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Oregon institutes PBM bill

BY Michael Johnsen

ALEXANDRIA, Va. — Oregon Gov. John Kitzhaber, a Democrat, has signed what the National Association of Community Pharmacy has characterized as groundbreaking reform legislation that applies reasonable standards to how pharmacy benefit managers audit community pharmacies, provides increased transparency into generic prescription drug reimbursement and ensures that PBM administrators of prescription drug claims are registered within the state.

Members of a Pharmacy Working Group, consisting of Oregon pharmacists, representatives of the Oregon Pharmacy Association, the National Association of Chain Drug Stores, NCPA, the Oregon Pharmacy Coalition, state legislators and representatives of the PBM community have collaborated on these issues over the past year, NCPA noted. 

“Oregon is demonstrating its leadership in the healthcare arena," stated Douglas Hoey, NCPA CEO. "This new law will help Oregon’s clinically trained pharmacists — the medication experts — to devote more time to their patients. The bill contains three notable provisions that will ultimately benefit any Oregon patient who enters a retail pharmacy."

Specifically, the bill will curb excessive pharmacy audit practices in pursuit of minor technicalities or trivial clerical errors. The bill will also require PBMs to update their reimbursement rates more frequently to better reflect the pharmacy’s actual drug acquisition costs, which can increase dramatically and virtually overnight. Also, the bill requires PBMs to register with the Insurance Division of Oregon, a step toward some level of regulatory oversight of the drug benefit management industry within the state.  


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RAD total, same-store sales in the black in June, company says

BY Alaric DeArment

CAMP HILL, Pa. — Rite Aid’s same-store sales increased by 0.7% in June, including increases in front end and pharmacy comps, the retail pharmacy chain said Wednesday.

Front-end comps for the chain increased by 0.4%, while pharmacy comps increased by 0.9%, including a 3.05% negative effect due to the introduction of new generic drugs. Same-store scripts decreased by 0.2%.

Total store sales were $1.927 billion, a 0.2% increase over June 2012.

For the 17-week period that ended Saturday, comps decreased by 1.7%, including a 0.4% increase in front-end comps and a 2.7% decrease in pharmacy comps and a 0.1% decrease in same-store scripts.

Total-store sales for the same period were $8.191 billion, a 2.1% decrease from the first 17 weeks of 2012.

 

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Obama administration delays employer insurance mandate

BY Michael Johnsen

WASHINGTON — The Obama administration on Tuesday announced a one-year delay on a health reform mandate that mid-size and larger employers provide health coverage or pay a penalty to 2015, according to published reports. 

According to a story in The New York Times, the postponement will not directly affect other central provisions of the law, including the establishment of health insurance exchanges. Neither will it relieve Americans from the responsibility of either having health insurance or paying penalties. 

However it may hinder the administration’s efforts to put those provisions into play and has many wondering if Obamacare is built upon a house of cards.

"This step could significantly reduce the number of uninsured people who will gain coverage in 2014," suggested Sara Rosenbaum, a professor of health law and policy at George Washington University, to The Times

However, according to the latest Kaiser Health Tracking Poll conducted in June, the average consumer wants and values health insurance, even young adults between the ages of 18 and 25. As many as 77% in that age group reported that insurance "is very important to them." Almost two-thirds are concerned about paying medical bills for a serious illness or accident and 44% are worried about paying for routine care. 

Estimates of the number of patients gaining coverage as of Jan. 1 2014 have been as high as 30 million and remain a key quotient to the plans many pharmacy operators are making for 2014. As emphasized by Mark Walchirk, president of McKesson U.S. Pharmaceutical, at last week’s McKesson ideaShare 2013 conference, a larger population participating in health care courtesy of healthcare reform does more than drive incremental prescription growth — it helps drive outcomes-based medicine. Community pharmacy is well positioned to drive healthcare savings by ensuring patients stay adherent and compliant with their therapies, he said. “Just small increases in adherence and compliance with medications can drive significant growth in the marketplace."

“Today’s delay is an admission that ObamaCare is not working," noted Rep. Luke Messer, R-Ind., who last week introduced the Small Business Job Protection Act, H.R. 2577 to provide relief for small businesses from the penalties associated with the Patient Protection and Affordable Care Act’s employer mandate. That legislation is supported by many retailers, including the National Retail Federation and the Retail Industry Leaders Associaton. 

Specifically, the Messer legislation seeks to re-designate a “large employer” for purposes of the employer mandate tax threshold as one with 100 or more full-time equivalent employees, instead of those with 50 or more under current law. The Congressional Budget Office had estimated that penalty payments imposed on businesses that fail to meet this mandate would amount to $130 billion over the next decade. 

“These penalties already are forcing employers to reduce the hours worked by some employees,” noted Messer. “They also deter small businesses from expanding and creating jobs. That is bad for workers, bad for small business owners and bad for our economy. In these tough times, we should be encouraging job growth, not discouraging new jobs with costly new taxes, penalties and regulations."

“Washington needs to focus more attention on the needs of America’s small businesses and entrepreneurs rather than placing additional burdens, mandates and regulations on them," commented David French, NRF SVP government relations, following the introduction of Messer’s bill. “Expanding the definition of a ‘large employer’ to 100 employees would protect a wider range of small businesses and retailers and allow them to grow and hire more workers. An employer should never have to choose between hiring an additional employee or paying a penalty."

Whether Messer’s legislation gains traction in Congress, mid-size and larger employers will enjoy a reprieve from the insurance penalty until 2015. 


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