Year End - New York City Pharmacists Society

N E W S L E T T E R
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NEW YORK CITY PHARMACISTS SOCIETY
631-521-7043
AN AFFILIATE OF THE PHARMACISTS SOCIETY OF THE STATE OF NEW YORK
The Voice of Pharmacy in the Big Apple
www.NYCPS.org
PSSNY HELPLINE 1-800-632-8822
VOLUME 16, ISSUE 9
OFFICERS
Jim DeTura, President
718-292-1856
Charles Catalano, Vice Pres.
718-358-1300
Bill Scheer, Treasurer
718-655-5558
Jim Schiffer, Secretary
212-616-7040
EXECUTIVE DIRECTOR
James A. De Franco
718-893-2400
BOARD OF DIRECTORS
Russell Gellis, Chairman
212-877-3480
Bill Scheer,
718-655-5558
Mike Agovino
718-543-3116
Ron DelGaudio
718-230-3535
Michael Escuder
212-213-5570
Ray Macioci
718-823-1085
Boris Mantell,
718-591-1040
John Navarra
212-213-5570
Joseph Navarra
212-213-5570
Alex Perchuk
718-835-2000
Rajan Pillay
212-927-0220
Mohammed Saleh
718-493-8118
PSSNY REGIONAL REPS
Ray Macioci
Bronx, Manhattan
Ron DelGaudio
Brooklyn, Staten Island
Charles Catalano
Queens
RECORDING SECRETARY
Rosemarie Tomasseti
917-750-6273
TABLE OF CONTENTS
President’s Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Meeting with the Office of the Professions . . . . . . . . . . . . 3
RX and the Law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Secretary’s Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Retail Council . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
The NCPA Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
PAAS Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
News from Around the Pharmacy World . . . . . . . . . . . . 11
OMIG Medicaid Audits . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Legal War Chest Update . . . . . . . . . . . . . . . . . . . . . . . . 15
Legal War Chest Round # 2 . . . . . . . . . . . . . . . . . . . . . . 16
Jim Schiffer
YEAR END 2007
PRESIDENT ’S MESSAGE
THE IMPORTANCE OF LIFE
D
uring this holiday season I decided to take
a break from the “normal” and instead
focus on something exceedingly more relevant, “The Importance of Life.” Everyday we deal
with issues that increase our stress level, raise our
blood pressure, lead to various coronary illnesses,
and above all disrupts our quality of life.
Recently I have reflected on the direction
pharmacy has traveled over the years and although
we have won some battles and made progressive
strides in others, we still find ourselves in a
cesspool of bureaucratic and regulatory bull. We
have a plaque in our pharmacy which states the following: “Cows may come and how but the bull
around hear lasts forever!” I’m sure you have your
version of the same in your pharmacy. I have also
reflected on life in general. The bottom line here is
that while we struggle and battle with many issues
facing our lives, not only in pharmacy but also in
our personal lives, life goes on. In many cases, if
we stop for just a moment, we will see that life is
Page 3
Meeting with the
Office of the
Professions
IG DITS
OM
D AU
MEDICAI
SENIOR EDITOR
Page 13
passing us by.
I invite you to take a moment and stop whatever you are doing. Put yourself in a quite place
where you can be uninterrupted for just 15 minutes.
That’s right, just 15 minutes. If you find this exercise too difficult to do due to lack of time, you are
already getting my point! You might want to have
a pen and paper with you while you do this.
Now close your eyes for a moment and take a
deep breath. Inhale deeply, hold it for about 10 seconds and let it ALL out and repeat it two more
times. Now list all the THINGS on your plate these
days. Work, responsibilities, deadlines, audits, etc.
Don’t hold back, list them ALL! When you are satisfied your list is complete, begin another list. Do
not go on until you are sure your first list is complete.
Now, list the last time you took a vacation, went
to a movie, took a day off and did nothing but relax.
Try to find other things you used to do for pleasure
continued on page 18
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PAGE 2 YEAR END 2007
NYCPS NEWSLETTER
NYCPS NEWSLETTER
YEAR END 2007 PAGE 3
MEETING WITH THE OFFICE
OF THE PROFESSIONS
I
attended a meeting of the Office of the Professions on
Nov 29, 2007, and this is a synopsis.
The OP office is the main operation center for all the
professions, pharmacy, medicine, nursing, etc., a total of
47 professions. There were over 80 attendees representing
most of the professions. Besides me, Craig Burridge,
(Exec Dir of PSSNY) Lawrence Mokhiber (Exec
Secretary of the St Bd of Pharmacy) and Elizabeth Lasky,
lobbyist for PSSNY, were present. You can see the list of
the professions by going to the web site:
http://www.op.nysed.gov
Let me touch on a few OP issues first and then I will
deal with an issue most dear to our hearts. What is most I
think are some of the links in the OP web site that can be
a benefit to our profession, such as the links that reflect
new policies. A few new policies include the ability to reregister on line, access to see results of State Board
Exams, Status of a pharmacy’s new registration, to mention a few.
You can also receive news alerts from the web site. Just
click in the homepage and scroll down to the paragraph
with the title: Announcing OPNEWS Listserv
Up-to-the-minute license and registration status is
available on this site or by calling 1-518-474-3817 (press
prompt #4, then #1). Information on the Web and their
telephone system is current and official. Licensees who
require written proof of licensure should file the Request
for Written Confirmation of NYS Licensure (PDF). This
request requires the submission of a fee and will be mailed
to a third party.You can also print and mail an
address/name change form. Please remember that OP is to
be notified within 30 days of any change in name or
address.
Another welcomed amenity is the new OP News and
Notes which can be obtained by subscription. Go to
[email protected]
I first want to expound on an important issue I
brought up with Mr Mokhiber: The problem of other
agencies interpreting the Pharmacy laws to their advantage. The Pharmacy Board on this issue has it’s hands tied.
They can’t legally force Medicaid and PBM’s to rescind
any rules that are implemented unfairly upon the pharmacies and pharmacists. The State Board had a meeting with
the Medicaid Inspector General (MIG) about the controversial issues they have imposed on pharmacies and pharmacists. They got nowhere. It is in our laps. Credit goes to
PSSNY and the NYCPS for pursuing this venture. The
main imputes of PSSNY will be to go after frivolous
administrative charges by the MIG. These acts of omission were not fraud but administrative errors. If anything
else, the pharmacies should not be penalized if fraud is not
the issue, especially using extrapolation which adds up to
astronomical amounts. If a pharmacy is to be penalized it
definitely should not be more than the fee. The MIG investigating a pharmacy in Syracuse using extrapolation was
fined over $8,000,000 for missing MMIS numbers, which
is absurd. He didn’t do that much in business since he
opened. He had to stop filling Medicaid Rx’s. This will be
brought up in front of a judge in Federal Court hopefully
by January 27. Hey, Judge. How about spending a day in
a pharmacy and see what it takes trying to get the License
number of a doctor from a teaching hospital. This is where
the Syracuse Pharmacy is located. The patient received the
Meds, and signed for them. The MMIS numbers are very
difficult to get. Where is the fraud?
Another pharmacy got cited for not writing the words
“telephone order” on the script. However, he kept a telephone log listing the Rx’s received by telephone. There is
nothing in the Pharmacy Board Regs that there is anything
wrong with this procedure.
Getting back to the meeting, it was interesting in the
fact the OP office is showing genuine interest in having
better dialogue with all the profession. Their ears are open
to any constructive ideas for better communication. Mr
Munoz, the Associate commissioner of the OP made the
opening remarks expounding upon this policy.
