Friday, December 11, 2009

Data Mining

Two Democratic Senators are attempting to end data mining of prescription records in order to prevent excessive influence from drug companies into prescription writing by physicians.

The amendment to the Senate health care bill would effectively ban pharmaceutical data mining, the drug company practice of buying prescription records to target sales pitches to doctors.

Sens. Herb Kohl of Wisconsin and Dick Durbin of Illinois say the measure will combat "harassing sales practices" and "restrain undue influence" of pharmaceutical salespersons.

Crime Prevention

The National Community Pharmacists Association and RxPatrol have released a short video to train pharmacy staff about "some of the pharmacy crimes occurring across the country. It also details low-cost measures to protect pharmacies and explains the steps to take if a robbery or other crime occurs."

The video is on RxPatrol's website and can be directly accessed here.

Wednesday, December 09, 2009

High Regard

Gallup does annual polling on Honesty and Ethics of Professions.

Can you guess the top three spots?

Nurses, Pharmacists and Medical Doctors are the top professions believed to have high ethics.

Great news for health care professions and a sign that your opinion is valued. Use it wisely.

Monday, November 30, 2009

Uh Oh

Bad news out of Pittsburgh. This article addresses an automated system to fill prescriptions. The writer questions whether robotic systems should be adopted to cut costs and possible lawsuits.

Where do the savings come from? Your job being cut.

Currently only three few hospitals in the United States have purchased and installed the one million dollar RIVA platform. Apparently, this long term investment pays itself out after two years by trimming a few lower level pharmacist jobs, reducing the number of medication errors and potential medical malpractice lawsuits, reducing wastes of doses and batches and avoiding disastrous cross contaminations of fluids.

Perhaps people need to read the articles from the LA Times to learn that a pharmacist does more than move pills from a bigger bottle into a smaller one.

Continuing Article

The LA Times carries several articles regarding the role of pharmacists in healthcare. Here is another.

Evidence shows that when clinical pharmacists collaborate with physicians, they improve health outcomes. And with their extensive knowledge of available drugs, pharmacists can help to save money by using the most cost-effective ones.

"Traditionally, pharmacists have not been seen as caregivers, says Dr. Paul Gregerson, chief medical officer for the institute. "But these days, they fill a gap that has been left in the current healthcare system where physicians are so rushed."

Underutilized Role of Pharmacists

The LA Times has an article describing the important, if underutilized, role that pharmacists can and should play in healthcare.

Physicians wholeheartedly agree about the importance of the pharmacist's role. "Pharmacists know more about medications than anybody else in the healthcare system," Gregerson says. "That's what they went to school for. . . . They're like walking encyclopedias."

Monday, November 23, 2009

Happy Thanksgiving!

I want to take the opportunity to wish everyone a Happy Thanksgiving. No matter what, we all have things to be thankful for.

Tuesday, November 17, 2009

Follow Up on Nevada Pharmacy Case

Here is a more recent article regarding Sanchez v. Wal Mart Stores et al. I posted an article from the Wall Street Journal earlier.

I was interviewed by USA Lawyer's Weekly regarding this case recently and I will post the article when it is online.

My thoughts on the defense are different. Rather than saying that this would be a burden on pharmacists and that not all pharmacies have Internet access, the focus should be on the woman. If the state had time to put her on a list of people suspected of doctor shopping, why couldn't the state bring charges against her? Target the offender, not the pharmacists.

Friday, November 13, 2009

How Does This Happen? Twice!

What is going on at these manufacturing centers to allow this type of contamination?

Federal health regulators have found tiny particles of trash in drugs made by Genzyme, the second time this year the biotechnology company has been cited for contamination issues.

The Food and Drug Administration said Friday that bits of steel, rubber and fiber found in vials of drugs used to treat rare enzyme disorders could cause serious adverse health effects for patients.

Department of Justice Crackdown

The Department of Justice is warning drug companies that the DOJ is investigating them for corruption. The DOJ will be primarily focusing on foreign dealings.

The U.S. Justice Department plans to focus on prosecuting those in the pharmaceutical industry who try to bribe foreign officials for preferential treatment of their products, a senior official said on Thursday.

