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News at a Glance
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ALSO VISIT:
News at a Glance - Current

News at a Glance - 2007
News at a Glance - 2005
News at a Glance - 2004

Most of the following articles are on Members-Only pages and require a TPA user name and password TPA members can access the following articles and more on our FRAUD/ABUSE, TENNCARE, COVER TENNESSEE, MEDICARE, LEGISLATIVE NEWS, and IMMUNIZATION and OTHER PHARMACY NEWS & TOPICS pages.

12.29.06 Tennessee Controlled Substance Database (TPA username and password required)
12.29.06 Forgeries Appearing in Middle Tennessee
A forged prescription was detected today in Franklin, Tennessee. Larry Fletcher, O.D., an optometrist in Springfield, was listed on the forgery as the prescriber. It did have his correct DEA number but had a suspicious looking change to the phone number. Dr. Fletcher has been advised and requests ANY prescription for controlled substances (written or verbal) be verified by calling his actual phone number at 615-384-5088.
12.28.06 Update MedicareRx - "January Preparation... the Best Medicine for Beneficiaries" (TPA username and password required)
Also covered in this update: 
-- Point of Sale Option Improved for 2007
-- Thanks for All You Do
-- CCRx Employer Retiree Plans Go into Effect on January 1
12.22.06 Use of Proair HFA

TPA has received several calls from pharmacists who received the TennCare communication regarding the status of Proair HFA on the TennCare PDL.  Those pharmacists have been asking questions regarding their ability to substitute Proair HFA for other albuterol CFC products.  Read complete article (TPA username and password required)

12.21.06 CoverRx Information (TPA username and password required)
12.21.06 BCBST Offers MTM Services in 2007 (TPA username and password required)
12.20.06 TennCare Notice: Status Change of Proair® HFA (TPA username and password required)
12.19.06 12/25 is Deadline for 1st Controlled Substance Database Submission (TPA username and password required)
12.19.06 TennCare Notice: Pharmacy Provider Conference Call on 12/19 and 12/20 (TPA username and password required)
12.18.06 Proposed Rule on Medicaid AMP Released

On Friday, December 15, the Centers for Medicare and Medicaid Services (CMS) announced proposed changes in the payment for certain prescription drugs in the Medicaid program. These changes implement provisions of the Deficit Reduction Act of 2005 (DRA). The DRA changes how the federal government limits payments to state Medicaid agencies for the aggregate costs of prescription drugs when a generic substitute is available. The DRA establishes a new FUL calculation that is based on 250% of the lowest Average Manufacturers' Price (AMP) in a drug class.  Complete article (TPA username and password required)

12.14.06 TennCare PDL Changes and More
TennCare has issued provider communications regarding PDL changes effective on January 4, 2007.   In the first notice, TennCare announced that all carisoprodol agents (brand, generic, and combination products) would be considered non-preferred on the TennCare PDL.  TennCare's second recent notice outlined additional PDL changes that will be effective January 4, as well as information about a Provider Education Conference Call scheduled for December 19-20, a new Prior Authorization Fax Form, and Multi-Ingredient Claims. (TPA username and password required)
12.14.06 Room Rate Extension for Southeastern Leadership Weekend at Grove Park Inn, Asheville, NC

The Grove Park Inn in Asheville, NC, has extended our special room rate deadline to Monday, December 18, 2006.  The special $125 nightly room rate is a STEAL at the Grove Park Inn - available for the weekend of January 19 -21, 2007, for the Southeastern "Girls of Pharmacy" Leadership Weekend.  After December 18, the list price for rooms goes up to approximately $265 per night.  The Grove Park Inn is award-winning and nationally recognized.  Call (800) 532-4033 today to take advantage of this incredible rate at a top-rated resort. For spa appointments, please contact Jennifer Simmons at (803) 354-9977.  Limited appointments and times are available!  Even though the weekend is fondly referred to as the "Girls of Pharmacy" weekend, men are more than welcome to attend.  Click here for the program and registration form.

