Executive Director Baeteena Black and Representative David Shepard met last week with Finance Commissioner Dave Goetz and other representatives from the Department of Finance, including Jim Shulman, Laurie Lee and Susan Cooper, to discuss the RxOutreach Pharmacy Program and the concerns and issues regarding community pharmacy participation. The State officials were very complimentary about the overall response and service from community pharmacies. They expressed some concerns with reports regarding a few pharmacies' apparent unwillingness to provide all the products on the RxOutreach program list. Pharmacists are reminded that if their pharmacy signed a participation agreement, they should be providing all drugs and products covered by the program. The ongoing reimbursement problems being experienced by community pharmacies were discussed. The two primary problems are: 1) pharmacies being paid less in some instances than the contracted $16.05 per prescription for the drugs on the RxOutreach generic list, and 2) pharmacies not being able to get certain NDC numbers for certain generics to be accepted for processing on-line by Express Scripts. State officials have pledged to work with the TPA to get these problems addressed as soon as possible. IMPORTANT: For the State to completely address the problem of certain products and NDC numbers not processing on-line, State officials have asked TPA to develop one comprehensive list of these products and NDC numbers. If you have had a problem with ANY product and ANY NDC number(s) not being accepted, PLEASE IMMEDIATELY send the following information for each of these products to TPA by fax (615-255-3528) or email (tpa@tnpharm.org): Product Name         Dosage Form       Strength       NDC Number REMEMBER, this is only for products that will not process on-line. Do not include information on products that have been paid incorrectly. Incorrect payment will be addressed separately. For qualifying prescriptions that have been reimbursed for less than $16.05 per prescription, State officials have stated payments for those claims will be automatically adjusted such that you should receive any additional payment due your pharmacy. TPA will continue to work with State officials and will continue to provide updated information as it is available.       10.11.05 TennCare:  Provider Disclosure Requirements Clarified Last year, the TennCare Bureau enacted new conflict of interest and disclosure requirements for all TennCare contractors, including the TennCare Pharmacy Benefit Manager (PBM) - First Health - and all Managed Care Contractors (MCCs). As a result, each MCC must annually notify all providers with whom it has verbal or written TennCare agreements, to require disclosure to the MCC of "financial relationships with state or federal officials, formal lobbying activities, or gifts or gratuities directed toward state or federal officials."  Complete article (TPA username and password required)       10.11.05 TennCare "Short List" Expansion Yesterday, the Governor announced additions to the "short list" of drugs that, beginning November 1, will no longer count toward the 5-prescription limit in place for most adults on the TennCare program. The additions will target diabetes, asthma and cardiovascular disease. While the press release fell short of listing the specific drugs being added to the short list, TennCare Deputy Commissioner J. D. Hickey recommended to the Governor the addition of the following generic medications.  Complete article and links to press relase and Hickey's letter to the Governor (TPA username and password required)       10.6.05 October is American Pharmacists Month American Pharmacists Month provides a golden opportunity to celebrate the pharmacy profession, recognize your pharmacy staff, and reach out to your patients. This month-long observance is a channel to conduct special events or to offer new services that will recognize your contribution to the healthcare team. Go to the American Pharmacists Association (APhA) website at www.aphanet.org and click on the "Know Your Medicine, Know Your Pharmacist" icon each time you visit, for continuing updates and new resources. Use the ideas in the downloadable Planning Guide to help you take full advantage of the heightened awareness the month-long observance will provide. Use the promotional items in the Product Guide to promote your pharmacy and its activities. Use American Pharmacists Month to help communicate your role in improving medication use and advancing patient care to your patients. Questions? Contact Gail Street, Public Relations Director, at gstreet@APhAnet.org.       10.5.05 Error in "Medicare and You" Handbooks The Tennessee Pharmacists Association has received notice that the "Medicare and You" handbooks recently mailed to millions of Medicare beneficiaries contain a serious error. The error occurs in the comparison charts listing the Medicare Prescription Drug Plans, specifically in the column headed, "If I Qualify for Extra Help, will My Full Premium be Covered?". Details are provided in the notice, the text of which is reproduced below. According to the notice, Medicare will post corrected electronic copies of the handbook on www.medicare.gov by October 7, 2005.  View notice (TPA username and password required)       9.30.05 Medicare Part D Quality Assurance Requirements The new Medicare Part D pharmacy program requires continuous quality improvement programs to be in place and in use by participating Medicare pharmacy providers. Other programs participating in the pharmacy benefits marketplace are also adding medication safety and quality improvement program requirements to their pharmacy network contracts. Complete article (TPA username and password required)       9.23.05 Online Access to Katrina Evacuees' Rx Info Pharmacists and physicians in Tennessee and across the country now have online access to the prescription drug records of Hurricane Katrina victims, thanks to the collaboration of government agencies and private sector companies. The effort has created the website http://www.katrinahealth.org, a secure online service created in response to the critical need to provide pharmacists and physicians who are treating Hurricane Katrina evacuees with access to the evacuees' prescription drug and dosage information.  Compete article (TPA username and password required)       9.23.05 National Consultant Pharmacist Week, October 24-30       9.23.05 TPA congratulates Larry Calhoun, Pharm.D., upon being named Founding Dean of the new College of Pharmacy at East Tennessee State University. Click here to read the ETSU press release (TPA username and password required)       9.22.05 Rx Assistance for Organ Transplant Patients Formerly on TennCare (TPA username and password required)         9.22.05 First Health Call Center Delays Due to Hurricane Rita and Interruption of the Houston Call Center (TPA username and password required)         9.21.05 VIOXX® Returns Must Be Postmarked by September 30, 2005 On September 30, 2004, Merck announced the immediate and voluntary withdrawal of VIOXX® (rofecoxib) from the market. In order to be eligible for reimbursement, all VIOXX must be returned by pharmacists, pharmacies and other trade purchasers to the NNC Group with a postmark no later than September 30, 2005. Read Merck's instructions for VIOXX return and reimbursement. (TPA Username and password required)       9.21.05 Crestor Added to TennCare PDL Effective Oct. 1       9.20.05 Rx Refills for Katrina Evacuees - Merck Information Merck has pledged to provide replacement products to any pharmacist who provides a Merck prescription to displaced patients who have lost their medications as a result of Hurricane Katrina. Read Merck's instructions for Rx Refills for Katrina Evacuees.       9.19.05 Disenrolled SPMI Population - Additional Coverage (TPA username and password required)         9.16.05 Some TennCare Pharmacy Reimbursement Checks May Be Delayed (TPA username and password required)         9.16.05 Obtain Information about Hurricane Katrina Evacuees' Insurance First Health has provided the Tennessee Pharmacists Association with the following information to help Hurricane Katrina evacuees and pharmacists.  Complete article (TPA username and password required)       9.15.05 Medicare Part D Seminar Information - POSTPONED!!  Information... The Medicare Modernization Act and the New Medicare Part D:  ARE YOU READY? To help you prepare for the Medicare Part D Prescription Drug Benefit that begins January 1, 2006, Pharmacy Plus Programs and the Tennessee Pharmacists Association are conducting a 2-hour Continuing Education seminar for pharmacists and pharmacy technicians at the locations and times below. Program information and registration materials       9.14.05 Immunization Updates: --CDC Recommends Immunizing Priority Groups With Injectable Trivalent Inactivated Influenza Vaccine (TIV) Until October 24, 2005 --FDA Approves New Influenza Vaccine --Chiron Receives Okay to Proceed With Influenza Vaccine Production Complete article (TPA Username and password required)       9.13.05 Update MedicareRx: "Some Medicare Drug Plans Will Offer Premiums Under $25" and "Retirees and the New Medicare Prescription Drug Coverage" (TPA username and password required).       9.13.05 Rx Refills for Katrina Evacuees - Medco Information The Tennessee Pharmacists Association has received the following information from Medco regarding the pharmacy needs of their members who are Hurricane Katrina evacuees.  Complete article (TPA username and password required).       9.13.05 Board of Pharmacy: Rulemaking Hearing The Board of Pharmacy has asked the Tennessee Pharmacists Association to notify members of a rulemaking hearing scheduled for 10:00 a.m. (Central) on Tuesday, October 18, 2005. Once promulgated, the rule change would allow the Tennessee Board of Pharmacy to charge an Internet Convenience Fee to implement the online renewal of licenses. Comments should be directed to the Office of Legal Counsel at the address identified in the notice. For details, view the document at http://www.tnpharm.org/MembersOnly/Breaking_News/Notice_of_Rulemaking_Hearing. pdf (TPA username and password required).       9.13.05 Cariten Seeks East Tenn. Pharmacies for Flu Vaccination Campaign The Tennessee Pharmacists Association is pleased to provide East Tennessee pharmacists with information regarding the Cariten Healthcare, Inc., 2005-06 Flu Vaccination Campaign. With a goal of ensuring that their commercial insurance members receive flu vaccinations this year, Cariten asks pharmacies planning to provide and administer vaccinations to notify Cariten of your plans. Cariten will inform their members of the availability of your immunization service. Cariten plans to keep the billing process simple and will assist with promotion. Click here for details (TPA username and password required).

