APhA YEAR IN REVIEW
POLICY AND ADVOCACY ISSUES

The American Pharmaceutical Association (APhA), the national professional society of pharmacists, addressed focused on several issues of importance to the pharmacy profession during 2000. Following are the highlights of those issues and their outcomes.

Securing recognition of and payment for pharmacist’s services patient care activities is APhA’s highest priority, and activity in 2000 capitalized on the country’s interest in adding a prescription drug benefit to the Medicare program. Payment for pharmacist-provided medication therapy management services was included in a number of Medicare proposals and in interim proposals designed to help those seniors most in need. The Medicare Beneficiary Prescription Drug Assistance and Stop-Loss Protection Act of 2000 (HR 5151) was introduced in September, and contained virtually every element of SENIORx Gold, the interim plan supported by a coalition of pharmacy and consumer organizations including APhA, the National Association of Chain Drug Stores, and the American Society of Consultant Pharmacists. The bill included recognition of and payment for pharmacist-provided medication therapy management Sservices. Although the interim approach, focusing assistance on those most in need, did not see direct action, the profession’s strong support for HR 5151 helped establish it as a benchmark for this activity in the 107th Congress. Introduction of the legislation confirmed APhA’s efforts to "change the debate" to include payment for both drug products and medication therapy management services.

The Association also continued to succeeded in the ffight for the inclusion of pharmacists as qualified diabetes educators, and pharmacies as qualified providers eligible to bill Medicare for payment, in the Medicare diabetes self-management benefit. APhA also continued the profession’s long-fought battle to secure provider status for pharmacists under the Medicare program.

APhA fought successfully to include special pay rates and an accession bonus for uniformed pharmacy officers in the National Defense Authorization Act and continues to advocate for the implementation of enacted legislation. APhA also advocated an increase in funding for loan repayment for Indian Health Service (IHS) providers, and increased funding for pharmacy residencies within the IHS.

APhA was also quite active on the state legislative front, working in conjunction with and as a resource serving primarily as a resource for state pharmacy associations. Administrative sSimplifyingication and administrative aspects of prescription processing and the advancement of pharmaceutical care were once again the highest state Association prioritiesies in 2000. A leader in the movement to help alleviate the administrative burdens posed by a variety of prescription drug cards for the past few years, APhA helped pharmacists turn talk of eliminating third party hassles that restrict patient care into reality.

Jointly released model legislative language—developed by APhA, NACDS, and the National Community Pharmacists Association—was sent to pharmacy leaders in all 50 states and Washington, DC, to serve as a guide for developing legislation. The model language emphasized state-to-state uniformity of a law requiring the adoption of a drug card that uses the standard developed by the National Council for Prescription Drug Programs. To date, Alabama, Georgia, Illinois, North Carolina, Tennessee, Texas, and Virginia have passed drug card bills. Many states are expected to introduce legislation in 2001.

Progress was also made through state practice act revisions, as pharmacists may now provide immunizations in 30 states. In addition, a total of 30 states allow pharmacists to participate in collaborative drug therapy management. APhA is working with NACDS, the Washington D.C. Pharmaceutical Association, and local public health officials to allow pharmacists to provide these services in the nation’s capital.

APhA fought to include special pay rates and an accession bonus for uniformed pharmacy officers in the National Defense Authorization Act. APhA also advocated an increase in funding for loan repayment for Indian Health Service (IHS) providers, and increased funding for pharmacy residencies within the IHS.

APhA worked closely with the staff responsible for drafting the Internet Prescription Drug Consumer Protection Act of 2000, a bill focusing on State regulation of domestic pharmacy sites and Federal reguuglation of international providers. Many of APhA’s suggestions were included in the bill, and the Association’s support for the bill was mentioned on the Senate floor when the bill was introduced. Activity on the State and Federal level will continue in 2001.

The 106th session of Congress adjourned without voting on the mis-named Pain Relief Promotion Act—the bill that would expand the authority of the Drug Enforcement Administration to to regulate the use of pain medication at the end of life under the Controlled Substances Act. An intense grassroots advocacy campaign, expressing concern with the bill’s unintended chilling effect on the use of pain medication resulting from increased regulatory oversight, was waged against this bill. Congress adjourned without voting on the Act, a victory for the profession and pain patients.