12.14.06 Update MedicareRx - "CCRx Recommends All MTM Cases Be Completed and Billed by Dec. 15" (TPA username and password required)
Also in this Update:  "CMS Announces Deemed Accreditation Organizations for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies."
11.27.06 TennCare:  PDL Status Change on Januvia® (sitagliptin) (TPA username and password required)
11.27.06 TennCare Pharmacy Benefit Workshop - Program Information, Schedule and RSVP Form (TPA username and password required)
11.21.06 Update MedicareRx - "Encourage Medicare Beneficiaries to Enroll in Part D Before Dec. 8" (TPA username and password required)
Includes links to:
-- CMS Open Enrollment Center
-- CMS Partner Center
-- www.medicare.gov
-- “Make the Most of Your Medicare Drug Plan Options by Comparing Plan Performance” – CMS Pub. No. 11226
-- “How to Make the Most of Medicare’s Information About Quality to Compare Plans and Providers” – CMS Pub. No. 11266
-- “Understanding the Choices You Have in How You Get Your Medicare Healthcare Coverage” – CMS Pub. No. 11225
-- New Plan Performance Information Now Available on the Personal Plan Finder
-- Fall 2006 Mailings Chart
-- Press Release: MemberHealth Acquires Medicare Part D Lines from AmeriHealth Insurance Company
-- MemberHealth Offers Co-op Advertising Opportunity
11.20.06 CoverRx Program to Begin January 1, 2007 (TPA username and password required)
11.16.06 Tennessee Controlled Substance Database Update (TPA username and password required)
11.14.06 Update MedicareRx - "CCRx MTM Target: All Patients Should Be Scheduled by December 1" (TPA username and password required)
-- Open Enrollment Begins TOMORROW, November 15
-- CMS Mailing Affected Beneficiaries Reassignment Notices: Plan Reassignment Notices
-- Beneficiaries Losing LIS Status
11.9.06 FDA: Nationwide Recall of Acetaminophen 500 mg Caplets
11.9.06 TennCare:  PDL Changes and Much More (TPA username and password required)
11.7.06 Medicare Part B-TennCare Crossover Information 
First Health writes:  "There has been some confusion surrounding Medicare Part D and the crossover payments from Medicare to TennCare for recipients who have utilized Medicare Part B services (i.e. diabetic supplies).  The attached document hopes to clarify the confusion.  Thank you for your commitment to the TennCare Pharmacy Program."  (TPA username and password required)
11.7.06 Update MedicareRx:  Pharmacy Open Door Forum TODAY (TPA username and password required)
-- Pharmacy Open Door Forum TODAY: Internet Relay Services
--
Information about LIS beneficiaries
-- CMTM Techncial Support -
Email and website
--
MTM information on TPA website
--
Information on Premium Withhold
11.7.06 APhA Immunization Incentive Grants - Apply by November 20 (TPA username and password required)
11.6.06 2006-07 Influenza Season - Recommendations for Using Antiviral Agents (TPA username and password required)
11.6.06 Larry Hill, D.Ph., Appointed to Board of Pharmacy
The Tennessee Pharmacists Association is pleased to announce the appointment by Governor Bredesen of Larry Hill, D.Ph., to a six-year term on the Tennessee Board of Pharmacy. Dr. Hill, owner of Chase Drugs in Harriman, Tennessee, fills the seat vacated by Dr. Reggie Dilliard upon the completion of his term. Watch for more information in the upcoming Tennessee Pharmacist!  TPA is grateful to Dr. Dilliard for his dedication and hard work for the last six years, and we thank Dr. Hill and the others nominated, for their willingness to serve.
11.6.06 Shipments Started for Plan B OTC Product
Barr Pharmaceuticals, Inc. began shipments of its dual label Plan B product to wholesalers and distributors today, November 6. The product is expected to be in pharmacies later this week. In August, FDA approved Barr’s application for Plan B to be available as an over-the-counter medication for women 18-and-older, while retaining its prescription status for women 17-and-under. The American Pharmacists Association (APhA) has developed a "Frequently Asked Questions" document to help pharmacists navigate this new product.  (TPA username and password required)
11.2.06 Upcoming DMEPOS - Diabetes Competitive Bidding Rule
The Tennessee Pharmacists Association has received the following information from the National Alliance of State Pharmacy Associations (NASPA) and the National Community Pharmacists Association (NCPA) regarding the upcoming DMEPOS - diabetes competitive bidding rule mandated by MMA.  Complete article... (TPA username and password required)
11.2.06 Vivian Loveless Elected to APhA Office
We are excited to announce that a third TPA member has successfully run for office in the American Pharmacists Association!  Dr. Vivian Loveless (vloveless@utmem.edu), U.T. College of Pharmacy Associate Professor, has been elected Member-at-Large in APhA's Academy of Pharmacy Practice and Management (APhA-APPM) Nuclear Pharmacy Practice Section.  Congratulations, Dr. Loveless!!

Dr. Loveless joins Drs. Tim Tucker (President-Elect) and Dick Gourley (Board of Trustees) as Tennesseans elected to APhA offices this year.  All will be installed at the 2007 APhA Annual Meeting in Atlanta, March 16-19, 2007. 

11.1.06 Controlled Substance Reporting in Tennessee
A number of members have requested information about a mailing received from Optimum Technology on behalf of the Tennessee Board of Pharmacy, regarding the new controlled substance reporting requirements that will begin in December.  Complete article... (TPA username and password required)
10.20.06 Tim Tucker and Dick Gourley Win APhA Elections
We are thrilled to announce that Tim Tucker and Dick Gourley have BOTH won their elections in the American Pharmacists Association!  This extremely well-deserved honor is, for each of them, a reflection of their extraordinary achievements and commitment.  We are very proud that their experience and abilities have been recognized at the national level, and we know that APhA and pharmacy will benefit greatly from their influence.  Congratulations, Tim and Dick! 

Tim Tucker, Pharm.D., has been elected APhA President-Elect! 
mailto:tltucker@aeneas.net, P.O. Box 189, Huntingdon, TN 38344

Dick Gourley, Pharm.D., has been elected to the APhA Board of Trustees!
mailto:dgourley@utmem.edu, 847 Monroe Avenue, Suite 226, Memphis, TN 38163