9.12.05    TennCare: Pharmacy Processing Changes
The Tennessee Pharmacists Association received a TennCare notice from First Health this afternoon. The notice provides information regarding upcoming pharmacy edits and grandfathered medications for the TennCare Preferred Drug List (PDL). Some of these edits require software changes and providers are instructed to contact their software vendor to help them make these changes. Complete article and link to notice (TPA username and password required).

9.12.05    New Draft of Pharmacy Services and Unnecessary Drug Guidelines
The Centers for Medicare and Medicaid Services (CMS) has released a second draft of proposed changes to the nursing facility State Operations Manual, on pharmacy services and unnecessary drugs. This draft has changed quite a bit from the previous draft, which received numerous and extensive comments. Click here to access the draft document (TPA username and password required). Please send your comments on the document to ASCP's Carla Saxton (mailto:csaxton@ascp.com) BY OCTOBER 14, 2005. In your comments, please identify your practice setting. ASCP will be submitting comments to CMS by the October 21 deadline.

9.12.05      Board of Pharmacy: Rulemaking Hearing, October 18
The Board of Pharmacy has asked the Tennessee Pharmacists Association to notify members of a rulemaking hearing scheduled for 10:00 a.m. (Central) on Tuesday, October 18, 2005. Once promulgated, the rule change would allow the Tennessee Board of Pharmacy to charge an Internet Convenience Fee to implement the online renewal of licenses. Comments should be directed to the Office of Legal Counsel at the address identified in the notice. Click here for details (TPA username and password required).

9.12.05      Rx Refills for Hurricane Katrina Evacuees - Express Scripts and
                       Caremark
Some pharmacists have reported being unable to refill prescriptions for Hurricane Katrina evacuees, receiving a "Refill Too Soon" message from PBMs. NCPA has provided the following information to assist pharmacists in resolving these problems.  Complete article (TPA username and password required)

9.9.05       Cariten Seeks Pharmacies for Flu Vaccination Campaign
The Tennessee Pharmacists Association is pleased to provide East Tennessee pharmacists with information regarding the Cariten Healthcare, Inc., 2005-06 Flu Vaccination Campaign. With a goal of ensuring that their commercial insurance members receive flu vaccinations this year, Cariten asks pharmacies planning to provide and administer vaccinations to notify Cariten of your plans. Cariten will inform their members of the availability of your immunization service. Cariten plans to keep the billing process simple and will assist with promotion. View program description (TPA username and password required).

9.9.05       Sheila Mitchell Elected to National Post
The American Society of Health-System Pharmacists announced today that TPA/TSHP member Sheila Mitchell of Methodist Hospital in Germantown was elected to the ASHP Board of Directors! CONGRATULATIONS, SHEILA!

9.9.05     Safety Net - Rx Outreach Processing Information (TPA username and password required)

The Tennessee Pharmacists Association has been asked to  circulate and post a "Tennessee RxOutreach Pharmacy Alert" from Express Scripts,  regarding claims processing for prescriptions filled under this program since August 22.  Note that although the document  states "You may submit claims on September 15 for any prescriptions dispensed after  August 22, 2005," TPA has sought and received written confirmation that you may submit claims on September 15 for prescriptions dispensed beginning on August 22.

9.8.05     TennCare Coverage Only Available to Katrina Evacuees Who Qualify for Federal Medicaid Program (TPA username and password required)

9.8.05     TennCare: Downtime for Software Installation this Weekend (TPA username and password required)

9.8.05     TennCare:  PDL Correction - Vytorin is a Preferred Agent (TPA username and password required)

9.8.05     TennCare Press Release:  TennCare Coverage Only Available to Katrina Evacuees Who Qualify for Federal Medicaid Program (TPA username and password required)

9.8.05     TennCare Notice: PDL Correction - Vytorin® is a Preferred Agent (TPA username and password required)

9.8.05     TennCare Notice: Processing Downtime for Software Installation This Weekend (TPA username and password required)

9.7.05     Hurricane Katrina Evacuees - Pharmacy Laws & Rules Affected by Executive Order
Governor Bredesen issued Executive Order No. 27 in response to  the influx of evacuees to Tennessee from states affected by Hurricane Katrina.  In a  memo to pharmacists, the Board of Pharmacy has  summarized the Order as it affects Pharmacy.  TPA members unable to access the documents online are  welcome to contact the TPA office (615-256-3023 or tpa@tnpharm.org)  to request a fax copy.

9.2.05   Information for Pharmacists:  Katrina Refugees
In response to the influx of refugees to Tennessee from states affected by hurricane Katrina, Governor Bredesen is preparing a declaration that will waive certain laws and rules relative to dispensing and licensing in Tennessee. The Board  of Pharmacy has issued a memo regarding this development.  Details will be provided in the Governor's order.

