Congress targets Rx abuse with pharm’s backing

Jim Frederick

With strong support from pharmacy leaders, Congress is moving to shut down prescription medication abuse and diversion with a multipronged legislative cudgel.

Prior to its October recess, the U.S. House of Representatives passed three industry-backed bills in September to help seal up the nation’s leaky prescription drug pipeline. The bills are expected to pass under “suspension of the rules,” which allows for expedited consideration of legislation.

The Safe Drug Disposal Act aims for a safe and effective means for consumers to dispose of their unused medications, including controlled substances. “NACDS worked…to include language ensuring that regulations by the Drug Enforcement Administration will not require any entity to establish a drug disposal program, such as a take-back program,” the pharmacy group noted on Sept. 22. “This would enable pharmacies and other entities to determine the best means for working with consumers and law enforcement to safely dispose of unused drugs.”

The National All-Schedules Electronic Reporting Reauthorization Act would fund state efforts to establish prescription drug monitoring programs. “While these programs can be useful…in combating diversion, it is important that they not be administratively burdensome or disruptive to patient care activities, and the legitimate practices of pharmacy and medicine,” NACDS urged.

The Combat Methamphetamine Enhancement Act would require all entities that sell products containing pseudoephedrine to certify with the DEA. “Chain pharmacies took voluntary, proactive steps to reduce the theft and illegitimate use of products containing pseudoephedrine and ephedrine,” NACDS noted.

NACDS president and CEO Steve Anderson praised the House of Representatives’ “legislative trifecta,” which he said “illustrates NACDS’ members commitment to ensuring that prescription and over-the-counter medications are used appropriately,” he added.

Meanwhile, Congress and the White House have taken aim at fraudulent and abusive billing practices that plague Medicare and Medicaid and cost U.S. taxpayers billions of dollars. The Centers for Medicare and Medicaid Services has proposed new regulations to help prevent what the agency said is $55 billion in annual improper payments to providers and health plans. In a related development, the House Energy and Commerce Subcommittee on Health held a hearing last month on “Cutting Fraud, Waste and Abuse in Medicare and Medicaid.”

The National Community Pharmacists Association weighed in with a statement to the House panel that accused PBMs of responsibility for much of the abuse in Medicare billing, as well as “misrepresentation to plans, patients and providers; improper therapeutic solutions; unjust enrichment through secret kickback schemes; and failure to meet ethical and safety standards.”

The Pharmaceutical Care Management Association’s view was in stark contrast to those charges. Responding to CMS’ call for tougher regulations to curb abuse, group president and CEO Mark Merritt said the government’s focus should be on preventing abuse rather than on pursuing wrongdoers after the fact for fraudulent billing practices. “Pharmacy benefit managers agree that prevention, not ‘pay and chase,’ is the key to fighting fraud,” Merritt noted.

In a separate move, the NCPA weighed in after the Department of Health and Human Services issued a proposed interim final rule on the implementation of the massive health-reform act. The agency recommended that health plans and insurers that participate in the health insurance exchanges scheduled to take effect in 2014 waive patient co-pays for certain services that could lead to long-term preventive health benefits and lower treatment costs. Among those services are certain recommended vaccines, as well as such services as blood pressure and cholesterol screening, tobacco-cessation and obesity-related counseling and intervention.

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