LTC Pharmacy News
January 2020
New Project: Health Policy Pro
Do you find Medicare and Medicaid health policy confusing? You're not alone. The payment rules for these major federal and state health programs are difficult to comprehend, especially when they are hidden in documents with hundreds of pages.
We're working on a website project to deliver bite-sized chunks of health policy tutorials directly to you. The goal is mastery of health policy one course at a time.

We're in the formative stages now, and hope to launch soon. If you want to keep up to date on our progress. Subscribe below.
From Elise Smith
It's now been a couple months since SNFs have been working under the new PPS model, the Patient-Driven Payment Model. Elise gives us more in-depth information and advice on how this model is changing the way SNFs operate and how we, as LTC pharmacy professionals, can help our SNF clients prosper. No one know this like Elise, so start reading now!
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Supreme Court Agrees to Hear PBM Case
The US Supreme Court agreed to hear an appeal from Arkansas related to a 2015 law requiring PBMs to be licensed by the state and allows state officials to review pharmacy contracts. 

The law was blocked by the Eighth Circuit Court of Appeals based on its conflict with the Employee Retirement Income Security Act. 

The court has not yet scheduled oral arguments
Federal Agency Updates
CMS Updates Part D Drug Spending Dashboard
CMS announced that the Part D Drug Spending Dashboard has been updated with 2018 data. As part of the update, the Dashboards now list prescription drugs in their first year on the market (in this case, drugs that were new in 2018). Under the previous methodology, it would take two years for a new drug to appear in the dashboard. This release also enacts changes that President Trump proposed in his budget by including information on prescription drug units that were paid for in Medicare Part B, but discarded.
HHS Appoints New CMMI Director
The Center for Medicare and Medicaid Innovation will have a new chief. Brad Smith, a former executive with Anthem, will lead the Innovation Center and be a special advisor to HHS Secretary Alex Azar for Health Innovation.
Current Flu Shot Not Very Effective
National Institute of Allergy and Infectious Disease Director Anthony Fauci tells CNN that the current flu vaccine is not as effective against the most common strain of flu as hoped. With a 58% effectiveness rate, the vaccine is mildly effective against the most common strain, but has a much higher effectiveness against the N1H1 strain.
Everything Else
Senior Living Occupancy Rates Stabilize in Q4
The latest updates from the National Investment Center for Senior Living and Care (NIC) reveals that senior living occupancy rates have stabilized during Q4 2019. Independent Living occupancy was 90.2% while assisted living remained even at 85.4%. Skilled nursing ticked up from 86.0% in Q3 to 86.3% in Q4. 

California Governor Wants to Start Drug Company
California Governor Gavin Newsom announced a proposal for the Golden State to create its own drug label in order to better manage the cost of prescription drugs for California citizens and, presumably, for programs like Medicaid.

Experts expressed skepticism, and the proposal hasn't been completely laid out, but the cost of prescription drugs continues to attract the attention of the public and shows no signs of slowing down.

Pharmacists Score High in 'Most Trusted' Poll
The annual Gallup Poll of most trusted professions puts pharmacists near the top, just below physicians and ahead of dentists. 

Nurses led the way, with 85% of respondents crediting them with high integrity and ethical standards.
Latest Employment Data Shows SNFs Shedding Jobs
The final employment report of 2019 reveals a relatively strong healthcare jobs market with the notable exception of skilled nursing facilities, which shed 6,700 jobs in December.

Analysts point to the impact of the new PDPM Medicare payment model as the primary reason.
SCPC Rolls Out Virtual LTC Pharmacy Tour
The Senior Care Pharmacy Coalition has unveiled a new tool in digital advocacy with the introduction of the Virtual LTC Pharmacy tour. According to SCPC Chairman Fred Burke, the virtual tool is another method for the LTC pharmacy industry to help break through the clutter of competing advocates in Washington DC and help the industry differentiate itself from other types of pharmacies with which policymakers may be more familiar.

Employers Having Second Thoughts about PBMs?
A report by the National Alliance of Healthcare Purchaser Coalitions suggests that employers are increasingly concerned about the lack of transparency surrounding the activities of PBMs. 

Employers are unsure whether they are benefitting from negotiated discounts and about the perceived waste in the system.