10.20.06 Bogus Prescrptions
T. K. Creson, Jr., M.D., in Memphis, Tennessee (901-795-1465) has asked the Tennessee Pharmacists Association to alert pharmacists that their office has become aware of 4 bogus prescriptions that have been turned in to pharmacies.  They were written on Dr. Creson's prescription pad, and 3 were signed "T. K. CreAson."  They are dated 10/04, 10/06, 10/11 and 10/13, 2006, and are written for Ampicillin, Tussionex, Lortab and Xanax.
10.17.06 Update MedicareRx - "New Tools Available to Help with Medicare Prescription Drug Plan Choices for 2007" (TPA username and password required)
-- Press Release: Medicare Prescription Drug Plan Finder
-- Fact Sheet on Enhancements to Plan Finder Tools on www.medicare.gov
-- Press Release: Fact sheet on Price Analysis for Drugs for Common Health Problems and Savings in 2007
-- Medicare Advantage Cost Plans and Demonstrations in  Tennessee for 2007
-- Stand-Alone Prescription Drug Plans in Tennessee for 2007
10.16.06 Update MedicareRx - LIS Re-determination Letters Are in the Mail (TPA username and password required)
Links Included:
-- Notice to beneficiaries who are no longer automatically eligible for the Low Income Subsidy (LIS) in 2007, and information about the notice
-- Notice to beneficiaries whose LIS level is changing in 2007, and and information about the notice
-- Help for beneficiaries applying for LIS (Social Security Administration
-- Ad informing Medicare beneficiaries about Prescription Drug Plan options for 2007
-- "Navigating the Medicare Prescription Drug Plan Finder, " a short tutorial
10.11.06 Medicare Prescription Drug Plan Finder - Recorded Webinar Available (TPA username and password required)
10.10.06 Coumadin: New Medication Guide (TPA username and password required)
10.6.06 Reminder - Cast Your Vote for APhA Elections by Friday, October 13!
10.5.06 Update MedicareRx - "Drug Plan Options in Tennessee for 2007" (TPA username and password required)
-- Includes link to list of Stand-Alone Prescription Drug Plans in Tennessee for 2007
10.3.06 Use It or Lose It: The Volunteer State Needs to Take the Lead in MTM
9.27.06 Federal Meth Law - Staff Training and Self-Certification (TPA username and password required)
9.27.06 CCRx Recontracting Begins December 1 (TPA username and password required)
9.26.06 Federal Meth Law Requirements - New Information about Staff Training Requirements and Pharmacist-Issued Prescriptions (TPA username and password required)
9.26.06 NPI Application Information (TPA username and password required)
9.22.06 Pharmacy CE Sept. 28, 8:15 a.m. Eastern - Live & Webcast
9.21.06 TPA Will Produce Logbook for Sale of Pseudoephedrine
--
ORDER FORM for Logbook
9.19.06 BCBST Seeks Pharmacists for Medication Therapy Management (MTM) Provider Network (TPA username and password required)
9.14.06 Update MedicareRx - "Planning Medicare Part D Awareness… for 2007" (TPA username and password required)
Links included:
-- Medicare’s Preventive Services
-- Timeline of upcoming events for pharmacists
--
Letter being sent to beneficiaries (on blue paper) who no longer automatically qualify for extra help
-- Model documents for use by Plans (Annual Notice of Change, Summary of Benefits, and more)
-- Prescription Drug Plan Finder
9.13.06 Additional Information Regarding Pseudoephedrine Sales Records (TPA username and password required)
--
Attorney General's Opinion regarding access to methamphetamine sales records and how HIPAA applies
9.12.06 Sales Logbook for State & Federal Meth Laws May Be Available  
9.8.06 URGENT NOTICE:  New Federal Law Requirements for the Sale of Pseudoephedrine Begin SEPTEMBER 30 (TPA username and password required)
9.8.06 Tennesseans Bid for APhA Offices; Ballots Due October 13
9.7.06 Participate in U.T. Golf Tournament, September 13, in Memphis, TN
9.7.06 Deadline Extended for BCBST Pharmacy Workshops
9.7.06 Help Students Attend NCPA Meeting
9.6.06 Update MedicareRx - "Medicare Chief McClellan Steps Down"  (TPA username and password required)
Also covered:  CCRx Meets Medicare Part D Low Income Benchmark in Our Region for the 2007 Plan Year
9.1.06 Update MedicareRx - "Pharmacy Open Door Forum - Wednesday, Sept. 6"  (TPA username and password required)
Links included:
-- Internet Relay Service for Pharmacy Open Door Forum
-- E-mail address for questions about Durable Medical Equipment for NPI Roundtable
-- Additional CMS information at NPI
-- Apply for NPI
-- Information regarding 9-day payment hold for Medicare Parts A & B (Deficit Reduction Act of 2005)
8.31.06 RECALL: Alaris Infusion Pumps
8.30.06 Update MedicareRx: "CMS Takes Steps to Correct Erroneous Plan Premium Refunds" (TPA username and password required)
Links included:
-- First CMS letter to beneficiaries
-- Second CMS letter to beneficiaries
-- Partner Tip Sheet
-- Article formatted for posting or publication
8.28.06

UML Survey Ends Thursday, August 31

In June, TPA’s Continuum of Care Committee posted an online survey seeking the advice of pharmacists and other healthcare providers to guide the development of a Universal Medication List (UML) form for patient use in Tennessee.  The ultimate goal is to have an electronic system available to access the patient information needed for appropriate medication management across the continuum of care.  The last day to complete the survey is this Thursday, August 31, 2006. If you have not already done so, please read the letter located at  www.tnpharm.org/UML_SurveyInvitation.pdf and complete the survey by following the link provided.

8.28.06

BCBST Announces Annual Pharmacy Workshop Schedule (TPA username and password required)

8.23.06 Substitution Law Clarification (TPA username and password required)
8.22.06 Pharmacists Invited to Patient Safety Symposium (TPA username and password required)
8.21.06 TennCare PDL Update:  Zoloft® and Sertraline (TPA username and password required)
8.16.06 Update MedicareRx:  "Medication Therapy Management Through Humana" (TPA username and password required)
Links included:
-- Humana's MTM Program Information
-- Tip Sheet:  - "How the Coverage Gap Works for People with Medicare Prescription Drug Plans"
-- Tip Sheet - "Bridging the Coverage Gap"
-- Reference chart of Patient Assistance Programs (prepared by the private organization RxAssist)
-- Updated "Monthly Deemed Notice"
-- HIPAA Privacy Guidance on Disclosing Protected Health Information - CMS Memo and CMS FAQ
-- REQUIRED Notice: "Medicare Prescription Coverage and Your Rights"
8.8.06

SouthEastern College of Anticoagulation / Antithrombotic Providers (SECAPS) Annual Conference - Sept. 22-23 in Nashville (TPA username and password required)

