LAS VEGAS, NV 14 December 2009—As legislators grapple with health care reform bills, pharmacists await the outcome of advocacy efforts that may change the landscape for the profession.
"It`s going to be an interesting couple of weeks as we go forward," said Joseph Hill, ASHP`s director of federal legislative affairs, during the December 8 session "Yes We Can: Obama, Health Care Reform, and Other Issues One Year Later," at ASHP`s Midyear Clinical Meeting.
"One of the things that`s really different this year is they`ve gone a lot farther than they`ve ever gone before," Hill said of congressional reform efforts.
The House passed a reform bill last month, and the Senate is debating its bill now. Still uncertain are a full vote on the Senate bill, reconciliation with the House version, and President Obama`s signing of a new law.
Pharmacy-related elements in the current legislation include a loan-forgiveness program and grants for pharmacist-provided medication therapy management (MTM) services.
Hill said ASHP and other pharmacy organizations presented a united front when lobbying for reform provisions.
He said this collaboration sent a powerful message to Congress about the relevance of pharmacy within the health care system.
"We didn`t get everything that we asked for, but...I think we should feel good about the progress that we`ve made," Hill said.
He said ASHP will continue to advocate for issues not included in health care reform legislation, like restoring funding for second-year postgraduate residencies and gaining recognition of pharmacists as health care providers under Medicare.
Health reform legislation will affect the workings of FDA, the Centers for Medicare and Medicaid Services, and other federal agencies that must find ways to implement the law, said Justine Coffey, ASHP`s director of federal regulatory affairs.
Even without reform, federal agencies are undertaking activities that may affect pharmacists in the months ahead. For example, she said, FDA is planning to implement a risk evaluation and mitigation strategy, or REMS, to govern the use of long-acting opioid medications.
Possible elements of that REMS include certification requirements for prescribers or pharmacists, although FDA is still gathering information from stakeholders and the public on how to proceed.
Still, Coffey said, "once a REMS for opioids is implemented, the new requirements are likely to impact all of you."
At the state level, health care reform`s effects on Medicaid programs are a central focus, said Geralyn Trujillo, ASHP`s director of state government affairs.
"The primary issue for the states is unfunded mandates for Medicaid programs," Trujillo said. Pharmacist-provided MTM services for Medicaid beneficiaries are addressed in House and Senate reform bills, she noted.
It is important for pharmacists to stay engaged with their local, state, and federal legislators, said Brian M. Meyer, ASHP`s director of government affairs.
Meyers reminded the attendees that patients are voters, and legislators need to know how their constituents benefit when pharmacists are part of the health care team.
"You...have a very unique story to tell," Meyer said. "Not very many legislators know that pharmacists work in hospitals and health systems. They have a certain perception of what pharmacy and pharmacists are and what they do. You have a great opportunity to expand that perception and tell them exactly what you do day to day."
