This morning the Senate voted passage of HR 3590 to reform America’s health care system. Now the House and Senate must reconcile their considerable differences in an expedited process intended to get a reform bill on the President’s desk efore his State of the Union address in late January or early February. The blogs are buzzing with enough pros and cons to make your head spin.

Pharmacists will play a significant role in this reformed system, as both House and Senate versions include better access to pharmacist clinical services, intended to reduce the toll of inappropriate medication use, including nonadherence. We support these provisions whole heartedly and thank our supporters in the House and Senate for their good work.

In the bill passed on Dec. 24, there are provisions that:

• Expand patient access to pharmacist clinical services
• Ensure patient access to medications
• Ensure a viable pharmacy infrastructure
• Improve the Medicare Part D medication therapy management program

We’ve got a lot of work to do to ensure our patients’ interests are kept ahead of special interests and the process plays out.  Thanks for your support.

Our APhA family wishes you a blessed and healthy holiday season and a prosperous and Happy New Year!

“’The die is cast. It’s done,’ a jubilant (Chuck) Schumer said, adding jokingly that ‘Harry’s almost going to have a drink.’

“Reid, a devout Mormon, abstains from alcohol.”

—From the December 21 Roll Call article by David Drucker on Sunday’s Senate debate and the cloture vote taken at 1 AM on Monday

Senate Democrats cleared a major hurdle during the night on Sunday when the Democratic Conference, with its 58 Democrats and 2 independents, closed rank and voted to end debate on the health care reform (HCR) package put forward by Majority Leader Harry Reid (D–NV). Combined with two more procedural votes later this week, the way is seemingly paved for the Senate to approve a HCR bill on Christmas Eve.

That’s the big picture. What ultimately remains for pharmacy in the Senate proposal is not totally clear, nor is it certain that major differences between this bill and the House version can be resolved.

Our Government Affairs staff and lobbyists have been in frequent and at times frenetic discussions with Hill staff as relevant provisions are proposed and quickly debated. APhA is in discussions with stakeholders about proposals relevant to several important aspects of pharmacy practice. These would provide funding for closing adherance gaps, a concept akin to but not exactly like MTM; include compounding in the definition of manufacturing, potentially opening the door for FDA regulation of pharmacy compounding (something we oppose); and pay for tobacco cessation counseling in Medicaid. A proposal in an earlier freshmen’s amendment (referring to the first-term Senators who introduced it) to improve Medicare Part D MTM has also been included in Reid’s final package.

Knowing what to oppose or support has been a challenge when we have not always had access to bills that change rapidly or were released in incomplete form. In general, we have continued to focus on those provisions specifically identified as relevant to pharmacy.

I’d like to offer special recognition to our Government Affairs Committee—a group of involved APhA members (volunteers) who spend many hours working with our Government Affairs staff to review and interpret language in the context of our policies in order to help us frame our positions and approaches.

We understand that Senator Mark R. Warner, Democrat of Virginia, and other freshman senators will introduce a set of health care reform amendments. One or more of these would place MTM in the mainstream — well beyond the grant programs that are contemplated now. While we are in the process of assessing the rest of the proposals, we will be firmly in support of this, and we encourage you to do the same.

Here is the language we’ve seen:

Sec. 10011. Improvement in Part D Medication Therapy Management (MTM Programs): This section would require Medicare Part D prescription drug plans (PDPs) to offer a minimum set of medication therapy management services to certain targeted beneficiaries. It also would require PDPs to routinely assess at-risk individuals who are not enrolled in MTM services and automatically enroll them (permitting beneficiaries to opt-out if they choose).