8.8.06 Commission for Certification in Geriatric Pharmacy (CCGP) Paper & Pencil Exam to Be Held in Phoenix, AZ  (TPA username and password required)
8.7.06 CMS To Link Medicare Provider Numbers with NPIs (TPA username and password required)
8.7.06 Jeanne Ezell Quoted on Medication Errors in Hospitals (TPA username and password required)
8.2.06 TennCare Notice:  PDL Changes Effective 9/5/06 (TPA username and password required)
8.2.06 Stolen Prescription Pads
Jill McDonald, DDS, of Paris, Tennessee, has asked the Tennessee Pharmacists Association to notify members that a prescription pad has been stolen from her office. The missing prescriptions are pre-numbered 7782 through 7799.
7.31.06 Coventry:  Part D Adjustments for Long-Term Care Patients (TPA username and password required)
Coventry Health Care/AdvantraRx/First Health Premier has issued a letter to its Medicare Part D long-term care (LTC) providers regarding adjustments and reimbursement to resolve errors that arose from the application of incorrect copays to prescriptions for dual eligible institutionalized beneficiaries during the period of time following their initial enrollment into Part D. Read the letter...
7.31.06 Update MedicareRx: "CMS Releases Final 2007 Marketing Guidelines" (TPA username and password required)
Links Included:
-- Final 2007 Marketing Guidelines
-- Information about transformation grants
--
Specific information about medication risk management program
-- CMS press release and charts showing complaint rates by plan
-- Information on plan call center
performance for assisting beneficiaries and pharmacists
-- CMS letter of warning to Part D sponsors
-- Clarification of plan due diligence in prior authorization of Part B versus Part D coverage determinations
7.28.06 NCSL Seeks Volunteers for Alliance for Pharmaceutical Care Booth

If you can volunteer to help with activities in the Alliance for Pharmaceutical Care Booth at the Annual Meeting of the National Conference of State Legislatures (NCSL) in Nashville, TN, August 15-18, 2006, please visit http://fs16.formsite.com/APhA/AllianceforPC/index.html to indicate your availability and areas of expertise.  For other information related to the event, visit: www.aphanet.org/AllianceforPC.

7.24.06 TennCare PDL: Advair® Status Change (TPA username and password required)
7.20.06 Action Needed:  DOD Bills Threaten Community Pharmacy
--
Background Information
7.17.06 TennCare Notice:  Changes to PDL Effective 8/15/06 (TPA username and password required)
7.14.06 Update MedicareRx:  "CMS Announces Publication of an Extra Help/LIS Outreach Toolkit" (TPA username and password required)
Link included:   Extra Help/LIS Outreach Toolkit
7.11.06 Forged Prescriptions in Tennessee (TPA username and password required)
7.10.06 Universal Medication List Survey - Deadline Extended
7.7.06 TennCare Announces New Director (TPA username and password required)
7.3.06 Update MedicareRx: "CMS Standardizes Processes for Handling Long-Term Care Copay Issues" (TPA username and password required)
Links included:
-- CMS Memo to LTC Pharmacies
-- LTCP Spreadsheets: "New Copay Issues" and "Follow Up"
-- Press Release: Medicare Steps to Improve Customer Service by Plans
-- REQUIRED Notice: "Medicare Prescription Coverage and Your Rights"
6.30.06 Look for New TennCare Contract in Remittance Advice Statements (TPA username and password required)
6.29.06 Update MedicareRx - "Plans Pledge Timely Payment and Willingness to Work Towards EFT" (TPA username and password required)
Links included:
-- POS Facilitated Enrollment Process in 4 Steps for Pharmacists
-- "Medicare Prescription Coverage and Your Rights" notice
-- Humana Pharmacy News Bulletin #20
6.29.06 APhA Student Loan Announcement - New Law Change (TPA username and password required)
6.28.06 Lower Copay for Zocor for BCBST Members (TPA username and password required)
6.28.06 TennCare Notice: 1) Zocor® Generic Coming to Market; 2) Short List Update (TPA username and password required)
6.22.06 TennCare Plans Consolidation of HCPS Programs (TPA username and password required)
This week, TennCare announced plans to to bring all Home and Community Based Services (HCBS) programs under one statewide organization operated by the Commission on Aging and Disability. Approval for these plans is being sought from the Centers for Medicare and Medicaid Services (CMS). If approved, the HCBS waiver consolidation will bring every TennCare HCBS enrollee access to newly requested home-based services once approved by the federal government. The TennCare press release, an excerpt of which is reproduced below, provides additional details regarding the changes planned and the populations that would be affected. No information was provided regarding the timeframe for approval or implementation. Press release (TPA Username and Password required)
6.22.06 American Cancer Society "Wall of Hope" Campaign
6.22.06 PCAB: Accreditation for Compounding Pharmacies (TPA username and password required)
6.22.06 Zegerid® Not Generically Equivalent to Omeprazole (TPA username and password required)
6.21.06 USP <797> Revisions: 1) Comments 2) Webinar (TPA username and password required)
6.21.06 TIPS Awards - June 30 Deadline
The Tennessee Improving Patient Safety (TIPS) Award - Recognizing Excellence in Improving Quality and Patient Safety deadline is fast approaching. There are so many good examples of programs Tennessee pharmacists have instituted, we really should have a few submissions. Please review the awards application and consider applying. (TPA username and password required)
6.16.06 Universal Medication List for Tennesseans - Survey
The Tennessee Pharmacists Association is seeking the advice of healthcare providers to guide the development of a Universal Medication List (UML) form for patient use in Tennessee. Our ultimate goal is to have an electronic system available to access the patient information needed for appropriate medication management across the continuum of care.
6.14.06 Pharmacist Appointed to TennCare Medical Care Advisory Committee
6.9.06 CCRx: Medication Review Benefit for New Members Begins July 1 (TPA username and password required)
 
6.7.06 Submit Katrina Uncompensated Care Costs NO LATER THAN JUNE 16, 2006
The Bureau of TennCare has clarified the steps required in order for pharmacies to receive reimbursement for some of the  uncompensated care costs sustained in the delivery of medically necessary services and supplies for Hurricane Katrina evacuees who did not have other coverage.  TennCare has charged organizations representing health care providers, including the Tennessee Pharmacists Association on behalf of pharmacists, with assisting them in this process, including disseminating  information and collecting, consolidating and forwarding Katrina claims to TennCare.  As TPA notified members last week, the turnaround time for submission of the required materials is very tight: In order for the TPA to complete the required work and submission to TennCare by their  deadline,  only claims submissions received by TPA on or before JUNE 16, 2006, will be considered. 