The department has been examining fraud and corruption in the healthcare system as part of the overall Obama administration drive to overhaul the system and reduce skyrocketing costs.


Another Wrinkle in the CVS-Caremark Story

The Wall Street Journal had an article in yesterday's paper reporting another wrinkle in the CVS-Caremark story.

Coventry Health, which is moving more than $1 billion a year worth of pharmacy-benefits-management business from CVS Caremark to a rival PBM, accuses the company of wrongfully paying hundreds of thousands of dollars or more in prescription drug claims.

The Coventry Health account is one of several "big client losses" amounting to a net $4.8 billion in erased business for next year that CVS Caremark discussed with investors last week. While investors already knew about some of the lost accounts, including Coventry, there were more than expected, and CVS stock swooned on renewed concerns about the company's hybrid drug retailer-PBM business model.

In a breach-of-contract lawsuit filed against CVS Caremark in September and moved to a U.S. district in Tennessee last month, Coventry alleges that Caremark incorrectly paid numerous drug claims to Coventry members that it should have denied.


Mississippi Court Ruling

Here is a story from Mississippi regarding Medicaid rates for pharmacists.

Mississippi Medicaid officials should have asked the Legislature for approval before tinkering with a law that would change reimbursements for pharmacists, the state Supreme Court has ruled.

The Supreme Court on Thursday upheld a chancery judge's ruling that the Division of Medicaid had no authority to change how pharmacists were paid to fill prescriptions for people enrolled in the program.

Justice Randy Pierce, writing Thursday for the Supreme Court, said while the courts usually bow to agencies on issues or rules and regulations, Medicaid officials acted outside their authority.

Thursday, November 12, 2009

Compliment

I noticed this blog today. It praises my website. The blog is "dedicated to showing off the very best business law website designs from around the Country."

I welcome the compliment.

Speaking of my website, it is newly re-launched with new pages and some new layouts. I hope you like it.

Salary Discrimination

Some people have asked me whether employers can prevent you from disclosing your wages. The short answer is- No.

According to Michigan law, an employer cannot prevent you from disclosing your wages as a requirement of employment. Included is requiring you to sign a waiver denying your disclosure rights. Neither can an employer fire, punish or discriminate against advancement for employees who disclose their wages.

The importance of these rules is to prevent pay discrimination between employees based upon age, sex or race. In my most recent newsletter, I address a pay discrimination case out of Massachusetts. The woman involved in the case received a $2 million award because Walmart paid her less than her male colleagues.

Newsletter

For those who haven't received it, the newest Pencak Report is in the mail. You can also access it via PDF on my newly re-launched website.

If you are not on the mailing list for my newsletter, please send me an email at cpencak@pharmacylawpro.com with your name and address so that you can join the mailing list.

Tuesday, November 10, 2009

Sheepdogs Back on Duty

I was hoping that a Democratic President could change the culture of the executive agencies that had neglected their responsibilities to protect the public from predatory monopolistic corporations for more than eight years. I was beginning to lose hope. Then the following news was released.

CVS Caremark has come under criticism from various groups and lawmakers who have asked the FTC [Federal Trade Commission] to review the nearly $27 billion merger of a major drug-store chain and large pharmacy benefits manager that formed the company in March 2007.

In June, the FTC said it was referring to its Bureau of Competition a national independent pharmacists group's concerns that CVS Caremark's pharmacy-benefits-management operation, or PBM, had improperly shared patient information with the company's retail side to steer customers to CVS stores, to the detriment of competitors and customers.

The National Community Pharmacists Association called on the FTC to reopen the CVS Caremark merger, claiming the company engaged in anticompetitive behavior. State legislators and members of Congress this year also asked the FTC for a review.

In May, the National Legislative Association on Prescription Drug Prices, a nonprofit directed by state legislators, encouraged the FTC to open an investigation into CVS's acquisition of Caremark Rx "and the activities and conduct of the firm since the merger." The legislative group said CVS Caremark's conduct threatens to harm consumers by increasing prices and decreasing service and convenience.