There are some important changes in our profession.
We will be able to pay for our fees by credit card and the
State board will be able to send information about any new
SP’s electronically to Medicaid.
Another issue brought up concerned about shortages in
certain professions. One avenue of approach the OP stressed
on was exposure of particular professions to high schools. A
couple of the professions had already made contacts, and on
a one on one basis got a few students interested in their profession. What are we as pharmacists doing? Can we on a
voluntary basis have an out reach program? In other words
invite students into our pharmacy and let them have a hands
on interaction with a pharmacy operation. Does any one
have any ideas how we can approach this scenario?
The bottom line about this meeting was the enthusiastic outreach the OP office is encompassing. Maybe we
should meet them halfway. JDF
By James A. De Franco
Executive Director, NYCPS
PAGE 4 YEAR END 2007
AND
THE LAW
NYCPS NEWSLETTER
PATIENT COUNSELING:
A “TWO BIRD” OPPORTUNITY
This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and the New York City Pharmacists Society through
Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.
P
atient counseling has been an unofficial part of the services provided
by pharmacists to their patients for
many years. When Congress passed
OBRA ’90, regulations were then promulgated by the states. These regulations
take a number of forms; mandatory counseling on new prescriptions, mandatory
counseling on all prescriptions, or a
mandatory offer to counsel on either new
prescriptions or all prescriptions.
Regardless of the form imposed, the profession has not done its best to implement
effective patient counseling. This was
highlighted in a recent TV news magazine story.
The profession needs to improve its
provision of effective patient counseling
for two reasons. First, patient counseling
is essential for patients to understand
their therapy and achieve significant outcomes. New therapies are becoming
increasingly effective, but many times not
without specific usage. For example,
“generic Fosamax®” has specific directions regarding timing and body position
after taking the drug. It is essential that
patients understand these directions and
follow them. Asthmatic patients can live
much more normal lives than in the days
before metered-dose inhalers and the
drugs they can deliver. However, many
patients do not know the proper order or
techniques to properly use their inhalers.
The increasing number of insulin products and delivery systems can be confusing to patients who are use to the traditional bottle and syringe therapy (which
has its own inherent problems).
Providing effective patient counseling
will improve patient outcomes and
demonstrate the pharmacist’s value in the
health care system.
The second reason to counsel
patients is as a further protection for the
pharmacist. The data in the Pharmacists
Mutual Claims Study indicates that a significant number of claims might have
been avoided with patient counseling.
These claims include those where
patients receive the wrong drug, patients
who receive prescriptions belonging to
someone else, doses that are inappropriate for the patient (typically pediatric or
geriatric patients), and claims where
patients do not receive the correct directions or don’t understand them. In these
examples, among others in the study,
patient counseling is an excellent method
of detecting prescription errors before the
patient is harmed. But it requires engaging the patient in a real dialogue about
their medications, including “Show and
Tell” counseling.
The limited data pool of the TV story
indicated a counseling rate of 27%.
While this may not be statistically significant as to the entire pharmacy profession, it is a long way from 100%.
Imagine the chaos if only 27% of drivers
chose to obey stop signs. This is the
pharmacist’s opportunity to kill two birds
with one stone as the old cliché goes.
Pharmacists can improve their compliance with law and regulations by providing effective patient counseling. The procontinued on page 18
NYCPS NEWSLETTER
YEAR END 2007 PAGE 5
PAGE 6 YEAR END 2007
SE C R E T A R Y ’S
REPORT
NYCPS NEWSLETTER
survive in this tough environment.
We can take a moment to
YEAR
thank the leadership of
END
NCPA along with their rela2007
tionship with NACDS (the
national chain pharmacy
f you have not read it elsewhere in organization) for - - at least for now this edition and earlier ones of the - postponing the implementation of
NYCPS
Newsletter
many Average
Manufacturers
Price
changes have taken place in the past methodology for generic Medicaid
couple of weeks.
prescriptions from their anticipated
Bill Scheer is now installed as our implementation date of January 31,
Treasurer after 14 years of dedicated 2008. A federal judge in Washington
service by Dilip Patel. Additionally, D.C. has halted the process of impleCharlie Catalano, our Vice President menting this horrific mess of a pricis assuming the role of Manhattan ing strategy in mid December. Thank
and Queens County Regional God someone on the bench is able to
Representative for PSSNY replacing understand complicated pharmacy
Mike Escuder.
issues and render a logical decision.
Lastly, I am no longer an indeAccording to what I learned from
pendent pharmacy owner, because on my friends in NCPA, the Centers for
November 28, 2007 I merged my Medicare and Medicaid Services
pharmacy records and inventory with (CMS) argued that the expert that
a local Rite Aid Pharmacy, where I NCPA/NACDS had brought in to teswill assist on a part time basis in the tify and give his opinion was all
RX department.
washed up with his arguments, a
Yes things are changing, the pharmacist well respected in the
world is constantly in change, some- pharmacy community, Dr. Stephen
times we perceive our pharmacy Schondelmeyer, Phamr D, PhD. As it
world not to be in a state of change turned out, Dr. Schondelmeyer has
but one of turmoil, and we may be served as a CMS expert on economics
right. Nevertheless, we need to keep and drug pricing for many years, so
abreast of the issues and obstacles the judge then turned to CMS attorthat we as pharmacists face on a daily neys and asked a question, (I parabasis. The going has gotten tough phrase now : “how is it that this perand we need to be strong in order to
I
STERLING & STERLING, INC.
I N S U R A N C E
Protecting People From Adversity
Adversity
STERLING & STERLING, INC.
Mr. Bill Adams and Mr. David Epstein
P.O. Box 9017, 45 Crossways Park Drive,
Woodbury N.Y. 11797
(516) 487-0300 or (800) 767-7837
Fax: (516) 487-0372
son who is lacking a true understanding of this AMP pricing is someone
that CMS has relied on for their own
research for so long?”. They had
nothing to say.
Read my News from Around the
World column for more details on this
important issue.
Folks we must maintain a constant
review of our pharmacy prescription
processing in order to make sure we are
doing all of our daily entries in the filling of prescriptions to the letter of the
law and state board of pharmacy regulations. You never know when New
York Medicaid will start nit picking a
mi-nute detail of your daily activity and
claim it is not the way it is supposed to
be.
Your state and local societies are
working hard to defend the honest
pharmacists in the trenches.
Join us in Saratoga in mid January
for the mid winter PSSNY convention.
For
more
information
see
www.pssny.org or call PSSNY at 800
632 8822. The meeting runs January
10-12, 2008. Plenty of CE and updates
on important Pharmacy issues will be
your reward for attending this convention and mid winter meeting.
Happy Holidays to all and may
you have a Happy Peaceful and
Health New Year 2008!
Jim Schiffer
©2007 James R. Schiffer
Protecting
Pharmacists
For Ov er 60 Years!
NYCPS NEWSLETTER
YEAR END 2007 PAGE 7
PAGE 8 YEAR END 2007
Retail Council offers workers’
compensation insurance program to PSSNY members
D
id you know the Pharmacists Society of the State of
New York includes the Retail Council’s workers’ compensation program on its list of member benefits? If
you’ve never considered the Council’s Safety Group, which can
save pharmacies up to 60% on this mandatory insurance, now’s
the time to do so. More than 170 independent pharmacies in
New York State are already participants because the savings
just can’t be beat!