The requirements for filing claims are very  specific, and providers must follow them to the letter in order to receive  funds.  Please read the Information and Instructions and follow them exactly. Note that the TPA website documents referenced in this message are not  password-protected

Four additional documents have been provided, three of which must be completed by pharmacies seeking reimbursement  and submitted to TPA no later than June 16, 2006 .  All of the  documents are available on the TPA website:

6.2.06 Court: Compound Drugs Are Outside FDA Scope
A federal court has ruled that compounded drugs are outside the scope of the Food and Drug Administration (FDA). Holding that compounded preparations are not new, unapproved drugs, the judge ruled from the bench against FDA's position that compounding medicines to fill prescriptions was illegal. "This landmark ruling stops the FDA's encroachment on the authority of state boards of pharmacy in its tracks and it ensures that patients and physicians will continue to have access to compounded medicines on which they rely," said L. D. King, executive director of the International Academy of Compounding Pharmacists (IACP). Read the full text of the IACP press release (TPA username and password required)
6.2.06 Compile Your Katrina Uncompensated Care Costs NOW
In April, the Tennessee Pharmacists Association notified members that TennCare's proposed Katrina Uncompensated Care Pool plan had been approved by the Centers for Medicare and Medicaid Services (CMS)... The entire process must be completed during June 2006. TPA is working very hard to seek clarification of the program details from the Bureau of TennCare... In the meantime, be sure you have all of your information together and are prepared to provide whatever may be required. Once the details are made available - probably as early as next week - immediate response on your part will be required. Be sure to watch your e-mail for TPA communications about this program. When received, the details will also be posted on our Breaking News page. (TPA username and password required).
6.1.06 TennCare:  PDL Changes Effective TODAY (TPA username and password required)
Today, the Tennessee Pharmacists Association received from First Health a TennCare provider notice with information about PDL changes that are effective today. These include additions to the Short List, additions to the Brand as Generics list, and changes to the CC, ST, and QL. Also provided is clarification on Benzodiazepines listed on the PDL, as well as a guide to Override Codes.
6.1.06 Pharmacist Comments Needed - Competitive Bidding Program for DME

The Centers for Medicare and Medicaid Services (CMS) has released a proposed regulation to implement a competitive bidding program for durable medical equipment(DME). TPA has reviewed information currently available on this important issue and has found the information produced by APhA to be succinct and easy to access and use. TPA is therefore providing the APhA information to members for your use in preparing your comments. TPA will be submitting comments to CMS on behalf of TPA members. If you have thoughts or comments you want to be certain are included in TPA's comments, please send them to mailto:tpa@tnpharm.org. Comments to CMS are due by June 30, 2006...  Complete information (TPA username and password required)

5.26.06 Update MedicareRx - "CMS Reminds Health Care Providers: NPIs Needed in Less than a Year" (TPA username and password required)
 
Links included:
-- Obtain NPI on the web
-- Obtain paper NPI application
-- Subpart concept and its effect on Medicare providers
-- NPI documents
-- NPI bulk enumeration through NCPDP
5.24.06 Update MedicareRx - "CMS Clarifies Coverage of Prescription Niacin under Part D" (TPA username and password required)
 
Links included:
-- Part D Enrollment Data
-- Recording of the CMS Special Open Door Forum on the Pharmacy Quality Alliance
5.23.06 NCPDP: Bulk Enumeration of Pharmacies and NPIs (TPA username and password required)
All healthcare providers, including pharmacists, must obtain a National Provider Identifier (NPI) prior to May 23, 2007, to identify themselves in HIPAA standard transactions. The National Council for Prescription Drug Programs (NCPDP) has made this process easier, as they have recently been named an Electronic File Interchange Organization (EFIO). This will allow them to provide bulk enumeration of pharmacy providers. NCPDP's recent communication to pharmacy providers provides information and a link to NCPDP's electronic application and website.
5.22.06 Legislation Amending the "Tennessee Affordable Drug Act of 2005" (the "Substitution Law")
Became Law Effective April 24, 2006
(TPA username and password required)
 
5.22.06 Proposed Changes to USP <797> (TPA username and password required)
5.22.06 NCPDP: Bulk Enumeration of Pharmacies and NPIs (TPA username and password required)
5.19.06 Tennessee Prepares for West Nile Virus Season (TPA username and password required)
5.10.06 Update MedicareRx: "Medicare Part D Claims Filing Window Extended to 180 Days" (TPA username and password required)
 
-- CMS memo regarding 180-day claims filing timeframe
-- Point of Sale Facilitated Enrollment guidelines
-- CMS memo regarding incorrect copays for duals
-- Reimbursement to LTC pharmacies
-- Q&A regarding institutionalized dual beneficiaries qualifying for $0 copays
-- CMS formulary update guidance
-- CMS memo regarding vaccine access
5.5.06 Legislative Alert / Action Needed: "TennCare Pharmacy Cost to Dispense Act of 2006" Moves Forward
 
5.5.06 WellPoint Communications Regarding Medicare Claims for Dual-Eligibles (TPA username and password required)
 
5.5.06 Nashville Doctor Reports Stolen Rx Pads (TPA username and password required)
5.2.06 Update MedicareRx: "CMS Issues Guidance on Mid-Year Formulary Change Requests" (TPA username and password required)
 