Additionally, in a memo from TennCare Bureau Deputy Commissioner Hickey, all TennCare providers are being encouraged to offer appropriate care for the Medicaid recipients of Louisiana and Mississippi who are fleeing the disaster areas created by Katrina. The Bureau is also assuring the provider community that TennCare will provide assistance in coordinating payment issues with the other states.   Louisiana and Mississippi Medicaid resource information for providers is included in the  memo as well: TennCare memo, Word format OR TennCare memo, PDF format.

TPA members unable to access the documents online are welcome to contact the office (615-256-3023 or mailto:tpa@tnpharm.org)  to request a fax copy.  (The office will be closed Monday for Labor Day.)

9.2.05   TennCare: Final Grandfathering Schedules and More
The Tennessee Pharmacists Association has received a TennCare notice from First Health that provides details on the final grandfathering schedules for the PDL, as well as information regarding:

• Benefit Changes for the Medically Needy Spend Down population
• Grier Consent Decree
• New Requirement for Prescriber's Last Name
• Co-payments for clozapine/Clozaril® and Effexor XR® 225mg doses
• Generics Medications and Copayments
• Guide for Override Codes
• Phone Numbers and Internet Links

Click here to view the 6-page notice (TPA username and password required).

9.1.05   Safety-Net: Rx Limits on Insulin and Diabetic Supplies
The Tennessee Pharmacists Association has received information regarding prescription limits for insulin and diabetic supplies obtained through the Safety-Net Retail Generic and Insulin Pharmacy Program. Click here to view (TPA username and password required).

TPA awaits answers to a number of additional questions regarding the Safety-Net Retail Generic and Insulin Pharmacy Program and will continue to provide information to members as it becomes available.

9.1.05   TennCare: Rx Limit for Adult Medically Needy as of 9/1/05
The Bureau of TennCare has asked the Tennessee Pharmacists Association to disseminate a newly revised provider notice to be used beginning today. The notice has been modified to reflect the fact that the entire adult Medically Needy population (except for people in long-term care institutions or the Home and Community Based Services [HCBS] waiver) will be subject to the 2 brand/5 prescription limit effective September 1st. It also includes information for providers concerning the availability of prescription assistance programs for low -income enrollees with a prescription limit. Click here to view notice (TPA username and password required).

8.25.05

Update on Safety Net Retail Generic and Insulin Pharmacy Program

As an update to the Safety Net Retail Generic and Insulin Pharmacy Program for TennCare disenrollees, the Tennessee Pharmacists Association has received a response to inquiries made on behalf of participating pharmacies who were told by Express Scripts that insulin won't be covered until September 15. Laurie Lee, Director of Health Planning, Tennessee Department of Finance and Administration, stated she will contact Express Scripts to ensure their staff answering pharmacists' calls understand that the State will pay back to Monday, August 22, 2005. She asked TPA to reinforce with pharmacists that "while we won't have the eligibility system set up until about Sept 15th, we WILL pay back to Monday, August 22, 2005 for insulin and supplies. Our expectation is that pharmacists will do what they can to help during the interim."   Complete article (TPA username and password required)

8.23.05

Update MedicareRx - "Provider Marketing Guidelines are Final" (TPA username and password required)

8.22.05

Update on Safety Net Retail Generic and Insulin Pharmacy Program

This morning, the Tennessee Pharmacists Association received additional information regarding the Safety Net Retail Generic and Insulin Pharmacy Program. The State has again stated although the eligibility system will not be set up until about September 15, the State will pay for covered services provided for eligible beneficiaries back to dates of service beginning today, Monday, August 22, 2005. The information answers questions regarding 1) how to verify eligibility and 2) the list of covered insulin and supplies.  Complete article, including links to covered insulins and diabetic supplies (TPA username and password required)

8.18.05      Express Scripts Rx Outreach Contract Procedure Clarified
This afternoon, August 18, TPA received an e-mail communication from Laurie Lee, Director of Health Planning, Tennessee Department of Finance and Administration, regarding the contract for participation in the Express Scripts Rx Outreach generic program. She clarified instructions for submitting the contract and asked TPA to notify pharmacists that, in order to participate in the program, YOU MUST FAX ALL THREE PAGES OF THE CONTRACT LABELED "EXHIBIT", INCLUDING THE SIGNATURE PAGE. Remember, the deadline for submission is August 26, 2005.

We regret to tell pharmacists who already faxed only the signature page that you must re-fax all three "Exhibit" pages, including the signature page, and must do so NO LATER than the August 26 deadline.

8.18.05

URGENT - Update: Safety Net Retail and Insulin Pharmacy Program

Today, Thursday, August 18, TPA received an e-mail communication from Laurie Lee, Director of Health Planning, Tennessee Department of Finance and Administration, providing updated information regarding the Rx Outreach generic program and the insulin pharmacy assistance program available to community pharmacies that sign and return by August 26, 2005, the Express Scripts contract previously communicated to you.   The information is in follow-up to questions asked by TPA and is provided in a Question-and-Answer format.  Complete article and link to Q&A document (TPA username and password required)

8.15.05      TennCare Issues Two Notices
Today, the Tennessee Pharmacists Association received two TennCare provider notices. The first is a 4-page notice, "Important Information for Providers Concerning Changes to the TennCare Program," reflects the recent decision to move forward with the MOU, thus preserving coverage for the Medically Needy population. TennCare instructs providers to discard earlier versions of this notice regarding eligibility and benefit changes. This notice contains the Prescription Limit and Pharmacy Co-pay information regarding the prescription benefit for Medically Needy (spend down) adults....  The second TennCare notice regards processing changes for the TennCare pharmacy program.  Complete article and links to both notices (TPA username and password required)

8.13.05  URGENT - Opportunity for Community Pharmacists to Contract & Participate
On Friday afternoon, August 12, around 5:15 p.m., TPA received an e-mail communication from Laurie Lee, Director of Health Planning, Tennessee Department of Finance and Administration, regarding the opportunity for community pharmacies in Tennessee to sign up to participate in the Express Scripts Rx Outreach generic program that provides 90-day supplies of a limited list of generic drugs (see list provided) at no cost to the patient, for disenrolled TennCare patients. In addition, community pharmacies that decide to sign the contract to participate in this program will also be required to provide insulin and supplies associated with the administration of insulin (no list or definition of these supplies available at this time) for this same group of disenrolled TennCare patients. If pharmacies sign the contract agreeing to participate in this program, the pharmacies are agreeing to supply all drugs and products listed on the program. Complete article, contract invitation for state of Tennessee, and Q& A: Safety Net Retail and Insulin Pharmacy Assistance (TPA username and password required)

8.12.05    Update MedicareRx - "Good News for Medicare Beneficiaries: Average Monthly Premiums for Drug Benefits Lower than Expected"  (TPA username and password required)

8.11.05    State to Provide Insulin & Diabetic Supplies for TennCare Disenrollees
Governor Bredesen announced today that the State will provide insulin and diabetic supplies to TennCare disenrollees through the end of the year, through the community pharmacy network being implemented through the Express Scripts contract. Over the next few days, the Tennessee Pharmacists Association will be working with the Administration to acquire Express Scripts information and contracts for distribution to pharmacies. TPA will continue to provide members with additional information as soon as it becomes available.