While community pharmacists and lawmakers voice concerns that CVS Caremark has improperly wielded its power as a combined drug retailer and PBM, the company has had trouble keeping and winning PBM clients, a situation made clear Thursday as Chief Executive Tom Ryan said the company had some "big client losses" for 2010.

The client news sent CVS shares down nearly 21%, or $7.50, to $28.65, and left some Wall Street analysts questioning the company's retail-PBM business model.
Whether or not CVS Caremark is guilty of the allegations is to be determined. But I am greatly encouraged to see the FTC is back in the business of investigating violations of predatory corporate activities.

I has always struck me as inherently objectionable when a fox is allowed to guard a chicken, much less over the entire chicken coop. We citizens are essentially sheep at the mercy of large corporate wolves. It is a delight to see that sheepdogs are back.

HPRP Provider

I recently had lunch with Dr. Bruce Baker of West Brook Recovery Center in Grand Rapids—an HPRP provider. Dr. Baker is a fascinating person and genuinely cares about the best results for his patients and health professionals.

Dr. Baker told me about the increased usage of prescription drugs among high school students. Although illicit drug usage has fallen among high school students across the country, 15.4% of 12th graders have abused prescription drugs within the past year. The most popular drugs are Vicodin, amphetamines, tranquilizers and sedatives. The majority admit to obtaining the drugs from a friend or relative and only 20% admit to purchasing from a dealer or stranger.

Perhaps reminding patients to secure their prescription drugs at home as a routine part of your counseling may decrease availability of drugs to youth.

Lucrative Business Plan?

Veterinary drug filling could be a lucrative opportunity for pharmacies. If you wish to research this opportunity further, I would be happy to work with you.

Generic Tamiflu

An interesting scenario could unfold if the H1N1 outbreak worsens. NPR reports that the CDC is open to importing generic Tamiflu, named Antiflu, made in India. However, Tamiflu is under patent in the United States until 2016. Would the government override this patent if the outbreak worsens and Tamflu shortages persist?

Prescription Disposal

I know that the Wayne County Pharmacists Association has done some work to reach a solution to disposal of prescription drugs in Michigan. Here is an article about Iowa's new plans.

Thursday, October 29, 2009

Pharmacy Liability Case

This blog post is from the Wall Street Journal. It addresses whether a pharmacy in Nevada is liable for the actions of a patient who abused pharmacy drugs. The pharmacies in the area were sent a letter warning them of this particular woman. Does this knowledge hold them liable?

A lawsuit filed by the victims and their families against Wal-Mart, who dispensed a painkiller prescription to Copening, asks whether drugstores must use information at their disposal to protect the public from potentially dangerous customers. In this case, state officials had sent letters to 14 pharmacies in the Las Vegas area warning that Copening could be abusing drugs.

Must Read from the Washington Post

As mentioned in my newsletter, this article is from the October 29, 2009 edition of the Washington Post. It is entitled, "DEA Crackdown Hurts Nursing Home Residents Who Need Pain Drugs".

Heightened efforts by the Drug Enforcement Administration to crack down on narcotics abuse are producing a troubling side effect by denying some hospice and elderly patients needed pain medication, according to two Senate Democrats and a coalition of pharmacists and geriatric experts.

Tougher enforcement of the Controlled Substances Act, which tightly restricts the distribution of pain medicines such as morphine and Percocet, is causing pharmacies to balk and is leading to delays in pain relief for those patients and seniors in long-term-care facilities, wrote Sens. Herb Kohl (D-Wis.) and Sheldon Whitehouse (D-R.I.).

The lawmakers wrote to Attorney General Eric H. Holder Jr. this month, urging that the Obama administration issue new directives to the DEA and support a possible legislative fix for the problem, which has bothered nursing home administrators and geriatric experts for years.

Monday, October 26, 2009

Alabama Supreme Court Case

In my upcoming newsletter, I address this Supreme Court case out of Alabama regarding the "learned intermediary" doctrine.

H1N1 Outbreak Tracking

Rhode Island is the first state to use electronic prescriptions to track outbreaks of the H1N1 virus.