-- CMS Formulary Guidance
-- CCRx: Special Notice About CMS Facilitated Enrollments
-- Renew your TPA membership online
4.28.06 Prompt Pay Legislation for Medicare Part D Introduced in House and Senate (TPA username and password required)
4.25.06 Update MedicareRx: "Over 30 Million People Enrolled in Medicare Drug Benefit" (TPA username and password required)
-- Latest enrollment data
-- Standardized Exception and Prior Authorization request form
-- CMS's clarification of plan due diligence in prior authorization of Part B versus Part D coverage determinations
-- CY 2007 Transition Guidance for Part D sponsors
-- Model pharmacy notice for patients about formulary exceptions and appeals process, with instructions
-- Renew your TPA membership online
4.21.06 TennCare Memo: Changes Effective in Early May (TPA username and password required)
-- Provider Education Conference Call
-- emergency supply process and Prior Authorization  required forms
-- Specific Drug Updates
-- TennCare MAC Pricing Update
-- Prescriber Last Name Edit
...and more
4.21.06 Update MedicareRx: "2% of Pharmacists Surveyed Call Part D Program a Success" (TPA username and password required)
 
-- Exception&PA_Request_Form.pdf
-- PowerPoint presentation for 5.2.06 Conference Call Training
-- Social Security Administration (SSA) Decisions by State
-- Multilanguage Publications Are Available from CMS
4.20.06 Update MedicareRx: "Pharmacy Quality Alliance... Now a Reality" (TPA username and password required)
 
-- McClellanRemarks.pdf
-- MessagingPressRelease.pdf
-- MessagingMemo.pdf
-- StandardizedAdditionalMessages.pdf
-- Pharmacy Quality Alliance
4.19.06 Katrina Uncompensated Care Costs
The Tennessee Pharmacists Association (TPA) is pleased to report that TennCare's proposed Katrina Uncompensated Care Pool plan has been approved by the Centers for Medicare and Medicaid Services (CMS)... Complete article (TPA username and password required)
4.17.06 Guide to Revised DEA Power of Attorney for Ordering Schedule II Controlled Substances by DEA Form 222 or Electronically
 
Pharmacies may order Schedule II controlled substances by either completion of a DEA Form 222 or through an electronic order process. The electronic order process was established by DEA regulations promulgated in 2005 (Final Rule, 70 Fed. Reg. 16902 (2005)).  The 2005 Final Rule amended several parts of the DEA regulations and added an entire new part – Part 1311 entitled "Digital Certificates." ...Even if you are not ordering Schedule II controlled substances electronically, some of the changes to the DEA regulations may affect you. ...To assist you with updating your POA form, the Tennessee Pharmacists Association is making available three documents in PDF format. Complete article and links to documents (TPA username and password required)
4.11.06 CMS to Host Special Open Door Forum on Pharmacy Quality Alliance (TPA username and password required)
 
4.11.06 Stolen Prescription Pads Resurface (TPA username and password required)
4.10.06 Immunization Certification: Isn't It Time?
The Tennessee Pharmacists Association is planning its Pharmacy-Based Immunization Delivery Certificate Program. Would you like to participate? The date and time are to be determined. The certificate program involves a self-study learning component (12 hrs CE) and the live training program (8 hrs CE). If you are interested in participating in the Pharmacy-Based Immunization Delivery Certificate Program and have not already informed TPA of your interest, please contact Kam Nola, TPA Associate Executive Director (kam@tnpharm.org, phone 615.256.3023 or fax 615.255.3528), by Friday, April 14, 2006. We will then let pharmacists know if there is sufficient interest to warrant presenting the program.
4.6.06 URGENT NOTICE: New Federal Law Requirements for the Sale of Pseudoephedrine Begin APRIL 8 (TPA username and password required)
 
4.5.06 Update MedicareRx: "CMS Releases the 2007 'Call Letters'" (TPA username and password required)
 
--www.cms.hhs.gov/apps/media/press/release.asp?Counter=1826
--www.cms.hhs.gov/PrescriptionDrugCovContra/
--WhatIfTransition_option2.pdf
4.4.06 Update MedicareRx: "Transition... Successful Navigation of Change" (TPA username and password required)
 
--transition-appeals_03-30-FINAL.pdf
--Transition Fact Sheet: http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=1817
--PharmacyNoticeApproved.pdf
--Roadmap.pdf
3.30.06 New CCRx Report Online for Pharmacies
Today, CCRx is informing participating pharmacies of new pharmacy-specific reports available to them on http://www.ccrx.net, detailing their patients who have non-formulary or quantity limit exceptions. This report should be very helpful to pharmacists as they help patients transition to formulary medications. Click here for complete information. (TPA username and password required)
3.29.06 REMINDER:  Take Online Part D Survey By March 31!
3.28.06 Update MedicareRx, "Plan-to-Plan Enrollment Reconciliation... Without Burdening the Pharmacy" (TPA username and password required)
 
--enrollment_reconciliation_process_final_3.21.06.pdf
--MA-PD_to_PDP_letter_final.pdf
--PDP_Letter-final _3_.pdf
--Cost_plan_letter_draft323.pdf
--www.hhs.gov/news/press/2006pres/20060323.html
--MedicareEnrollmentByTnCounty.pdf
--Final_CY_2007_Formulary_Guidance.pdf
--FormularyGuidance -2007-Draft_to_Final.pdf
3.27.06 Immunization Certification: Isn't It Time?
Let TPA know if you're interested in becoming certified to immunize in Tennessee...
3.27.06 REMINDER:  Take Online Part D Survey By March 31!
3.24.06 TPA Awards Nominations
3.22.06 Update MedicareRx: "The Special Transition Period is Coming to an End" (TPA username and password required)
 