Here’s how the Retail Council’s Safety Group can save
your business money:
40% average
savings thanks to
annual dividend*
In November, eligible pharmacies
who participate in
the
Retail
C o u n c i l ’s
W o r k e r s ’
Compensation
Safety
Group
received checks
for close to half of
the premiums they
paid in policy year
2006 back in the
form of a dividend. The 40%
dividend represents a return of
more than $5 million to the 1,300
retailers who participate in the
group.
Such savings
isn’t new to Retail
Council members.
Dividends have
been awarded for
29
consecutive
years averaging
39%, and since
1978, members of
the Safety Group
have
received
more than $82
NYCPS NEWSLETTER
million in dividend returns.
Upfront policy renewals
In addition to the dividend, eligible pharmacies can receive an
upfront premium discount of up to 20% each policy year. Add
this to the 40% dividend and you can quickly see how the Retail
Council’s workers’ comp coverage is the best deal around on
workers’ comp for pharmacies!
Additional Savings for 2008
Thanks to recently enacted legislative reform of the state’s
workers’ compensation insurance system, rates for this insurance are being cut an average of 20% for 2008 policy renewals.
Members of Safety Group 493 will also see a significant reduction in the NYS Assessment, an annual charge to all workers’
compensation policyholders for administrative expenses and
special funds. The assessment for our Safety Group policyholders with NYSIF will be only 6.6% for the 2008 renewal – other
continued on page 18
NYCPS NEWSLETTER
YEAR END 2007 PAGE 9
T HE N C P A R E P O R T
REAL PROGRESS IN GETTING
BUSINESS NEGOTIATING RIGHTS
P
erseverance is the key to achieving
your goals on Capitol Hill. It has
been a struggle securing the right for
independent community pharmacies to
join forces against the take-it-or-leave-it
contracts of pharmacy benefit managers
(PBMs). However, tangible progress has
finally been achieved thanks to an organized, targeted lobbying and grassroots
campaign that finally bore fruit this Fall.
First, Sens. Johnny Isakson (R-Ga.),
Tim Johnson (D-S.D.) and Lindsey
Graham introduced the legislative fix, S.
2161, on October 15.
Historically,
the
Senate has been unreceptive to pharmacy
business negotiations
so this initial step is a
significant accomplishment. Second,
the House Judiciary
Committee passed the
companion bill, H.R.
971, by a voice vote
on November 7,
which means the next
step is a vote before
the entire House.
Both bills restore
fairness and provide
regulatory relief to the
contract negotiations
process between the
small business owners
of independent community pharmacies
and the giant PBMs
who administer prescription drug plans.
Currently, PBMs dictate reimbursement
rates to independent
pharmacies when setting contract terms.
This anti-free market
dynamic is due to
PBMs
unchecked
market power contrasted with the average
independent community pharmacy which
has only $3.6 million in pharmacy sales.
Adding insult to injury, publicly trade drug
store chains have the leverage to negotiate
fair contracts with PBMs due to the large
number of stores they represent. S. 2161
and H.R. 971 correct this inequity by creating a special exemption to anti-trust laws
that currently prohibit independent community pharmacies from joining together
to correct this inequity.
The bills leveling of the playing field
would give pharmacies a voice to the many
objectionable PBM practice foisted on
patients, such as constantly shifting and
shrinking their formularies based on manufacturers’ rebates that greatly restricts
treatment options. Additionally, PBMs
prohibit pharmacies from dispensing 90day prescriptions so they can move these
patients to their own mail order facility,
which is clearly a conflict of interest.
Ultimately, we will be better able to serve
the needs of our patients if we are empowered to pool together in demanding contracting fairness, as opposed to the current
situation that simply increases the profit
margins of PBMs.
None of this progress could have been
achieved without the Herculean efforts of
NCPA’s advocacy efforts. NCPA’s calling
card is advocacy and we have redoubled
continued on page 18
PAGE 10 YEAR END 2007
PAAS REPORT
ALERT: Watch Out for PBM/Mail Order Slamming
PAAS is receiving a growing number of reports of
PBMs covertly moving patient’s prescriptions
from community pharmacies to their own
mail order operations.
When a PAAS pharmacist
attempted to process four refills for
their patient the pharmacist
received a “Refill Too Soon” message on the 4th prescription. The
patient was out of medication and the
pharmacy’s records indicated that the refill
was due. Upon investigation the pharmacist found:
1.The patient received a telephone call from a telemarketer questioning “Do you want to save 30% on prescriptions?” The patient of course stated, “Yes.”
2.The mail order operation placed the patient’s medication on “fill hold” to lock any other provider out of filling
the prescription. This was the reason for the “Refill Too
Soon” rejected claim message. These steps were taken
prior to the mail order operation contacting or receiving
a prescription from the doctor. The “fill hold” designation
means that a potential prescription order was pending.
PAAS suggests you inform your patients to be careful to
not allow themselves to be taken advantage of.
NYCPS NEWSLETTER
Increased Risk for Date Written Error Traps
We have always encouraged you to make sure every
prescription has a complete date written showing month
day and year. We have explained the importance of entering the date written in your computer when you fill a prescription. Due to new DEA rules that go into effect
December 19th 2007 which allows prescribers to write three one month prescriptions for a Schedule II controlled substance as long as they
indicate the date that each prescription may be filled. In this
situation, the date written is still
entered in your computer but you
must make sure the patient gives you
the prescriptions in the correct order and
that you do not fill any prescription earlier than the
fill date indicated by the prescriber.
PAAS has seen significant audit charge backs occur
in situations where a prescriber has post-dated a Schedule
II controlled substance prescription and the pharmacy has
filled it early. With this new ruling, you should no longer
be receiving post-dated prescriptions. When issuing prescriptions for multiple months of a Schedule II controlled
substance the prescriber is to write the correct issue date
on the prescription and then include a note indicating
when the second and third prescription may be filled.
This essentially will allow a prescriber to provide a
continued on page 14
NYCPS NEWSLETTER
YEAR END 2007 PAGE 11
JIM SCHIFFER REPORTING...
nd 2
E
r
a
Ye
News from Around
The Pharmacy World
007
YEAR END 2007 EDITION
These past few weeks have been a very
tough and emotional time for me personally, as after nearly 29 years of owning and operating a community pharmacy in the very neighborhood in which
I was born and raised, (Sunset Park,
Brooklyn), I made the decision to — on
November 28, 2007 - - shut down our
pharmacy operations and merge my
patient’s prescriptions along with all of
our pharmacy and otc inventory with a
local Rite Aid Pharmacy.
These are truly turbulent times for
pharmacy, and especially for independent pharmacy owners, margins are
evaporating, mail order factories continue to steal our patients and the issues
with Medicare Part D just add insult to
injury. I write elsewhere in this newsletter about my decision to close and merge
with Rite Aid. In the meantime, life goes
on and so does the news to report. -JS
AMP DELAYED - — HORRAY!
Here we are at the close of another
tough year. At least Santa delivered some
presents to pharmacists, like having a
federal judge declare the implementation
of Average Manufacturers Price (AMP)
delayed until the US Department of
Health and Human Services, (HHS),
Centers for Medicare and Medicaid
Services (CMS) redo the process of
implementing the AMP via following the
proper protocol for rulemaking as defined
by the existing language in the statute
that created AMP. The judge, Honorable
Judge Royce C. Lamberth granted a temporary restraining order which was
requested jointly by NCPA and the
National Association of Chain Drug
Stores (NACDS).
Judge Lamberth went so far as to
state on the record, “A wholesale rewrite” of what Congress had intended in
the implementation of the statue which
created a pricing strategy known as AMP.