8.10.05  Local Pharmacies Allowed to Participate in Rx Outreach
We are pleased to announce that negotiations between the Tennessee Pharmacists Association, the Tennessee Retail Association, and the Bredesen Administration have resulted in a positive outcome for Tennessee's pharmacies and those Tennessee citizens disenrolled from TennCare. Governor Bredesen announced today that, beginning the first week of September, community pharmacies will be able to participate in the Rx Outreach program to provide free generic drugs to TennCare disenrollees. Click here to read the Governor's News Release. (TPA username and password required).  TPA will provide members with additional information about enrolling in this program as soon as it is available.

8.10.05    TennCare: Updated "Short List" & Brands Classed as Generics
The Tennessee Pharmacists Association learned today that First Health/TennCare has published an updated "Short List" of medications that will not count towards prescription limits and will continue to be available to the TennCare enrollee after the limit has been met. Additionally, First Health has posted the  list of branded drugs to be classified as generic drugs for the purpose of prescription limits. (TPA username and password required)

8.5.05     TennCare Rejection Codes
This TennCare notice clarifies information regarding rejection codes produced by the pharmacy POS system. (TPA username and password required)

8.5.05   Update MedicareRx - "Thinking about Enrollment...Tools of the Trade"
(TPA username and password required)

8.4.05   Express Scripts, Inc. (ESI) Network
At the request of Tennessee Department of Finance representatives administering the Express Scripts pharmacy "safety net" contract for disenrolled TennCare patients, the Tennessee Pharmacists Association is providing the following information... Complete article (TPA username and password required)

7.29.05    TennCare Benefits for Medically Needy Spend Down Population
Late Friday afternoon, First Health sent the Tennessee Pharmacists Association a TennCare notice containing the following information:

"The pharmacy benefit for the Medically Needy Spend Down TennCare population is scheduled to change under the current reform initiatives. These recipients were scheduled to lose their TennCare pharmacy benefit as of August 1, 2005..." Complete article (TPA username and password required)

7.28.05    UPDATED Plan Table for Medicare Part D Programs - provided as a service to you through PMG from PAAS National  (TPA username and password required)

7.28.05  Help Uninsured Tennesseans Obtain Meds Free or Deeply Discounted
The Tennessee Pharmacists Association has been asked by member pharmacists where they can refer patients who are indigent, have no pharmacy benefit and must have medications to survive. TPA has reviewed available pharmacy assistance programs and is now recommending Partnership for Prescription Assistance to pharmacists, to help hundreds of thousands of qualifying Tennesseans who lack prescription coverage get the medicines they need. Complete article (TPA username and password required)

7.28.05    Prescription Scam in West Tennessee
The TPA has been asked to alert pharmacists to a scam in the western part of the state.  Complete article (TPA username and password required)

7.26.05  TennCare: New Information about August 1 Changes
Late yesterday, the Tennessee Pharmacists Association received a TennCare notice from First Health that details some of the changes outlined in previous notices, specific to pharmacy processing. Providers are advised to contact their software vendors for information regarding the location on their systems of the NCPDP fields that are referenced in this notice. Among other information provided in the 4-page notice is a phone number for TennCare recipients to call with questions regarding changes in their benefits. The notice also includes a chart identifying the most prevalent denial/error codes and additional details surrounding them.  Complete article and links to notice and chart (TPA username and password required)

7.25.05    TennCare Conducting Pharmacy Audits
TPA has been notified TennCare is now conducting audits of pharmacies participating in the TennCare Pharmacy Program. The following information was provided to update pharmacies about the planned audits.  Complete article (TPA username and password required)

7.15.05    TennCare Safety-Net Program Information
The Administration for the State of Tennessee has provided information to the TPA regarding the Administration's safety-net pharmacy plan announced at the end of June. The information provided consists of a document providing a general overview of the plan and copies of the four unique letters and accompanying unique documents that either have been mailed or soon will be mailed to the four categories of TennCare patients being disenrolled from TennCare: 1) General [non-Seriously and Persistently Mentall Ill (SPMI) and non -Medicare]; 2) SPMI; 3) SPMI and Medicare; and 4) Medicare.
Links to all documents, general program information provided by the state, and a chart showing an overview of the benefits (TPA username and password required)

7.12.05    Notice: Provider Education Conference Calls (7/26 and 7/27), PDL Changes, Grandfathering Schedule, Eligibility Changes, Benefit Changes and more [TPA username and password required]

7.6.05   TennCare Benefit Changes
TennCare has e-mailed the Tennessee Pharmacists Association information they stated will be mailed to providers this week. The document, entitled "Important Information for Providers Concerning Changes to the TennCare Program," details the following... Complete article and links to document and to Short List of medications that will not be subject to the prescription limit [TPA username and password required]

7.5.05   TennCare:  Pharmacy Benefits for Disenrollees
As you know, in a surprise move last week, Dave Goetz, Commissioner of Finance and Administration, announced a plan to provide prescription drugs to disenrollees through Express Scripts. In response to calls and questions, Goetz e-mailed a memo received late this morning that does provide some additional information... Complete article and links to entire memo and to list of generic drugs to be provided free of charge [TPA username and password required]

7.1.05   Surprise TennCare Safety Net Announcement: Express Scripts
(TPA username and password required)

6.28.05  TennCare News - Notice, PDL, Grandfathering, Rx Limits & More
On Monday afternoon, June 27, TPA received a notification from First Health revising the implementation schedule for the new TennCare Preferred Drug List (PDL). This communication states the PDL which will becomes effective on July 1, 2005, will only be the interim PDL. According to First Health, they are planning to make changes to the PDL on the first of each month for the next several months... For information on changes to the previously announced "grandfathering" schedule, information not in the notice, such as changes in prescription limits and effective dates, and links to important documents, read the complete article (TPA username and password required).

6.27.05  Update MedicareRx:   "First...What Will the Customer Need?"
(TPA username and password required)

6.22.05    TPA Launches Online Medicare Resource
The Social Security Administration and Centers for Medicare and Medicaid Services have begun sending information to beneficiaries about the new Medicare Prescription Drug Coverage that begins January 2006, and pharmacists will soon be fielding a wide variety of questions from patients wondering about their eligibility. To ensure that you are prepared to answer these questions, the Tennessee Pharmacists Association (TPA) is continuing to put timely information about the Medicare Prescription Drug Coverage into the hands of member pharmacists throughout the state. TPA's newest educational tool for members is an online resource entitled "Medicare Part D Prescription Drug Coverage: Information for Pharmacy Patients" (TPA username and password required).