--HPMS_Transition.pdf
--PharmacyNoticeApproved.pdf
--HomeInfusionReminder_03.10.06.pdf
--Home-Infusion-SMD.pdf
3.16.06 Update MedicareRx: "Identify Medicare Part D Problems: Your Survey Responses Needed"
--Link to Survey
--National "Medicare & You" Training Conference Call, March 24
--Message from Mark McClellan
3.13.06 TennCare:  Albuterol Pricing Update
As you may know, a problem recently arose regarding TennCare pricing on albuterol inhalers.  In response to inquiries from the Tennessee Pharmacists Association, the pricing has been adjusted, and pharmacies should now receive proper reimbursement for the drug.
3.10.06 CCRx:
--PA Code to be Discontinued
--Dual Eligibility & Low Income Status:
------
Chart
------
Tip Sheet
(TPA Username and Password Required)
3.6.06 TennCare Notice: PDL Changes Coming April 1, and More (TPA Username and Password Required)
 
--Appropriate Diagnosis for Prior Authorization Bypass
3.3.06 TennCare Notice: PDL Changes Coming April 1, and More (TPA Username and Password Required)
 
--Appropriate Diagnosis for Prior Authorization Bypass
3.3.06 Update MedicareRx: "Join CMS for Next Week's Pharmacy Open Door Forum:  March 7" (TPA Username and Password Required)
 
Also includes news from CCRx about Call Center hours, premium billing information and quantity limit edits.
3.2.06 TennCare: State Moves to Soft Limits (TPA Username and Password Required)
3.1.06 Urgent Dispensing Errors Alert -- OMACOR & AMICAR
3.1.06 Update MedicareRx, "March 1 Is Here; Plan for New Enrollees and Plan Switchers" (TPA Username and Password Required)
 
Includes information about an audio/training conference being held March 2!
2.27.06 Update MedicareRx: "Secretary Issues Progress Report II on Medicare Prescription Drug Benefit" (TPA username and password required)
Deadlines for comments to CMS: March 1 and March 6
2.23.06 Novartis Recalls Diovan Tablets 80mg 90's (TPA username and password required)
2.22.06 CCRx Checks & Remittance Reports
MemberHealth sent out the first pharmacy reimbursement checks via first class mail, separate from the associated remittance reports, to get checks to pharmacies faster and help pharmacies with their cash flow.  Complete information (TPA username and password required)

2.16.06

February NEWStream (TPA username and password required)

2.14.06

Update MedicareRx: "Transition Must Be Meaningful... and That Takes Time... and Engagement" (TPA username and password required)

 

Includes a discussion about transition issues, a CMS "Request for Medicare Prescription Drug Coverage Determination" form, as well as a Pharmacy Notice that can be posted in pharmacies and provided to pharmacists in lieu of individual notices from each plan, which would otherwise be required. Also covered are tips for smoother enrollments in March, questions-and-answers about co-branding and the Wellpoint POS process, a table that provides Part D coverage clarifications for specific products/drugs/drug categories, the extension of billing limits to 90 days, CCRx implementation of EFT, and CMMR's response to President Bush's comment that "it's not immoral to make sure that prescription drug pharmacists don't overcharge the system." Provides information for accessing all documents referenced.

2.3.06

Update MedicareRx, "Medicare Part D Mobile Office Tour in  Tennessee" (TPA username and password required)

 

Lists the dates and locations for Part D enrollment events being held  across the state, February 7 through February 10, 2006.   Also included are instructions for accessing a press release issued by HHS Secretary Leavitt yesterday, in which he commends  Tennessee's pharmacists.

2.2.06

TennCare: ICD-9 Code Prior Authorization Override

First Health disseminated two TennCare documents today: 1) a provider letter that describes a process effective March 1, 2006, for using ICD-9 codes for processing selected pharmacy claims, as well as other general information; and 2) "Appropriate Diagnosis for Prior Authorization Bypass" - a table of selected ICD-9 codes with a description of their diagnoses.

Regarding the new process described for using ICD-9 codes, be aware that potential problems exist with the fields identified by TennCare...   Complete article and links to the two documents (TPA username and password required)

2.2.06

Update MedicareRx: "Secretary Leavitt Visits Pharmacies... and Issues His Findings" (TPA Username and Password Required)

 

Includes link to 1-month progress report on the Medicare Prescription Drug Benefit and information about extension of the 30-day transitional coverage period for an additional 60 days.

2.1.06

CMS Conference Call Recording - New Information

On January 30, TPA sent members information from the Centers for Medicare and Medicaid Services (CMS) regarding conference calls held on January 31. CMS has provided updated information about how to access a recording of the second call... These calls provided specific information and tips about using the E1 and Point of Sale facilitated enrollment solutions. Complete article (TPA username and password required)

     

1.30.06

Update MedicareRx: "Tuesday, Jan. 31: Conference Calls on E1 & POS Facilitated Enrollment" (TPA Username and Password Required)

 

Also included in this issue is information about Pharmaceutical Company Patient Assistance Programs, how to assist beneficiaries with appeals, coverage determinations and exceptions, and Humana updates regarding their transition policy extension and automated eligibility verification system.

1.27.06

Deadline Extended for MidYear Hotel & Early Registration

1.26.06

Medicare Part D Formularies Available via Epocrates (TPA Username and Password Required)

1.26.06

Contact US Representatives on Budget Bill (TPA Username and Password Required)

1.25.06

January NEWStream (TPA Username and Password Required)

1.25.06

Important Information Regarding New TennCare Pharmacy Agreement

A number of TPA members have contacted the office regarding the new Pharmacy Participation Agreement that is being circulated by the Bureau of TennCare. Several of these inquiries have involved the new Conflict of Interest provision found at Section 10.9 and the new Lobbying provision found at Section 10.11.  Complete article (TPA Username and Password Required)

1.25.06

Revised CCRx Communication: 1) Beneficiary Letters, 2) MTM Program
--
Clarification of Error in Jan. 24 Communication
(TPA username and password required)

1.23.06

CMS Conference Call: January 24, 2006 (TPA username and password required)

-- Medicare Part B drugs as it relates to Medicare Part D
-- Drugs excluded from coverage under Part D
-- Link to a summary of the issue, which may be used as a reference guide on Part B vs. Part D drugs for pharmacists

1.20.06

Take Action on Medicaid Cuts Today

The Tennessee Pharmacists Association has received information from the National Community Pharmacists Association (NCPA) regarding its Action Alert, "Take Action on Medicaid Cuts."  According to NCPA, "The U.S. House of Representatives will have one final vote on the Budget Reconciliation package which contains billions in cuts to  pharmacy reimbursement in Medicaid. Call your Representative's office today.  Updates, talking points and contact information are all part of our latest Action Alert [http://capwiz.com/ncpa/callalert/index.tt?alertid=8392491&type=CO]." To locate your Representative's contact information, please enter your zip code in the "Call Now" box that appears in the Action Alert.

