Legislative and Regulatory Reports
From Washington, D.C.
MEDPAC, Bipartisan
Commission to Consider Graduate Medical Education. Two groups
created by the Balanced Budget Act of 1997, the Medicare Payment
Advisory Commission (MEDPAC) and the National Bipartisan Commission
on the Future of Medicare, will make recommendations later this year
about Medicare programs, including future funding for pharmacy
residency training.
MEDPAC merges two groups, the Prospective Payment Assessment
Commission and the Physician Payment Review Commission, to advise
Congress on Medicare payment policies and other policy issues
affecting the program and the broader health system, including
graduate medical education. The group met for the first time in
October 1997 and is required to issue a report by March 1.
The National Bipartisan Commission on the Future of Medicare will
review and analyze the long-term financial condition of Medicare and
identify problems that threaten its financial integrity. The
commission must also make recommendations about the financing of
graduate medical education and consider alternative broad-based
sources of funding. The group’s recommendations will address not
only medicine, but all health professions that currently receive
Medicare funds, including pharmacy.
ASHP will continue to monitor the activities of these groups and
advocate strongly for funding of pharmacy residencies as an urgent
national priority related to the safe and effective use of
medications. Look for more information in future issues of the ASHP
Newsletter.
In Brief. The Food and Drug Administration (FDA) has
issued draft guidance outlining the factors it will use to determine
whether a medical product sponsor may be held responsible for the
promotional practices of a pharmacy benefit management
company (PBM). Concerns about the effects of what has been
termed “drug switching” on patients served by PBMs is driving the
proposal. ASHP will be submitting comments to the FDA on this issue.
From the States
The Virginia State Board of
Pharmacy recently adopted final regulations concerning automated
dispensing devices. The Virginia Society of Health-System
Pharmacists (VSHP) staged an intense lobbying effort that urged the
board to make changes in the sections on access, stocking, and
recordkeeping and other issues. ASHP joined VSHP’s comments and
encouraged the agency to follow standards set by the National
Association of Boards of Pharmacy and to broaden the scope of the
regulations beyond hospital settings. The regulations go into effect
this month.
Collaborative drug therapy management continues to be a
hot issue on the state level. Legislation drafted in Colorado,
Maryland, New Hampshire, and Virginia brings the total of bills
either drafted or introduced to eight. This month, state societies
will receive advocacy packets from ASHP’s Government Affairs
Division containing materials to aid in lobbying efforts.
Ohio, Alabama, Indiana, and New Jersey have introduced narrow
therapeutic index drug products (NTI) bills to be considered
during the 1998 legislative session. In Texas, where media scrutiny
following the passage of NTI legislation has been critical of
pharmacists (see story on page 6), a joint task force of the Texas
state board of pharmacy and the Texas board of medical exam-iners
has issued a list of NTI drugs. A proposed rule will be presented at
the Board of Pharmacy meeting this month.
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