This new educational resource contains information and documents that will help member pharmacists explain the new Medicare Prescription Drug Coverage to your patients. TPA will continue to add new information in the coming weeks, and we encourage you to check back often. In addition, we hope you will contact TPA (615-256-3023 or communications@tnpharm.org) if you have suggestions for ways to improve TPA's newest member benefit. Thank you!

6.21.05      Disciplinary Actions against Licensed Practitioners
The following practitioners licensed by the Tennessee Department of Health have recently been subject to disciplinary action, and pharmacists should no longer fill prescriptions authorized by them. Complete article and link - TPA username and password required

6.20.05    TennCare: Highlights from First Health Conference Calls
During Provider Education Conference Calls on June 16 and June 17, First Health provided clarification concerning TennCare edits that are taking place now and over the next few months. Complete article and link - TPA username and password required

6.20.05      ASHP Medicare & MTM Resource Center
ASHP has created a Medicare Modernization Act (MMA) Resource Center  to help its members better understand the complex issues around MMA and Medication Therapy Management (MTM) services.  Complete article and link - TPA username and password required

6.16.05

TPA's Baeteena Black to Represent Pharmacists Nationally in Medicare Part D Endeavor

At a national press conference held today at the U.S. Department of Health & Human Services in Washington, D .C., President Bush announced the rollout of a nationwide comprehensive outreach program to educate Medicare beneficiaries regarding the Medicare Part D Prescription Drug Coverage that will begin in January 2006. Tennessee Pharmacists Association Executive Director Baeteena Black, seated on stage with President Bush, was named to represent pharmacists nationally in this endeavor. TPA will keep members informed about this important honor and responsibility in the coming months.

6.13.05  TennCare Notice, PDL, Conference Calls & More
First Health has asked the Tennessee Pharmacists Association to provide members with the TennCare Bureau's detailed 8-page notice regarding the Point-of-Sale (POS) system used for processing TennCare pharmacy claims. The notice includes details on the following:

• The Preferred Drug List (PDL) will become effective July 1, 2005 (and is now available on the TPA website - TPA username and password required). The individual changes to the PDL are detailed in the notice.
• Provider Education Conference Calls on June 16 and June 17, 2005, will address processing questions resulting from the newly implemented pharmacy edits. If you have questions that you would like answered during one of these calls, fax them to 615-532-7681 by Tuesday, June 14.
• Grier Consent Decree Reminder
• Links (TPA username and password required): 
  TennCare notice
  Preferred Drug List (PDL) (effective 7/1/05)
  Clinical Criteria for PDL (effective 7/1/05)
  Step Therapy for PDL (effective 7/1/05)
  Quantity Limits for PDL (effective 7/1/05)

6.10.05  Victory Upheld: Memphis Employees Retain Right to Choose Pharmacy Provider
In response to the case brought by the Tennessee Pharmacists Association (TPA) and several other parties named below, a state court of appeals decision affirming the ruling of Shelby County Chancellor Walter L. Evans that enjoined the City of Memphis from forcing enrollees in its health plans to obtain certain medications from mail-order pharmacies has become final. The City could have asked the Tennessee Supreme Court to review the decision issued on March 22, 2005, but did not do so...  Complete article - TPA Username and Password required

6.10.05  TennCare Pulls Pediatric High Dose Edit
TPA has been in contact with TennCare this week, in response to phone calls from several TPA members reporting problems with the pediatric high-dose edit recently implemented by TennCare and First Health. TennCare Pharmacy Director David Beshara called today to acknowledge the problem... Complete article - TPA Username and Password required

6.8.05   TPA and American Cancer Society Provide Information for Your Patients
TPA has been working with the American Cancer Society to produce a "Slim-Jim" that pharmacists can download and use in their stores.  The Slim-Jims, so-called because they are on "slim" cards, contain information regarding Cancer Detection Guidelines on one side and Patient Support Programs Information on the reverse side.  The product is designed in such a way that pharmacies can add their personal information to the cards if they so desire. Click here to access the Slim-Jim, print the document (in color or black and white) on heavy 8½"x11" paper (front and back), and cut each sheet in thirds.  Alternatively, send the PDF file to your local printing vendor for handling.

6.7.05 TennCare Changes Regarding Compounded Medications
TPA has just received a reminder from TennCare regarding changes associated with filing compounded prescriptions. The notice stated:

"This notice is a reminder of the compound dispensing fee changes that go into effect on Tuesday, June 7, 2005 . Below is the message that was sent in last week's notification... Complete article and links to documents referenced - TPA Username and Password required 

6.2.05 TennCare: Changes & Questions
The following paragraphs contain a summary of critical TennCare issues discussed during the May 26 conference call between pharmacy providers and Pete Philips, DPh, Pharmacy Provider Educator with First Health. Today, June 2, TPA received a TennCare notice that deals with some of these issues further, describes edits not previously discussed, and announces Provider Education Conference Calls scheduled for June 16 and June 17. The notice is available on the TPA website... Complete article and links to documents referenced - TPA Username and Password required

5.20.05     TennCare:  Therapeutic Tolerance, POS Edits & Provider Education Conference Call
TPA is providing its pharmacist members with some important updated information recently received from TennCare and First Health, as TPA is not aware of any notification that has been sent directly to providers.   Complete article and TennCare notice (TPA Username & Password required)

5.18.05  Administration Reveals Plans for "Health Care Safety Net"
Yesterday in the Senate Commerce Committee, the Administration revealed its plans to facilitate the expansion and augmentation of a health care "safety net" in Tennessee.  The plan was presented as an amendment to SB 2300 by Kyle and is intended to provide a "safety net" for uninsured Tennesseans, many of whom will be disenrolled from TennCare beginning around August 1, 2005.  This amendment is 15 pages in length and contains many program components purported to provide medical assistance, both medical services and pharmacy, to those who are uninsured or lack the financial resources to secure medical care.  This coverage is to be provided within the existing revenue of the 2005 and 2006 budget. Download the Legislative Update containing provisions of the bill and key points - TPA Username and Password required

5.17.05  Letters & Applications Being Mailed This Week to All Who Might Qualify for Drug Benefit Low Income Subsidy (LSI) Complete article and links to letters and application - TPA Username and Password required

5.17.05  Update MedicareRx Launched - "TPA Partners with CMS to Provide Weekly Medicare Updates to TPA Members" - TPA Username and Password required

5.13.05  Plan Table for Medicare Part D Programs (from Ed Heckman, PAAS National) - TPA Username and Password required.

5.11.05    Legislative Update  -- Call to Action
     SUBSTITUTION BILL, ORTHOTICS BILL, OTHER BILLS OF INTEREST
     Contact Your Legislators!