"Surescripts is using information supplied by pharmacies to document how much Tamiflu and other antivirals are being dispensed to patients. The company is giving the data — categorized by zip codes of the pharmacies where the medicine is dispensed and the age group of the patient receiving it — to epidemiologists at the state health department."

American Pharmacy Educator Week

It is the inaugural American Pharmacy Educator Week. Celebrate the people that helped get you to where you are today.

DME

Here is a news story out of Montana regarding the official signing of the DME accreditation delay. I addressed this bill in a couple previous postings as well as my upcoming newsletter.

"Tester argued that the accreditation process can be expensive and time consuming for community pharmacies that are often the only option for seniors in rural communities. He also argued that accreditation is redundant, as pharmacies are already subject to oversight and regulation as medical professionals and as state-licensed businesses."

CVS GreenBag Tag

CVS is starting a program to reward users for turning down bags or using reusable bags. More information can be found here.

You know I'm in favor of moves that will protect trout habitats.

Prescriptions for OTC Decongestants?

As the meth problem continues, some communities are responding by requiring prescriptions for all medicines containing pseudophedrine. Oregon has a state-wide law and now a town in Missouri has passed a law locally requiring a prescription.

"The new law's critics include the Missouri Medical Association, Missouri Retailers Association and the Missouri Pharmacy Association. Many in the pharmacy industry say such laws will make it more difficult and expensive for those who are sick to get relief."

Friday, October 23, 2009

Donating Cancer Drugs

This is a helpful development for those who cannot afford cancer drugs.

Here is a link to Michigan's guidelines for its Cancer Drug Repository.

Continued Fight against Meth

The news lately is filled with communities and states trying to fight meth through tracking pseudophedrine purchases. It seems like it won't be long until a stricter federal law is enacted.

In August, Democratic Sen. Ron Wyden of Oregon drafted federal legislation calling for a nationwide prescription mandate for pseudoephedrine; he said he planned to introduce it this year. The White House Office of National Drug Control Policy, which establishes policies and priorities for drug-control programs, is examining Oregon's law, though it hasn't taken a position on it.

Thursday, October 22, 2009

A Bill Threatening Wisconsin's Pharmacists

Here is another example of "big box pharmacies" driving independent pharmacists out of business. Obviously the "big box pharmacies" receive more income from other sales and can afford to sell prescriptions for lower prices.

Monday, October 12, 2009

Newsletter Announcement

I know it has been delayed, but the Fall 2009 newsletter is almost finished. It is in the final editing stages and will be going to the printer later this week.

We will also be posting an electronic PDF on my website soon so you can read it there too.

I hope you enjoy it as much as I've enjoyed writing it.

Georgia Pharmacy Audit Bill of Rights

Here are a couple links to the Georgia Pharmacy Audit Bill of Rights. I discuss the importance of this bill as an initial step in my latest newsletter.

Here is a link to a website with the text of the bill.

Here is a link to a savable or printable version of the bill.

A Fine Editorial

From the Hartford Courant, comes this editorial by Pharmacist Robert Bradley.

"Anyone who values having the option of going to a local independent pharmacy and dealing with a pharmacist who knows you personally and has the time to discuss your prescription needs should contact their state legislators and the governor's office and ask them to support small pharmacies by reconsidering this new state law on self-insurance."

And First off the Line is...Iowa

Iowa is making great strides in converting to electronic prescriptions.

"Iowa's largest integrated health care system and the nation's largest provider of electronic prescribing software today announced the launch of an initiative to convert a majority of the state's physicians from paper prescriptions- known to be the cause of costly medical errors- to electronic prescribing."

Liberty is not a Popularity Contest

This is a frightening precedent for civil liberties.

I have to agree with dissenting Judge Karen Nelson Moore, who wrote,

"I cannot think of any other circumstances where we have endorsed an invasion of a person's privacy with so few facts from which to draw an inference that the intrusion would likely uncover evidence of a crime."

U.S. District Judge Janet Neff wrote,

"There is no such things as a fair-weather Constitution, one which offers the harbor of its protections against reasonable search and seizure only in palatable contexts and only to worthy defendants."

Constitution liberties are not subject to popularity contests. Law enforcement has an innate tendency to expand its jurisdiction like a wildfire in the wind. Judges must be a firebreak to prevent harm and humans being consumed by that fire.

