Community Pharmacists Commend Medicare's Decision to Delay Burdensome Dispensing Requirements on Long-Term Care Pharmacies


Alexandria, Va. - April 6, 2011

The National Community Pharmacists Association (NCPA) today applauded an announcement by the U.S. Centers for Medicare & Medicaid Services (CMS) that it plans to delay implementation of its proposed Medicare Part D long-term care "short-cycle" rule for one year and to modify the requirements to be less onerous for independent pharmacies.

"Medicare officials are doing the right thing for patients and the long-term care pharmacists who serve them," said NCPA Executive Vice President and CEO Douglas Hoey, RPh. "Pharmacists are committed to working with Medicare and other health plans to reduce costs, while maintaining quality care. However, there is no creditable evidence that this proposed move to shorter dispensing cycles would reduce costs and, in the end, we fear it could actually increase costs for taxpayers. That's why a broad coalition of lawmakers and health care providers is urging CMS to hold off on the program to allow for data gathering necessary to implement this program intelligently."

A final rule issued late yesterday by CMS makes several important policy changes to address concerns raised by NCPA and others. First, it delays implementation of the short-cycle rule from Jan. 1, 2012 to Jan. 1, 2013. Second, it would ease the requirements on how LTC pharmacies account for dispensed, but unused, medications. Third, the final rule requires that LTC pharmacies dispense solid oral doses of brand-name medications in 14-day-or-less supplies, compared to the more onerous 7-day-or-less mandate in CMS' proposed rule.

In the months leading up to CMS' April 5 announcement, NCPA partnered with a broad coalition of U.S. Senators, Representatives and health care groups raising serious questions about the merits of and justification for the short-cycle rule. U.S. Senators Ron Wyden (D-OR), Ben Cardin (D-MD) and Debbie Stabenow (D-MI) wrote to CMS about the rule. Their concerns are shared by 10 Representatives who sent a letter of their own. It was signed by U.S. Representatives Peter Roskam (R-IL), John Barrow (D-GA), Shelley Capito (R-WV), Geoff Davis (R-KY), Lloyd Doggett (D-TX), Paul Gosar (R-AZ), Sam Graves (R-MO) and Nan Hayworth (R-NY), Adam Kinzinger (R-IL) and Aaron Schock (R-IL),

Twenty leading health care groups also weighed in, questioning CMS' reliance on "one unpublished survey done by a single pharmacy using expensive and proprietary techniques" as justification for the policy. The groups urged CMS to delay implementation of the rule until a more proper, comprehensive analysis could be conducted.

"This additional time does two important things," Hoey added. "First, it gives CMS more breathing room to fully reconsider this policy. For example, NCPA and others continue to advocate that the agency seek high-quality, unbiased data to fully evaluate the cost impact of the short-cycle rule before moving forward with it. Second, this window gives independent pharmacies and other LTC providers additional time to make the considerable changes in workflow and staffing that may be necessary to comply with the final requirements. We deeply appreciate the support of this broad coalition of lawmakers and health care providers."

NCPA formed a Long-Term Care (LTC) Division in 2010. Not only is the division active in seeking acceptable outcomes for critical issues such as short cycle drug dispensing and nurse-as-agent, but partnerships with like-minded organizations and other tools are being utilized to help ensure independent community pharmacies can flourish in the LTC arena. The main hub for the efforts can be found at www.ncpaltc.org.

The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 23,000 independent community pharmacies, pharmacy franchises, and chains. Together they represent a $93 billion health-care marketplace, have more than 315,000 employees including 62,400 pharmacists, and dispense over 41% of all retail prescriptions. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com.

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