SB 1360 / HB 1410  (Substitution):  Enacts the "Tennessee Affordable Drug Act of 2005"
Now moving forward in both the Senate and House.  The two  bills are traveling with different amendatory language. At some point, the differences must be resolved in order to get the legislation enacted. TPA will continue to work toward  having this legislation become law.

SB 0508 / HB 0404 (Orthotics):    Enacts the "Tennessee Orthotics, Prosthetics and Pedorthics Act of  2005"
Amended as requested by TPA and moving forward.  ACTION  NEEDED:  Contact your State Senator and ask them to support SB 0508 as amended in the Senate General Welfare Committee.

SB 1989 / HB 1870:  Enacts the "Prescription Medicine Fair Pricing Act of 2005"
Would have allowed importation. There will be no action on the bill this year.

SB 0778 / HB 1375:  Enacts the "Medication Misuse and Abuse Prevention Act of 2005"
Requires use of  ""smart card" technology in order to get any prescription filled in Tennessee. The bill calls for TennCare to provide the necessary technology to providers  and cards to all Tennesseans.  An amendment calling for only a 13-county pilot project has been adopted in the House.  The bill as amended will be heard in the House Health Committee on May 17.  ACTION NEEDED:  Contact  your Representative if he or she is a member of the House Health & Human Resources Committee, and ask them to oppose the bill.

Download the Legislative Update for details about the bills, meeting times, committee members, and instructions for learning who your legislators are and how to contact them.  If you have difficulty with the download, call the TPA office, 615-256-3023.

Thank you for your support!

5.9.05   Legislative Update   --  Call to Action
                       --ORTHOTICS BILL--
                       Be on Capitol Hill May 10!

SB 0508 / HB 0404:   Enacts the "Tennessee Orthotics, Prosthetics and Pedorthics Act of 2005" -  This bill as drafted would prevent current orthotic/prosthetic fitters from continuing to provide care for patients they  serve. The amendment agreed upon by TPA was placed on the bill in the Senate, and the amended bill was approved unanimously. HB 0404 will be considered by the full House Health & Human Resources Committee on Tuesday, May 10. 

ACTION NEEDED: Contact your State Representative, if he or she is a member of the House Health Committee , to express your concern about and opposition to SB 0508 / HB 0404 as currently drafted. Tell them the only way we can support this bill is if it is amended in the House to address pharmacists' concerns. Be on the Hill on Tuesday, May 10.

Download the Legislative Update for details about the Orthotics bill, meeting time, committee members, and instructions for learning who your legislators are and how to contact them.  If you have difficulty with document, call the TPA office, 615-256-3023.

5.5.05   Legislative Update   -- URGENT --  Call to Action
                       --SUBSTITUTION BILL--
                       Be on Capitol Hill May 10!

SB 1360 / HB 1410 :  Enacts the "Tennessee Affordable Drug Act of 2005"
Pharmacists are strongly urged to contact their Representatives over this  weekend and be on Capitol Hill on Tuesday, May 10.  The bill was not discussed in  the House Health & Human Resources Committee on May 3 because of a lengthy discussion  on another bill. The bill will be voted on May 10.

ACTION NEEDED: Contact your Representative if he or she is a member of the House Health Committee. Get an absolute commitment from them to support  HB 1410 with Rep. David Shepard’s amendments. Tell them it is important to keep the permissive therapeutic substitution component in the bill. Tell them the bill has  passed out of the Senate General Welfare Committee. Either call or e-mail the TPA office (615-256-3023, kelly@ tnpharm.org) to let us know where the members of this  committee stand. This is very important. Be on the Hill on Tuesday, May 10.

Download the Legislative Update for details about the Substitution  bill, meeting time, committee members, and instructions for learning who your legislators are and how to contact them.  If you have difficulty with document, call the TPA office, 615-256-3023.

5.3.05     Therapeutic Duplication Edit for Benzodiazepines Implemented at Point-of-Sale
Complete artcle (TPA Username and Password required)

4.29.05    Legislative Updates  -- URGENT --  Call to Action
                   SUBSTITUTION BILL and ORTHOTICS BILL ON FAST TRACK--
                   Be on Capitol Hill May 3 (Substitution & Orthotics)
                   and May 4 (Orthotics)

SB 1360 / HB 1410 (Substitution Bill) enacts the "Tennessee Affordable Drug Act of 2005".  The bill passed out of the Senate General Welfare Committee and will be voted on in the House Health Committee on May 3rd. Contact your Representative and be on Capitol Hill on May 3rd!

SB 0508 / HB 0404 (Orthotics Bill) enacts the "Tennessee Orthotics, Prosthetics and Pedorthics Act of 2005". This bill will be considered in the House Health & Human Resources Committee on Tuesday, May 3, and in the Senate General Welfare, Health & Human Resources Committee on Wednesday, May 4th.    Contact your Representative and/or Senator and be on Capitol Hill on May 3rd and 4th!

4.28.05  Inspections for Meth Violations Begin Tomorrow, April 29
Remember, pharmacies must be in compliance with the requirements of the "Meth-Free Tennessee Act" by this Friday, April 29, 2005. The requirements are available to members in a one-page document here.  NEW INFORMATION: TPA has been told by representatives of the TBI and the Tennessee District Attorneys Conference that all law enforcement agencies have been alerted and requested to visit pharmacies in their communities beginning on April 29, to assure pharmacies are in total compliance with the new law.  In addition, the following includes clarification (in bold) of the requirements for pharmacies. Complete article (TPA Username and Password required)

4.27.05    April 29 is Deadline for Compliance with "Meth-Free Tennessee Act"
On March 30, Governor Bredesen signed into law the Meth-Free Tennessee Act of 2005, now Public Chapter 18. This comprehensive legislation is designed to combat methamphetamine manufacture and abuse in Tennessee. For pharmacies, the law takes effect 30 days from the date of signing. Therefore, pharmacies must be in compliance with the requirements of the law by this Friday, April 29, 2005. Complete article, requirements and supporting documents (TPA Username and Password required)

4.26.05  TennCare Edits Implemented Today, April 26
The Tennessee Pharmacists Association today received a statement from First Health regarding the TennCare Therapeutic Duplication edits and Dose Optimization Edit scheduled for implemention today. Complete article and supporting documents (TPA Username and Password required)

4.22.05          Legislative Update  -- URGENT -- Call to Action
                       --SUBSTITUTION BILL ON FAST TRACK--
                           Be on Capitol Hill April 26&27

Bills will be  considered in both House and Senate Health Committees the week of April 18! SB 1360 / HB 1410 enacts the "Tennessee Affordable Drug Act of 2005". The bill was discussed in the House on the 19th, but the vote was postponed until April 26.  In the Senate, the bill was  postponed until April 27.

Pharmacists are  strongly urged to contact their legislators over this weekend and be on Capitol Hill on Tuesday , April 26, and Wednesay, April 27.  This bill as amended reforms the  Tennessee Substitution Law.