That legislation has caused indigestion
for pharmacists already, as the Deficit
Reduction Act also required educational
programs at pharmacies, as well as any
other entity which under one common
Tax ID Number, doing over $5 million a
year in Medicaid, must provide proof of
education of their staff on how they
should report any potential fraudulent
activity taking place at their location.
Some History to help understand
HHS and CMS promises to appeal at
least part of the court decision which
might be interpreted to change the manner in which drug companies report AMP
FOR PURPOSES OF STATE MEDICAID REBATES. As you may recall,
AMP was created nearly 18 years ago as
a government tool to determine how
much the drug companies, both brand
and generic manufacturers, owe state
Medicaid program administrators on the
OBRA 90 rebates based on best price of
each company pricing strategy. Before
OBRA 90, if a manufacturer let us say of
a Rx drug like Cozaar, had offered incentives to any purchaser, including a for
profit managed care health plans to place
Cozaar on their preferred formulary, with
a 75% discount off of AWP, in the form
of back end reporting on sales with
accompanying rebates to the managed
care plan, it left the rest of the marketplace, including state Medicaid programs
paying a higher price and in an indirect
way subsidizing the savings to that particular plan. After the passage of OBRA
90, pharmaceutical manufacturers that
wanted their products to be covered by
state Medicaid programs had to expose
all of their pricing schemes and pass such
savings onto all of the state Medicaid
programs. In order to establish a baseline
of all of these rebates, manufacturers
were required to present their average
manufacturers price (AMP) to the HHS
Health Care Finance Administration
which until the Bush Administration was
known as HCFA, (now known as CMS).
Then HCFA /CMS would take that information and share it with the state
Medicaid agency directors in order to
determine what was owed to each state
based on sales of the products on
Medicaid. The generic companies must
rebate a flat rate to the state Medicaid
programs while the discounts on branded
items I have been told off the record by
some Medicaid senior staffers are quite
steep. Some drugs were distributed for
FREE as a result of the value of the
rebate.
Getting back to the AMP problem,
when Congress signed this Deficit
Reduction Act (the federal law that
among other things, created the AMP
issue for pricing drugs at the retail level),
continued on page 12
PAGE 12 YEAR END 2007
NYCPS NEWSLETTER
AROUND THE PHARMACY
FROM PAGE
11
into law in February 2006, it was never
anticipated that there would be a ground
swell of opposition by the pharmacy profession. It seems that this issue has united
the PBM’s and their association with the
likes of the NACDS, (the National
Association of Chain Drug Stores) and the
leadership of NCPA to be all on the same
page on this issue. I will continue to post
the information on this serious issue as
developments occur, but for now, no AMP
for pharmacy. Is that all good news? No,
not really, because the CMS folks refuse
to adjust generic prices for the existing
Federal Upper Limit drugs that they are
tracking. And the various PBM’s that use
FUL pricing as a means of testing their
prices are also riding the gravy train
because if a drug has gone up in price, and
it remains on the FUL list, then pharmacists may be getting shortchanged in their
reimbursement for such drugs being dispensed. For instance generic versions of
Oxycodone tablets are now being underpaid by state Medicaid programs because
the drug has gone up drastically in price,
and the excuse given by the Medicaid
authorities is that is what we have as a
price from CMS. HIP of New York is also
using that line as an excuse to underpay
pharmacies for generic drugs they see fit
to use the FUL pricing scheme for. I
guess when the price is low enough to pay
below cost to the pharmacies, HIP uses it,
why not, and they get away with practically everything short of homicide.
Canadian Drug Problems continue.
The New York Times, in mid
December, exposed a new method of manufacturing, and shipping counterfeit drugs
all over the world, and the source of these
drugs….illegal manufacturing plants in
the Republic of China. The Times did an
excellent job of following the path of
these bootleg drugs which include the
likes of brand name drugs like Plavix and
Viagra, from China to the Cayman
Islands, or another off shore location to a
PO Box in England only to be reshipped
once again from Canada. The internation-
al bootleg cartel is huge and the folks purchasing these products are unsuspecting
individuals looking to save money by
shopping on the web at supposedly On
Line Canadian Pharmacies. It even
appears that these drugs circle the globe
once or twice before making it into people’s homes so the packaging and shipping containers look authentic enough, the
trip to the UK is to make the shipping
packaging look real. Do the drugs work
like the real “McCoy’s”? That answer is
something that nobody seems to know, but
I would tend to doubt the effectiveness of
these products especially in conditions
which require constant monitoring such as
hypertension, diabetes and anti clotting
issues. I guess the pharmaceutical industry was correct on this issue all along and
it was not just the pricing factors that
come into play. In the United States, with
the coming of Medicare Part D two years
ago, drug reimportation has been put
aside, and I for one believe we can do
without drug reimportation; we have
enough problems maintaining safety
issues at the FDA without throwing another monkey wrench in the works.
The FDA has a monstrous job on its
hands between the safety of food (including pet foods) and drugs that are legally
made here in the good old US, or made
under contract for US manufacturers overseas.
Then look at the issue of toys coming
in from China tainted with lead. Who
wants to buy toys for kids this Christmas /
Holiday season anyway, not knowing
what is truly inside of the product.
FDA inspections of overseas pharmaceutical manufacturing plants are not as
vigorous as they should be and each arm
of the US government is stretched to the
limit, as a friend of mine working for the
DEA has reminded me, that even the DEA
is financially strained budget wise,
because we are fighting an ongoing war
(longer than we expected) on two fronts
and all of the resources of our government
are sharing in budget reductions in order
to pay for this long term focus on the wars
in Iraq and Afghanistan. George, what
did you do to us? How many days are
there left until January 20, 2009?
(When we get a new commander in
chief?)
Even the US Post Office, with their
recent 2 cent mailing price increase under
their belt, is all screwed up. In New
Jersey, just as the intense holiday mailing
season started in mid November, the post
offices (as least in central New Jersey)
have trimmed their consumer window
hours back. Now all post offices in my
county open at 10 am, and close promptly
at 5 pm, Saturdays they open at 11 AM,
due to financial issues. What did that do
to consumer shipping patterns? Many
people when to FedEx/Kinkos Stores and
UPS Retail Stores to ship holiday gifts
instead of dealing with postal problems.
So the US Post Office cut hours and I bet
cut income drastically as a result. It
reminds me of the movie Dumb and
Dumber. And we were supposed to give
the government a chance to totally screw
up our health insurance?
Medco on the Expansion!
Medco has just announced their
intention to create the world’s largest mail
order pharmacy factory in Indiana. This
facility will be the size of 6 football fields
and will be able to do millions of prescriptions for the Medco sponsors. The question I have for Medco is how many pharmacists will it employ? A similar Medco
state of the art, but yet smaller facility, has
been operating in southern New Jersey
and when it opened, the newspapers were
bragging about all of the jobs that were
being created which included FIFTY yes
50 pharmacists. The New Jersey facility
handles hundreds of thousands of prescriptions weekly and the calculations that
were made showed a pharmacist/prescription/ check per hour that exceeded one
hundred prescriptions. This trend is just
another obstacle in the constant battle for
community pharmacy survival. In the
meantime, as the stock market is showing
signs of a recession, the PBM stocks continue to do well. Express Scripts is at 73
per share, CVS (CVS/Caremark) is hovering around 40 dollars a share and Medco,
who entered the market four years ago at
continued on page 19
NYCPS NEWSLETTER
YEAR END 2007 PAGE 13
OMIG MEDICAID AUDITS ARE COSTING SOME PHARMACIES IN THE MILLION$ OF DOLLARS , IS IT FAIR ?
