From NCPA – Congress Needs to Hear From Seniors (edited)

Posted Jan. 28, 2015

In a recent letter, Douglas Hoey, CEO of NCPA made relevant observations and suggestions regarding coverage for seniors.


“What's to say that this year's still unsettled Aetna/Coventry Part D snafu won't be repeated in the 2016 plan year? What assurances should patients have that the Medicare Plan Finder, the government's plan cost and pharmacy access comparison tool, contains accurate information? Should patients—and the Centers for Medicare & Medicaid Services—just assume that plan sponsors or PBMs aren't knowingly trying to rig the system?


Congress created Medicare Part D a decade ago, and now is a good time for it to ask some specific questions and examine if this public-private partnership is operating at maximum efficiency or if it could do even more for seniors. It's at the micro level where the impact is felt from situations like the one involving Aetna.

PQA Retires 'Diabetes: Appropriate Treatment of Hypertension' Performance Measure

Posted Jan. 14, 2015

By Michael Johnsen – Published in Drug Store News


SPRINGFIELD, Va. — The Pharmacy Quality Alliance on January 12,2015, announced the retirement of the performance measure, "Diabetes: Appropriate Treatment of Hypertension." PQA member organizations had the opportunity to comment on this measure prior to the official vote.  As many as 83% of member respondents voted to retire the performance measure. 


Key points of the rationale supporting retirement of the measure include:

  • The PQA-endorsed measure looked for either an angiotensin converting enzyme inhibitor, or angiotensin receptor blocker, or direct renin inhibitor to be prescribed in a population with diabetes and hypertension; and
Aetna Part D Plans / CMS

Aetna Part D Plans / CMS

Posted Jan. 9, 2015

By Patrick M. Berryman SRVP & COO

National Community Pharmacists Association

Dear independent pharmacy leaders,


We know that many of you have members that may have been experiencing problems with pharmacy network participation in certain 2015 Aetna Part D plans.  We have worked directly with some of you coordinating with CMS.  We are aware of the inaccurate Plan Finder information and the process that Aetna utilized to create their 2015 pharmacy networks which ultimately contributed to the current marketplace confusion.


To address these concerns as they have come to the forefront, NCPA has communicated with CMS multiple times starting in December including two separate letters and a conference call today outlining the problems for patients and pharmacies and suggesting solutions to the current confusion created by the Aetna actions.  Among our recommendations to CMS were an extended Special Enrollment Period (SEP) for Part D beneficiaries who have been misled in the 2015 enrollment process due to misinformation about the pharmacy network (to allow patients to switch Part D plans), a mechanism for pharmacies to transmit claims and receive payment for these patients’ prescriptions in a transition period during the SEP, and for scrutiny to be placed on the 2015 and current 2016 Aetna Request for Information process being utilized by Aetna for network development which we feel does not meet the Any Willing Pharmacy guidelines for Medicare Part D Basic plans.

In today’s conference call, we were able to verify the following information:

Dave's Corner

Posted Dec. 30, 2014

David Mayper Executive Director PFOANovember was a busy month for me with trips to Memphis, California, and North Carolina. All trips involved meetings with business partners and members in the surrounding area.

Ronda Hubbard and I met in Memphis and toured the API warehouse. In addition to the new A Frame technology installed, it gave Ronda and me an opportunity to meet with AAP’s Jon Copeland, Clint King and Ashley Dawkins. We discussed programs, issues and opportunities. We also spoke with representatives of a generic manufacturer, got insights into the areas of programs, price increases and more. The API facility has plenty of capacity to grow. Its positioning close to the Memphis Hub of FedEx will continue to make it a great distribution spot for AAP and our members using the API program.

The California trip gave Mark Holden and me opportunity to visit members and targets in Southern California. We also met with Stan Winters, our Board member, along with his new store owner Jean Ly. We met with ABC sales manager, John Laird to discuss issues and opportunities. We participated in a very well attended annual dinner meeting and exposition for the San Gabriel Valley Pharmacy Association and separately met with representatives for MPC as well as our business partners from CPNI.

My visit to North Carolina included visits largely in the eastern portion of North Carolina. I took the opportunity to work with Wesley Drake from AAP. Wesley is a long time member of the AAP staff and set most of the appointments for me in conjunction with Jamie Wilbanks. We also met with Board member, Gaye Moseman while in the area.

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