ACTION NEEDED:    Contact  your Representative and/or Senator if he or she is a member of the House or Senate Health Committee. Get an absolute commitment from them to support SB 1360 /  HB 1410. Either call or e-mail the TPA office (615-256-3023, kelly@tnpharm.org) to let us know where the members of  these committees stand. This is very important. Be on the Hill on Tuesday, April 26, and Wednesday, April 27.

Download the Legislative Update for details about  the bill, meeting times, lists of House and Senate Health Committee members, and instructions for learning who your legislators are and how to contact them.  If you have difficulty with the file call the TPA office, 615-256-3023. 

Thank you for your support!

4.21.05  Therapeutic Duplication Edit Change Confirmed
The Tennessee Pharmacists Association received the following written confirmation from First Health today:

"[T]he coding changes relative to Therapeutic Duplication on Long-acting and Short-acting Analgesics have been thoroughly tested and implemented in the production POS system...."   Complete article (TPA username and password required)

4.19.05    Launch of Merck Prescription Discount Program
Merck announced today the launch of the Merck Prescription Discount Program -- an initiative that provides discounts on selected Merck medicines to cash-paying customers who have no other prescription drug coverage. TPA is taking this opportunity to inform members about the program before it goes into effect on Monday, April 25, 2005.  Complete article and downloadable "information guide" for pharmacists (TPA username and password required)

4.18.05          Legislative Alert     -- Call to Action --
                       --ORTHOTICS LEGISLATION MOVING FORWARD--
Two bills that could limit a patient's access to basic orthotic braces and supports and diabetic shoes from pharmacists and other providers are now moving in both the House and Senate.

Both bills as  drafted would prevent current orthotic/prosthetic fitters from continuing to provide care for patients they serve.  If  you provide orthotic and related services in your pharmacy, please contact the TPA by phone (615 -256-3023) or e-mail kelly@tnpharm.org to let us know.  Pharmacists are urged to contact their legislators to express concern and  opposition to these bills. 

The attached document contains details about the bill and instructions for learning who your legislators are and how to contact them.  If you have difficulty with the attachment, you may download the Legislative  Alert from the homepage of the TPA website, www.tnpharm.org,  or call the TPA office, 615-256-3023. 

Thank you for your support!

4.15.05          Legislative Alert   -- URGENT --  Call to Action
                       --SUBSTITUTION BILL ON FAST TRACK--
Bills will be  considered in both House and Senate Health Committees the week of April 18! SB 1360 / HB 1410:    Enacts the "Tennessee Affordable Drug Act of 2005" 

Pharmacists are  strongly urged to contact their legislators over this weekend and be on Capitol Hill on Tuesday, April 19, and Wednesay, April 20.  This bill as amended reforms the Tennessee Substitution Law.

ACTION NEEDED:    Contact  your Representative and/or Senator if he or she is a member of the House or Senate Health Committee. Get an absolute commitment from them to support SB 1360 /  HB 1410. Either call or e-mail the TPA office (615-256-3023, kelly@tnpharm.org) to let us know where the members of  these committees stand. This is very important. Be on the Hill on Tuesday, April 19, and Wednesday, April 20.

Download the Legislative Alert for details about the bill, meeting times, lists of House and Senate Health Committee members, and instructions for learning who your legislators are and how to contact them.  If you have difficulty with the file call the TPA office, 615-256-3023. 

Thank you for your support!

4.14.05    Business Associate Under HIPAA
Many of you recently attended Seminars on HIPAA Security Compliance and purchased HIPAA Security products developed and offered by NCPA and PRS. Jeff Hedges, Special Projects Manager for PRS Pharmacy Services, has provided TPA with information concerning Business Associate Agreements as they pertain to the Security Rule. This information was developed in response to calls received by PRS on this subject. TPA members may download the document provided by PRS regarding Business Associates under HIPAA, for your information and use. As a reminder, the Security Rule portion of HIPAA becomes effective April 20, 2005.

4.12.05    State Wins TennCare Court Battle
The Sixth U.S. Circuit Court of Appeals in Cincinnati ruled today that Tennessee officials don't need a judge's approval to cut 323,000 adults from TennCare... Complete article (TPA username and password required)  

4.8.05   TennCare Changes: Therapeutic Dup & Step Therapy Edits
TennCare has asked the Tennessee Pharmacists Association to notify our members regarding the following important changes affecting claims beginning Tuesday, April 12, 2005.  Complete article (TPA username and password required)

4.4.05   Free HIPAA Security Teleconferences
TPA members may be interested in the free Security Teleconferences shown below, being offered by SharpWorkGroup.

• April 6: "Are you on track with HIPAA Security Compliance? How to gauge your progress"
• April 20: "HIPAA Security Open Forum for Rural Hospitals"
• May 11: "HIPAA Security Maintenance"
• May 25: "Are We There Yet? Auditing your HIPAA Security Program"

TPA members may view complete information here.

3.31.05 Anti-Meth Legislation Becomes Law (New supporting documents added 4/4/05)

Yesterday, March 30, 2005, Governor Bredesen signed into law the Meth-Free Tennessee Act of 2005, the comprehensive legislation designed to combat methamphetamine manufacture and abuse in Tennessee. For pharmacies, the law takes effect 30 days from the date of signing. Therefore, by April 29, 2005, pharmacies must be: maintaining restricted pseudoephedrine-containing products in one of two ways, following restrictions regarding the quantities that can be sold, and keeping records that contain the specific information required in the law. TPA members may click here to download the specific requirements with which pharmacists must comply, including requirements added in the most recent amendment to the bill. Additional information will be provided as it becomes available. Supporting Documents:

• Exempted Products List
• Meth-Free Tennessee Act of 2005
• Summary of the Law
• Pharmacy Practice Act: Excerpt on Sale of Non-Prescription Drugs (T.C.A. §63-10-206)
• Governor's News Release

3.24.05 - 3.28.05  TennCare POS Edits Implementation to Resume
During TennCare's Provider Education Conference Call on Thursday, March 24,  the Tennessee Pharmacists Association learned that the TennCare Bureau mailed all  pharmacies a 3-page notice March 23, concerning changes that will impact the Point-of-Sale (POS) system used for processing pharmacy claims. The notice stated the implementation of certain edits will occur over three phases during March and April.
Complete article and link to TennCare notice (TPA username and password required)

3.23.05  Memphis Employees' Right to Choose Pharmacy Provider is Upheld:
Trial Court's Injunction Preventing City of Memphis  From Implementing Mandatory Mail-Order Affirmed by Court of Appeals
The Tennessee Court of Appeals has upheld the decision of  Shelby County Chancellor Walter L. Evans' finding that the City of Memphis cannot force  its employees to obtain certain medications from mail-order pharmacies, because this violates state law. Enrollees in the City's health plans are comprised of both current and retired City employees.... The Any Willing Pharmacy Act requires that local pharmacists be given the same right to participate in health plans as other providers, such as mail-order pharmacies. The lawsuit was brought by several  parties, including a local pharmacist, Rodney A. Tubbs, D.Ph., the Tennessee Pharmacists  Association, a retired City of Memphis firefighter, Bobbie D. Gray, a local pharmacy, Rx Shoppe located at 3701 Riverdale Road, and the Association of City Retired Employees...
Complete article (TPA username and password required)