The following story is reprinted
with express permission of the
Democrat and Chronicle, the leading
daily newspaper in Rochester New
York.
The author, Mr. James Goodman
has covered issues in Monroe County
for a long time. Feel free to read more
in the Democrat and Chronicle at
www.democratandchronicle.com, and
you can post comments regarding
your feelings on this story as well.
http://www.democratandchronicle.co
m/apps/pbcs.dll/article?AID=/200711
16/NEWS01/711160375
Some pharmacies cry foul
over Medicaid audits
Post Comment
(November 16, 2007) — Saratoga
Pharmacy has learned that an audit by
Monroe County of its Medicaid prescriptions can be costly.
Dana Gignac has operated the
pharmacy for 16 years on Lyell
Avenue. He had been filling about
3,000 Medicaid prescriptions a week.
But the state in early August
stopped reimbursing the pharmacy for
Medicaid prescriptions because the
county audit said the business had been
overpaid by as much as $8.4 million.
Medicaid prescriptions were bringing
in about $150,000 a week.
Gignac said the pharmacy has no
choice now but to turn away Medicaid
customers.
Saratoga is one of 28 pharmacies
flagged by the county for audits. They
range from the CVS Pharmacy near
Twelve Corners in Brighton to Canales
Pharmacy in Henrietta and Miller’s
Pharmacy in Wheatland.
This is the first concerted effort by
county governments to detect waste,
fraud and abuse among Medicaid
providers. Monroe is one of 12 counties
participating in the initiative,
launched
almost two years ago.
Monroe County will
keep 25 percent of any
money returned as a
result of its audits, after
the expenses are covered.
“We want to make
sure people are following the rules,” said
county
Budget
Director
Bill
Carpenter.
The audits of pharmacists by Monroe and
other counties have
come under criticism
for being a heavyhanded attempt to turn
bureaucratic errors and
disputes over interpretation of Medicaid regulations into costly
penalties.
“They have more to do with administrative issues. The drugs have been
dispensed appropriately,” said Selig
Corman, director of professional affairs
for the Albany-based Pharmacists
Society of the State of New York.
Gignac contends that the audit was
badly flawed and has sued state officials, seeking payment of the withheld
reimbursements, currently totaling
about $1.8 million.
Meanwhile, Saratoga Medicaid
customers are looking for another pharmacy.
Rochester resident Angela Ford
said she is disabled and has depended
upon the pharmacy’s home delivery
service for the Medicaid prescriptions
that she and her son need.
“I don’t know where to go,” she
said.
Monroe’s audits
In December 2005, the state
offered counties an opportunity to
examine providers of Medicaid services, which in the past had been a state
responsibility. In Monroe County, some
of the 8,804 providers are the focus of
these audits because they — not the
120,000 Medicaid recipients they serve
— typically receive Medicaid payments.
In August 2006, with Monroe one
of the counties authorized by the state
to conduct audits, County Executive
Maggie Brooks announced that the
Bonadio Group, a Pittsford accounting
firm, had been hired to do the audits
here.
Each county came up with its own
list of Medicaid providers to be audited. In Monroe, in addition to 28 pharmacies, three providers of mental
health services, three drug treatment
providers, four medical equipment
providers and three doctors were identified for audits, according to the state
Medicaid Inspector General’s Office.
continued on page 14
PAGE 14 YEAR END 2007
NYCPS NEWSLETTER
OMIG Medicaid Audits: CONTINUED
FROM PAGE
Multiplier effect
In a pharmacy audit, the Inspector
General’s Office says, it randomly
selects 200 prescriptions from a recent
one- or two-year period. Carpenter said
someone gets flagged for an audit for
any number of reasons, such as a computer check of billing records showing
unusual behavior or a high volume of
Medicaid business.
Neither Robert J. Enright, a principal of Bonadio, nor Carpenter would
comment on what they said were ongoing audits.
A big complaint from the pharmacies is that they are being told to repay
amounts to Medicaid much larger than
the payments questioned in the sample.
Canales Pharmacy owner John
Stephens said that based on the
Bonadio audit, the state wants him to
pay $179,669 in penalties for $1,841 in
questioned payments. He said his errors
show no wrongdoing and are minor —
such as being given a license number
from a doctor that had an incorrect
digit.
“They are trying to force us to close
down,” Stephens said.
Michael Welsch, owner of Miller’s
Pharmacy in Wheatland, said he recently received notice that he must pay back
119 times the amount of Medicaid payments found to be unjustified by the
audit.
Some of the shortcomings concern
such matters as the wrong year on a
record of a prescription. “We told them
13
a lot these issues are minor clerical
issues,” Welsch said.
The audits assume that the problems found in the sample occurred at a
similar rate for all the prescriptions of a
pharmacy during the period sampled,
and the amount that the state wants
repaid is based on what could be
expected to be found for all the prescriptions filled during the period covered by the sample.
Such projections — called extrapolation — are often used in Medicaid
and Medicare audits.
“It has been time-tested and supported by court rulings,” said Robert
Hussar, the state’s first deputy inspector
general for Medicaid.
But others say that is not always the
case.
“The real question is how valid is
the sampling,” said Rene Reixach, a
local lawyer with an expertise in
Medicaid.
The Saratoga audit
Saratoga Pharmacy’s audit dates to
October 2006, when several auditors
from Bonadio spent four days at the
pharmacy, reviewing 200 prescriptions
from 2004 and 2005.
A May 21, 2007, audit report lists
the biggest problem being 53 instances
of “undelivered prescription items,”
while in more than 30 cases questions
were raised because the Medicaid identification number of a hospital or medical clinic was used in the prescription
instead of the identification number of a
PAAS:CONTINUED
FROM PAGE
10
patient with up to three months prescriptions for a
Schedule II controlled substance.
PAAS encourages our members to be diligent in
watching these dates. For further information
regarding this ruling, contact Mark W. Caverly,
Chief, Liaison and Policy Section, Office of
Diversion
Control,
Drug
Enforcement
Administration, Washington, DC 20537, telephone
(202) 307-7297.
doctor working there.
Using extrapolation, Bonadio said
the $4,844 of overpayments in the sample meant the state could assume that
for all Medicaid transactions during the
two-year period Saratoga could be
asked to repay between $6.3 million
and $8.4 million.
An Aug. 3 order from the Inspector
General’s Office notified Saratoga that
Medicaid reimbursements would be
withheld for an unspecified period.
Gignac has previously been disciplined on two occasions. Most recently,
the state in May suspended his license
for a month and fined him $5,000 for
providing inadequate supervision. He
was put on a list that prohibits him from
supervising Medicaid prescriptions —
a task that was then taken over by
another pharmacist at Saratoga.
Gignac’s lawsuit against state officials contends that the audit not only
failed to look at all the facts but also
misconstrued Medicaid rules.
David Berger, a lawyer representing Gignac, said Gignac has signatures
or signed statements to show delivery
from all but a handful of the 53 prescriptions in which proof of delivery
was in question.
Gignac said he should not be
forced out of business because the state
wants him to pay millions for what he
calls disagreements over regulations.
“If I made mistakes, I should have
to pay for them,” he said. “But they are
manipulating the situation, making it
far worse than it should be.”