1.20.06

Tim Tucker Represents Pharmacists in Washington Today

The Tennessee Pharmacists Association was contacted by the Tennessee Commission on Aging & Disability, about an opportunity for a pharmacist to testify today in a hearing in Washington, D.C., with Rep. Henry Waxman, to address the challenges faced by low-income consumers and pharmacists under Medicare Part D.

TPA is proud to announce that our own Tim Tucker, Pharm.D., was selected for this opportunity. TPA and APhA, in which Tim is an active member, were instrumental in arranging for him to represent pharmacists in this national arena. All national pharmacy organizations were contacted by TPA for their input. Read Dr. Tucker's testimony...

1.19.06

Improving Access to Health Info: Please Complete Survey

1.18.06

Update MedicareRx: "Addressing Implementation Issues" (TPA username and password required)

 

1.18.06

CDC: Don't Use Amantadine & Rimandatine for Flu this Year (TPA username and password required)

 

1.18.06

TennCare Safety Net: 1) Home Oxygen Program, 2) FQHC Success (TPA username and password required)

 

1.17.06

CMS Administrator Commits to Solving Problems (TPA username and password required)

1.17.06

TennCare:  Provider Disclosure Requirements Clarified

...when providers receive notification from MCCs requesting disclosure, it is not necessary to disclose membership dues paid to the Tennessee Pharmacists Association or contributions to the Tennessee PharmPAC or Tennessee Pharmacy Practice Preservation Fund (PPPF).  Complete article

1.12.06

URGENT! Information Needed for Katrina Reimbursement

Late yesterday, the Tennessee Pharmacists Association and other health care associations received a memo from J. D. Hickey, Deputy Commissioner, Bureau of TennCare, requesting information regarding uncompensated care costs for medically necessary services and supplies for Hurricane Katrina evacuees who did not have other coverage. This information was requested in November, however, the State has asked us to request it a second time. We apologize, but we must ask you to submit the requested information now, whether or not you did so in November.

View Mr. Hickey's memo here. Note that the State is asking for estimates of the NUMBER OF PERSONS (not number of prescriptions) and TOTAL COSTS. Please provide your pharmacy's numbers to date, whether or not they have changed from the information you submitted previously. Your data needs to be provided to TPA no later than 9:00 a.m. CST, Tuesday, January 17. TPA will compile the information from pharmacists and forward it to the State, which will then forward it to the Centers for Medicare and Medicaid Services (CMS). The intention is to effect some level of reimbursement to providers for these uncompensated care costs.

Please submit your information to communications@tnpharm.org, or fax it to 615-255-3528, by 9:00 a.m. CST, Tuesday, January 17. Thank you very much for your cooperation.

1.12.06

Medicare-TennCare Crossover Payments (TPA username and password required)

1.12.06

Update MedicareRx: "Pharmacy Support... Is Customer Support" (TPA username and password required)

 

Includes tips from NDCHealth (now Per-Se Technologies) to help pharmacists optimize their use of the E1 enrollment query

1.10.06

Live CMS Conference Call for Pharmacy TODAY (TPA username and password required)

1.9.06

Update MedicareRx: "Providing Solutions and Moving Forward"

Details the improvements made by the Centers for Medicare and Medicaid Services (CMS) in response to the problems that have arisen during Medicare Part D implementation. Several documents are referenced, which are available for download on the Medicare News page.  (TPA username and password required)

1.9.06

CMS Tells Part D Plans:  Fix Transition Problems

...Centers for Medicare and Medicaid Services (CMS)...has sent a memo to all plan sponsors, emphasizing the necessity of their upholding transition  policy requirements to ensure that "enrolled beneficiaries get their needed first prescriptions filled at the point of sale."  Complete article includes links to CMS memo to plans and CCRx 1/8/06 Daily Update. (TPA username and password required)

1.6.06

CCRx Makes Progress with Part D Problems

Includes links to today's CCRx Daily Update, ID Request Form, and Transition Request Form. (TPA username and password required)

1.6.06

Medicare Part D: 1) CMS Phone Help Goes 24/7  2) MTM Contact List (TPA username and password required)

 

1.5.06

Synopsis of Medicare Part D Conference Call

Includes CMS e-mail address for pharmacists' use in reporting problems and asking questions. (TPA username and password required) 

1.5.06

Update MedicareRx: "Conference Call TODAY" (TPA username and password required)

1.4.06

Medicare Part D Problems

Not surprisingly, pharmacists are experiencing a multitude of problems as a result of Medicare Part D implementation. Many members have called the Tennessee Pharmacists Association to report these problems, and TPA is working with the Centers for Medicare and Medicaid Services (CMS) to resolve them. The problems we are aware of are shown below... Complete article (TPA username and password required)

     

1.3.06

Stolen Rx Pads (TPA username and password required)

 

ALSO VISIT:
News at a Glance - Current

News at a Glance - 2007
News at a Glance - 2005
News at a Glance - 2004


Tennessee Pharmacists Association
500 Church Street, Suite 650, Nashville, TN 37219
615-256-3023 phone     615-255-3528 fax
tpa@tnpharm.org

©Copyright 2007, Tennessee Pharmacists Association
All rights reserved.