3.22.05  30+ Free Informational Brochures Available from Pfizer
Christi Capers, Pharm.D., from Pfizer Pharmaceuticals has provided Tennessee Pharmacists with the opportunity to access to over 30 informational brochures that may be utilized in their practice. These brochures include selected medication compliance pieces, as well as drug- and disease-specific information.  Please take the time to look over the order form (TPA username and password required) and see what might be helpful in your practice.  These brochures are provided at no cost to you and could be of real value to you and your patients.  If you have any questions about the brochures, TPA has copies and would be able to advise you.  Please call Page Dunlap, Pharm.D., at the TPA office (615-256-3023) or e-mail questions to page@tnpharm.org

3.21.05    Use of TennCare Grier Drug Store Notice Continues to Be Required
Pharmacists are reminded the TennCare Grier Drug Store Notice form is still required to be given to any TennCare enrollee who leaves any pharmacy without the full prescription as approved by the prescriber. This includes all instances where the Grier Override Code "8" is used.  Pharmacists should ensure they are using the correct TennCare Drug Store Notice Form (TPA username and password required).

3.18.05    TennCare POS Edit Implementation on Hold
The Tennessee Pharmacists Association has learned from the TennCare Bureau that the implementation schedule for future POS edits has been placed on hold until further notice. This includes re-implementation of the Therapeutic Duplication and Dose Optimization edits pulled on March 11.  Complete article and TennCare notice (information regarding Grier and Provider Education Conference Call) - TPA username and password required

3.12.05    TennCare Pulls Recent DUR Edits on 3 Drug Categories
During an extensive conference call Friday evening, Baeteena Black, Tennessee Pharmacists Association (TPA) Executive Director, was able to convey to J. D. Hickey, Deputy Commissioner of TennCare, the severity and pervasiveness of the problems created by the recent implementation of hard edits. As a result, Dr. Hickey has issued the following statement: "TennCare advises that effective Friday, March 11, 2005, the DUR edits are being pulled on the 3 drug categories (gastric, antihistamine and narcotic) for at least a week."

TPA will continue to keep pharmacists informed as developments unfold. Members are encouraged to contact TPA with their questions or concerns: 615-256-3023; tpa@tnpharm.org.

3.10.05    Legislative Update: Agreement Reached on Meth-Free Tennessee Act of 2005
The Meth-Free Tennessee Act of 2005 (SB2318/HB2334), the comprehensive legislation addressing the many concerns regarding the illicit manufacture of methamphetamine in Tennessee, is moving forward and is close to becoming law. Tennessee pharmacists and the patients they serve will be affected by this law. Pharmacists need to  begin preparing now for the requirements in the legislation related to changes in the regulation and sale of pseudoephedrine-containing products. TPA's Legislative Update (TPA username and password required) spells out the specifics of this legislation. 

3.8.05   TennCare POS Edit Implementation Causes Problems
Many TPA members called to report difficulty in processing certain claims through First Health due to implementation of the POS edits today (March 8).  TPA Executive Director Baeteena Black has been in contact with First Health to resolve this issue and has received the following advice and direction from First  Health:   Any claims that return a rejection for Therapeutic Duplication, Quantity Limits exceeded, or DUR reject should be evaluated for clinical appropriateness. Please have the provider with the appropriate clinical information call 1 -866-434-5524 to obtain a Prior Authorization for the medication requested.    Complete article and links to documents received from First Health (TPA username and password required)

2.18.05  TennCare Changes in Pharmacy Grier Override Codes
On Friday, February 18, 2005, TPA received from TennCare an updated notification regarding changes in the use of Grier Override Codes. The fact that changes were expected was mentioned in the information sent to TPA members via email on Thursday, February 17, 2005. The changes regarding use of Grier Override Codes will become effective on March 8, 2005. The basic Grier Override Code changes are as follows... Complete article and link to TennCare Notice, including example transaction for the Grier Overrides (TPA username and password required).

2.17.05    Changes in TennCare Claims Processing
The Bureau of TennCare has once again requested the assistance of the Tennessee Pharmacists Association in advising pharmacists of important changes that will affect the processing of pharmacy claims for the TennCare Program. The first changes are scheduled to occur on March 8, 2005, with additional changes scheduled to be implemented on March 22, 2005, and April 12, 2005. Some of these announced changes will be implemented at a later date yet to be determined. Available for review by TPA members is a pharmacy provider notice for pharmacists from the Bureau of TennCare. Also available  is a copy of a letter being sent this week to approximately 29,000 Tennessee prescribers who have issued a prescription to any TennCare patient in the last three months.  Please pay particular attention to the information regarding the Unit of Measure Field. In the near future First Health plans to begin requiring the mandatory submission of NCPDP field 600-28 Unit of Measure...   Complete article, links to TennCare letters to pharmacists and prescribers and Step Therapy Edits document (TPA username and password required)

2.10.05    Disciplinary Action for Dentist
The Disciplinary Coordinator for the Tennessee Health Related Boards has provided information that Champ Clark, DDS, of Monterey, TN, has surrendered his license. Pharmacists should no longer fill prescriptions authorized by him. The order can be viewed at http://www2.state.tn.us/health/licensure/displaypdf.asp ?profcode=1201&licen=4423&thedate=1/28/05.

2.8.05   Summary Suspension of Pamela Ventra, MD
The Disciplinary Coordinator for the Tennessee Health Related Boards has notified the Tennessee Pharmacists Association of the summary suspension of Pamela Ventra, MD, and has asked TPA to notify pharmacists to stop filling prescriptions authorized by her. She has practiced in Chattanooga and in Trenton, Georgia.

2.4.05   TPA Members Entitled to Discount on Disability Insurance
The Tennessee Pharmacists Association is pleased to announce a new benefit for members. The Association endorses the products and services offered through the Pharmacists Mutual Companies. As a result of our endorsement, TPA members will be entitled to an Association discount of 10% off the premium of an individual disability income policy issued through the Principal Life Insurance Company. In addition, pharmacists have been placed in a select occupation class by Principal and will receive an additional 10% discount. The new disability policy also has a special mental/nervous substance abuse rider, and the good news is, this can also generate another 10% discount.

30% discount for TPA members - that's a great member benefit!

Disability insurance is a product to protect your most important asset - your ability to earn an income. Principal Life offers a comprehensive disability portfolio for personal and business owner needs, including Disability Income, Overhead Expense, and Disability Buy-Out options. For more information, see the product brochure at