James Goodman
Staff writer
Hard Copy Missing Information
Recent audits have emphasized the importance of
making sure all hard copy, original prescriptions on file
contain the legally required information. A hard copy
that “refers” to an earlier prescription number must still
contain all required information. PBM/TPAs are recouping payment for hard copy prescriptions that lack any of
the following: the date written, full patient name, complete drug name (and strength if applicable), quantity to
dispense, DEA number for controls, refill authorization
and mathematically usable directions.9
NYCPS NEWSLETTER
YEAR END 2007 PAGE 15
LEGAL WAR CHEST UPDATE
For the past four years, The New York City Pharmacists Society has had a Legal War Chest to fund the local battles that we as community pharmacists fight by ourselves day after day. We have fought
various battles including some with PBM’s, and other enemies of community pharmacy. We have educated government officials about the
shortcomings to patients and pharmacies the way PBM’s make payments to pharmacies. We are fighting for our survival. This fund is serperate from the current PSSNY Legal Defense Fund which is being utilized to fund the current PSSNY Medicaid dispute.
As our War Chest grows, we will be enabled to fight the fight
for survival in this dog eat dog health care environment. Thanks to the
generosity of our members this fund continues to grow.
As we see the outrageous PBM contracts, the erosion of our
patients due to mandatory mail order contracts and the reduction of our
levels of reimbursement due to the newly formed Medicare Part D Contracts. At this time more than ever, we truly need a strong professional
voice to fight for our concerns. Please join us in these necessary struggles.
Enclosed is the current list of contributors for the New Year
2007. We will publish past donations as space permits.—the list is done
alphabetically, not in order of receipt or donation amount. (new contributions have an asterisk*)
Thank you Mark Shprinzes of 16th Avenue Pharmacy for
notifying me that you indeed were the person who donated $300 in
early January toward our cause.
J. Schiffer
Final Updated List 2006
David Asencio, Ascencio Pharmacy . . . . . . . . . . . . . . . . . . . . . . .$200
Dominic Amerdolara, Salzman Chemists . . . . . . . . . . . . . . . . . . . .$250
Robert Baker, Thriftway STM Rx . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Robert Baker, Thriftway Classon . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Albert Bluestein Radin Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . .$100
Amer Chowdry, Lincon Care Drugs . . . . . . . . . . . . . . . . . . . . . . . .$250
John Demetriades, Farmacon Pharmacy . . . . . . . . . . . . . . . . . . . .$250
Narsinh Desai, Leroy Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . .$1,000
Jim DeTura, Melrose Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . .$2,500
Jay Dhaduk, Leroy Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . .$500
Keith Diamond, Dermer Pharmacy & Surgical . . . . . . . . . . . . . . .$350
Gloria Fumo, Salzman Chemists . . . . . . . . . . . . . . . . . . . . . . . . . .$250
Roy Eisner, The Charles Pharmacy . . . . . . . . . . . . . . . . . . . . . . . .$200
Steve Gelwan Thriftway Washington . . . . . . . . . . . . . . . . . . . . . . .$300
Howard Goldsmith, Kenby Pharmacy . . . . . . . . . . . . . . . . . . . . . .$150
Paul Hushin, Lakeland Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . .$200
Peter Kassel, Kasell Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . .$200
Steve Kaufman, Manhattan Plaza Pharmacy . . . . . . . . . . . . . . . . .$200
John Lam, JW Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$200
Peter Lau, Confucius Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Alan Lee, Mittman Pharmacy* . . . . . . . . . . . . . . . . . . . . . . . . . . . .$250
Long Island Pharmacists Society . . . . . . . . . . . . . . . . . . . . . . . . . .$500
Michael Morelli, Arrow Pharmacy . . . . . . . . . . . . . . . . . . . . . . .$1,000
Sal Pagano, Hartsdale Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . .$250
Alex Perchuk, Thriftway SBC Rx . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Alex Perchuk, Thriftway Kings . . . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Stewart Rahr, Kinray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$2,500
Nicholas Riccio, Krutick’s Pharmacy . . . . . . . . . . . . . . . . . . . . . .$250
Stuart Rubin, Rafieh Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . .$100
Jim Schiffer, Jim & Phil’s Family Pharmacy Ltd . . . . . . . . . . . . . .$300
Nadira Singh, Thriftway Church . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Lesly Thelemaque, Thriftway Vanderveer . . . . . . . . . . . . . . . . . . .$300
Chandrakant Trevedi, Raan Pharmacy . . . . . . . . . . . . . . . . . . . . .$200
Yan Vilensky, Thriftway Flatbhush . . . . . . . . . . . . . . . . . . . . . . . . .$300
Alex Zatsepilo, Thriftway Foster . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Gilbert Zuckerman, Kenby Pharmacy . . . . . . . . . . . . . . . . . . . . . .$150
Our war chest total to date (2006) . . . . . . . . . . . . . . . . . . . . . .$16,300
Final 2007 Donations List it has been updated as of December 24, 2007
Purna Aramalla, A Fair Deal Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . .$500
Michael Agovino, Sedgwick Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . .$250
Raymond Bacci, Jim & Phil’s Family Pharmacy . . . . . . . . . . . . . . . . . . . . .$100
Robert J. Baker, Thrifway Kings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$350
James Cannella, Pharmacist at Melrose Pharmacy . . . . . . . . . . . . . . . . . .$200.
Charles Ciaccio, Mishkin Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$500.
Jim DeFranco, DeFranco Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . .$1,000
Jim DeTura, Melrose Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$5,000
Kieth Diamond, K. Diamond Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . .$350
Edwige Dorime, Five Star Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$250
John Duffy, Grove Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$250
Howard Feder, Myrtle Ave Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$150
Russell Gellis, Apthorp Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$1,000
Steve Gelwan, Thriftway Washington . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$350
Frank Giordano, Mermaid Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$100.
Steve Kaufman, Three S/Manhattan Plaza RX . . . . . . . . . . . . . . . . . . . . . . .$500
Robert Nathanson, Congress Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . .$1,000
Alan Lee, Mittman Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$500
Anthony Morano, Friscia Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$100
Mohammed Patel, Oak Park Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Alex Perchuk, Thriftway/SBC Rx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$350
Alex Perchuk, Thriftway STM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$350
Alex Perchuk, Thriftway STJ RX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$350
Gene Roberts, Parkway Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$250.
James Schiffer, Jim & Phil Family Pharmacy . . . . . . . . . . . . . . . . . . . . . . .$400
Adam Siegel, Parkway Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$250
Nadira Singh, Thriftway Church . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$350
Parthiv Shah, Three P Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$1,000
Parthiv Shah, Saldo Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$1,000
Parthiv Shah, Fuller Drug Store . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$1,000
Mark Shprinzes, 16th Avenue Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . .$300
Vincent Mazzamuto, Sedgwick Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . .$350
Sam Weinstein, Turtle Bay Chemists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$200
Lesly Thelemaque, Thriftway Vanderveer . . . . . . . . . . . . . . . . . . . . . . . . . .$350
Sambasiva Venigalla, Leff Prescription Center . . . . . . . . . . . . . . . . . . . .$1,000
Yan Vilensky, Thriftway Flatbush . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$350
John Viscardi, Health Wise Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . .$500.
Alex Zatsepilo, Thriftway Foster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$350
Our war chest total for 2007 . . . . . . . . . . . . . . . . . . . . . . . . . .$21,450
2007 LEGAL WAR CHEST COUPON
The NYCPS Board of Directors appreciates the vote of
Can we count on you to join us in this fight to survive?
confidence from our colleagues, in making these contribu- If you have not already done so, please send in your contritions. Thanks you for this support!
bution with the coupon below.
Yes, count me in; I want to contribute to the New York City Legal War Chest!
Name __________________________________________________________________________________
Pharmacy ___________________________________________________Donation Amount _____________
Address ________________________________________________________________________________
City, State _______________________________________________________________________________
Please send to: NYCPS Legal War Chest c\o Mr. William Scheer • 77 Louis Drive • Farmingdale, NY 11735
PAGE 16 YEAR END 2007
NYCPS NEWSLETTER
PSSNY MEDICIAD LAWSUIT UPDATE OCTOBER 31, 2007
Halloween was not a good time for ghosts
nor goblins nor pharmacists working in New
York State. That was because the judge in
Albany County Supreme Court that finally
reviewed and rendered a decision on the PSSNY
Petition against the Office of Medicaid
Inspector General regarding proper use of institutional MMIS numbers served the pharmacy
profession a trick not a treat. Judge Donahue
held that the OMIG did not improperly reinterpret the regulation regarding proper use of
MMIS numbers in submitting claims for prescriptions. Without this decision being overturned by a higher court OMIG is free to continue this harassment of pharmacists throughout
NYS. What is even worse, in audits, OMIG is
using instances of pharmacists using the institutional MMIS number as part of an audit recovery and then to add insult to injury OMIG
extrapolates these findings to add more of a
penalty to pharmacists in their audit summary of
what is allegedly owed to OMIG in overpay-
ments. Therefore PSSNY has decided to appeal
the decision to a higher court. This is an important time for pharmacists in New York State to
be united behind their state organization and
fight this improper interpretation of what pharmacists do all day long in providing care to
patients served by residents and interns in hospital clinics and emergency rooms. If you have
not contributed to the PSSNY legal fund now is
the time to do it. Thank You. 9
Craig Burridge
LEGAL WAR CHEST “SPECIAL MEDICAID FUND” ROUND #2 COLLECTION RESULTS
List has been updated as of 7/15/07
133rd Street Pharmacy, New York......................................$200
Accu Returns, New York .....................................................$100
A.P.K.G. Pharmacy, New York.........................................$1,000
Atluri Pharmacy, Bronx ......................................................$500
Avenue X. Pharmacy, Brooklyn ..........................................$200
Biomed Drug & Surgical, New York ...............................$1,000
Briarwood Pharmacy, Jamaica ..........................................$500
Canarsie Plaza Pharmacy, Brooklyn ...............................$1000
Cannella James, Auburndale..............................................$200
Cash Rx Plus, New York .....................................................$300
City Drug & Surgical/ Amsterd, New York.........................$500
City Drug & Surgical/ Audobon, New York .......................$500
City Drug & Surgical/Heights, New York ..........................$500
City View Pharmacy, Astoria...........................................$1,000
Clinton Apothecary, Brooklyn .........................................$2,000
Colombo’s Pharmacy, Middle Village ................................$500
Columbus Ave. Pharmacy, New York .................................$500
Concord Drug, Briarwood .................................................$500
Congress Pharmacy, Bronx .............................................$1,000
Cropsey Pharmacy, Brooklyn .............................................$200
Dermer Pharmacy & Surgical, Brooklyn ...........................$500
E. Jerome Pharmacy Inc., Bronx.....................................$1,000
Embassy Pharmacy, New York ...........................................$500
Esco Drug Co., New York................................................$1,000
Franco Pharmacy Corp., Jackson Heights .....................$1,000
Firo Inc., Bronx ..................................................................$500
Grace Pharmacy, Elmhurst ................................................$200
Halpern Pharmacy, New York .........................................$1,500
Healthcare Pharmacy, New York........................................$500
J.J. Columbus /Town Drug, New York................................$500
Jim & Phil’s Family Pharmacy, Brooklyn..........................$350
J.J. Pharmacy Co., New York ..........................................$1,000
K&S Pharmacy, Bronx .......................................................$150
Kings Park Slope Pharmacy, Brooklyn ...........................$1,500
Kings Brooklyn Pharmacy, Brooklyn ..............................$1,500
Leroy Pharmacy, Bronx, ..................................................$1,000
Lieb Pharmacy, Brooklyn ...................................................$500
Marlboro Drug Co., Brooklyn ............................................$500
Medcourt Pharmacy Inc., Jackson Heights ...................$2,000,
Melrose Pharmacy, Bronx ...............................................$5,000
Metropolitan Pharmacy, Forest Hills.................................$250
Metropolitan Pharmacy, Richmond Hill ............................$250
Mid Concourse Pharmacy, Bronx ...................................$1,000
MHN RX Melrose, Bronx....................................................$500
Monicas Pharmacy, Brooklyn..........................................$1,500
Myrtle Ave Pharmacy, Ridgewood ..................................$1,000
Neergaard Pharmacy 5th Avenue, Brooklyn ......................$500
Neergard Pharmacy 7th Avenue, Brooklyn ........................$500
Paras Drugs, Brooklyn ....................................................$1,000
Pilgrim Pharmacy, Bronx ................................................$1,000
Raysol Pharmacy, New York............................................$1,000
Rite-Way Pharmacy, Bronx.................................................$500
Rosenblum Pharmacy, Brooklyn.........................................$400
RX-2000 (RX Center), New York .....................................$2,500
S. Bros Pharmacy, Brooklyn...............................................$540
Scarpa Pharmacy, Brooklyn ............................................$2,500
Scheer Drugs, Bronx........................................................$1,000
Sedgwick Pharmacy, Bronx ................................................$750
Shalom Pharmacy, Flushing...............................................$500
Stellas Pharmacy, Brooklyn................................................$250
St Jesus Pharmacy, New York..........................................$1,000
Super Value Drugs, Brooklyn ..........................................$1,000
Thriftway/Church, Brooklyn ...............................................$350
Thriftway/Flatbush, Brooklyn.............................................$350
Thriftway/Foster, Brooklyn .................................................$350
Thriftway/Hosp, Brooklyn...................................................$350
Thriftway/Kings, Brooklyn..................................................$350
Thriftway/SBC, Brooklyn ....................................................$350
Thriftway/Services, Brooklyn..............................................$350
Thriftway/STJ, Brooklyn .....................................................$350
Thriftway/STM, Brooklyn ...................................................$350
Thriftway/Vanderveer, Brooklyn .........................................$350
University Chemists, New York ..........................................$500
University Chemists, New York ..........................................$500
Woodhaven Pharmacy, Woodhaven.................................$1,000
Washington Pharmacy, Bronx.............................................$250
World’s Fair Pharmacy, Flushing ...................................$1,500
Z-Stop Pharmacy, Bronx..................................................$1,000
Total:..............................................................................$60,590
Make checks payable to PSSNY Legal War Chest
“ SPECIAL MEDICAID FUND ”
210 Washington Avenue Extension, Albany, NY 12203
Your Name: _________________________________________________________________________________
Your Pharmacy Name: ________________________________________________________________________
Address: ____________________________________________________________________________________
Telephone : ___________________________________
Amount:
$5,000
$2,500
$1,500
$1,000
Other_____________
NYCPS NEWSLETTER
YEAR END 2007 PAGE 17
NYCPS NEWSLETTER
YEAR END 2007 PAGE 18
longer a time to say and do all the things you issue of the NYCPS newsletter goes out, I will
wanted to when your time here is no longer. go back to writing on all those issues that
attempt to destroy us, causing us enormous
FROM PAGE 1 Remember, nobody has ever complained on
their
deathbed
that
they
did
not
put
enough
time
grief and heartache.
and list the last time you actually did it and
Please contact me by e-mail at
enjoyed it free from distraction and interruption. in at work!
The importance of life is the present. We are [email protected] and let me know if this
Next and MOST IMPORTANTLY, when
was the last time you spent time with your fam- called to be thankful for what we have and for had any meaning in your life. Whether or not it
ily? When was the last time you hugged your those near and dear to us. If these family mem- made a difference or even got you thinking.
In the meantime, I would like to wish
children or grandchildren? When was the last bers are no longer close to you for whatever reason,
I
urge
you
to
take
the
initiative
and
make
that
everyone
a very Merry Christmas, Happy
time you told your husband or wife you love
call
you
know
you
have
been
wanting
to
make.
Hanukah,
and
Happy Kwanza.
him or her? When was the last time you sat
We are celebrating Christmas, Hanukah,
Also a Happy and Healthy New Year. May
down with your family to have dinner and
Kwanza,
and
ringing
in
the
New
Year!
Now
is
2008
bring every one of you all the joy and hapshared conversation at the dinner table? If you
the
time
to
make
even
subtle
changes
in
our
piness
you deserve.
are like many, you probably do not even know
If you have a moment, click on this
what the dinner table looks like any more. In lives. Rest assured, all the nonsense with
fact, when was the last time you saw any of Medicaid, Medicare, PBM’s etc, will all still be link,http://www.musicradio77.com/mayyou.html
and click on the audio. If you cannot get the audio,
these people listed above? These people are there long after we are gone.
your family. These are the people you love and So take me up on this little exercise and see if in just read the written version. It’s worth the
go out every day to support and provide for. fact it does not change something within. I will time.9
Sincerely,
These are the people who should be bringing even guarantee your relationship with your family
will
be
better.
My
guarantee
is
that
if
you
Jim Detura R.Ph.
you the greatest joy and happiness in your lives.
Remember, once they are gone, they are gone do not see an improvement, you can have your
President NYCPS
forever! There is no going back. There is no old lifestyle and relationships back!
[email protected]
I also guarantee that by the time the next
www.retailcouncilnys.com.
ETAIL OUNCIL CONTINUED
Safety and Security
FROM PAGE 8
The Retail Council’s Safety Group is not self insurance, nor do
carriers will still be required to collect the 15.5% assessment! our participants incur any “joint and several liability” risks as
Many workers’ comp policies are up for renewal so now is do those in self-insured trusts. The Retail Council’s Safety
the time to act on this money-saving program. Call the Retail Group is a fully insured plan and is completely underwritten by
Council at (800) 442-3589 for your free, no-obligation quote the New York State Insurance Fund. * A dividend cannot be
on workers’ compensation through Safety Group 493. The guaranteed. 9
Retail Council’s Web site is another great resource –
THE PRESIDENT’S REPORT:
R
C
:
RX AND THE LAW: CONTINUED
FROM PAGE
4
fession shouldn’t allow patients to sign away their right to counseling unknowingly. This patient counseling will then result in
additional positive patient outcomes by a better-educated
patient population. Throw in additional protection for the pharmacist from liability claims and the reasons to counsel become
a no-brainer. Will it be easy? No. Is it worth it? Of course.
NCPA REPORT: CONTINUED
FROM PAGE
9
our efforts by growing our advocacy group. Our team met the
Senate offices of the three original sponsors of S. 2161 on a continual basis to secure their support and get the bill introduced. We
also met with almost every one of the House Judiciary
Committee’s 40 members on H.R. 971 and we used a coordinated fax, e-mail, and phone bank campaign with NCPA members in
the Judiciary Committee members’ congressional districts urging
them to support the legislation. During crunch time when the bill
was being considered, we worked with legislators to negotiate
© Don R. McGuire Jr., R.Ph., J.D., is General Counsel at
Pharmacists Mutual Insurance Company.
This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should
consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with policies and
procedures of their employers and insurance companies, and act
accordingly.9
By Don R. McGuire Jr., R.Ph., J.D.
amendments that helped maintain bipartisan support. The less
controversial the bill the better, since the PBMs are going to fight
this development tooth and nail.
Now we need to turn our efforts to pressuring the House leadership? Speaker Nancy Pelosi (D-Calif.) and Majority Leader
Steny Hoyer (D-Md.)—to have vote on the floor on H.R. 971 and
encourage the Senate Judiciary Committee to take action on S.
2161. 9
By Bruce Roberts, RPh,
National Ccommunity Pharmacists Association
NCPA executive vice president and CEO
PAGE 19 YEAR END 2007
News Around the World
From Page 12
$26.50- per share has now broken the
$100 mark per share and they have
announced a two for one stock split. It
seems that investing in PBM is still a good
idea, from a financial viewpoint.
Remember those Liberty Medical Supply
Company commercials with that guy from
the movie, “Cocoon”, also he was the
postmaster general for Seinfeld, and he
also did many Quaker Oats commercials,
named Wilford Brimley? Well now he is
working for Medco as they have acquired
the Liberty Medical company for $1.5 billion, boy is that a lot of oatmeal! Medco
had been serving as a mail order pharmacy partner for Liberty Medical for a couple of years. Liberty Medical had been
owned by PolyMedica and Medco just
gobbled them up, like they know best!
Liberty Mutual has been doing much with
Medicare Part B for some time, and this
NYCPS NEWSLETTER
appears to be a good fit for Medco as they
want to capitalize on various disease
states and Diabetes is one of those target
diseases they have their eyes on.
VIOXX SETTLEMENTS
Merck pulled a rabbit from their lawyers
hat and plans on offering a settlement to
the nearly 27,000 lawsuits representing
nearly 50,000 plaintiffs for the sum of
$4.85 billion. Those plaintiffs who can
substantiate a relationship between their
use of VIOXX and suffering a heart attack
or stroke will be eligible to share in a
piece of the settlement fund. This is not
considered a class action settlement and
also if less than 85% of the cases against
Merck with claims against VIOXX,
accept this deal, then this is a NO DEAL.
Merck insists on an 85% acceptance rate
for this to take effect. Merck is smart in
wanting to put this fiasco behind them.
CMS Certification Continues
Reliable sources in Centers for Medicaid
and Medicare Services insist that the cer-
tification program will get into full gear
by Mid year (probably July) 2008.
Therefore if you want to participate in the
Medicare Part B program, and if you want
to stay involved in your state Medicaid
programs, you must get your pharmacy
certified for the Medicare Part B products
you dispense to patients. NCPA will
assist their members in obtaining certification which will cost several thousand dollars and will require it appears to be a biannual renewal. You can also become certified by other organizations, such as
NAPB if you wish. Contact your PSSNY
leaders for more information. NCPA
website is www.NCPANET.org, and the
NABP website is www.nabp.net.
Folks time to wrap this year end issue
up. Hopefully 2008 will be a better year
than 2007!
Happy New Year to one and all.
Jim Schiffer
©2007 James R. Schiffer
MEMBERSHIP APPLICATION—NEW YORK CITY PHARMACISTS SOCIETY
41 E. 11th Street, 11th Fl., New York, NY 10003
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This newsletter is published by the NYC Pharmacists Society as an exclusive service to its membership. The annual newsletter subscription
rate is $100.00. Unless specifically indicated as such, the views expressed in this publication do not necessarily constitute official positions
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© Copyright 2007 New York City Pharmacists Society. Under license from our collective authors. All rights reserved.
NYCPS NEWSLETTER
YEAR END 2007 PAGE 20