Judges must steel themselves against all-too-human, inner emotions and exercise mental discipline.

It is precisely where a defendant is unpopular or reviled that calm and levelheaded thinking in a judge is most required.

While this case involves the repugnance of child pornography, the law of this case will soon be applied to other searches for any alleged crimes. This holding is not limited to child pornography cases. Anything you ever searched is on a computer today.

Friday, October 09, 2009

Generic Replacements

The Alabama Attorney General has stepped in to prevent district attorney suits against CVS, Walgreen, Wal-Mart and Rite Aid. The attorneys allege that these pharmacies filled prescriptions with generic drugs, even when doctors did not specify the use of generics.

The district attorneys claim the Alabama AG is protecting big business and vow that voters will remember this in the next election.

"If that's the position he wants to take, good luck in the next election," said District Attorney Arthur Green of Jefferson County's Bessemer Division.

Thursday, October 08, 2009

Follow H.R. 3663

You can follow the status of the DME Bill here.

Interesting Case

The Washington Post has an interesting story about World War II era war bonds. Several states have filed a suit against the Treasury Department seeking the repayment of war bonds. However, if the owners of relatives of these war bonds cannot be found, then the states stand to collect the money. This is interesting to the states in these difficult times.

The case should be an interesting Constitutional law issue.

Pro Bono Requirement

I see that the University of Michigan Law School is asking students to pledge to do at least 50 hours of pro bono work. Wayne State University and Cooley Law students volunteer their time also. I think the work done by the students will be an excellent asset to the community, especially in these difficult times.

Wednesday, October 07, 2009

DME Medicare Delay

For those concerned about the durable medical equipment accreditation Medicare deadline for pharmacies, a bill is awaiting signature by President Obama to push back the deadline until December 31, 2009. It has already been passed by the House and Senate.

"The Senate acted wisely to ensure seniors can continue purchasing essential medical supplies from their community pharmacies. Without it, thousands of independent community pharmacies would be forced to stop supplying diabetes testing supplies and other products to their patients." Bruce Roberts, National Community Pharmacists Association EVP and CEO



National Pharmacy Week

Remember that National Pharmacy Week is October 18-24 this year.

What will you do to celebrate your profession?

Thursday, July 23, 2009

Lack of Updates

I apologize for a lack of updates lately, but I have been swamped at work recently.

However, I continue to work on the latest newsletter, changes to the website and another big project.

I look forward to sharing with you thoughts and the latest news on pharmacy law.

Tuesday, July 14, 2009

Health Care

When I graduated from WSU College of Pharmacy, I was skeptical of the HMO concept and, in particular, the promise that a health insurance company would actually try to maintain health under a capitation system. I figured the insurance company would try to provide as little service as possible to the patients and increase profit to the maximum. In the transpiring years, I have seen nothing to dissuade me from that viewpoint.

When I graduated, national health care was pejoratively called "socialized medicine" and was portrayed as "un-American", or at the very least, "French".

It did not take me too many years as a lawyer and pharmacist to see that the United States of America should have established national health care under a single-payer model 40-years ago, based upon the Medicare system or VA.

We are long overdue to have national health care and I am afraid that it may be too late, even now. The Senate, in particular, is owned by insurance companies and drug makers. We will hear a lot of canards and scare talk about single-payer and the problems it will cause, but it is clearly a smoke screen to preserve the tremendous profits made by insurance companies.

The biggest canard is the claim that in a single-payer system, government bureaucrats will make health care decisions for individuals. This contrasts with our current system in which an insurance employee makes health care decision for individuals- with profit maximizing in mind.

As a pharmacist, who would not agree that having one claim form and only one payer to deal with is infinitely preferable to applying for, being audited by and verifying coverage with 70 or more private insurance companies.

There is no free market anywhere on the planet and there never was. The reality of the matter is an individual citizen has no bargaining power versus an insurance company. Currently, we use private health insurance companies as middlemen, creating huge profit centers. Would it not be much less costly to use a government agency, such as Medicare, administering the system with employees who are paid a fixed salary?

I think this is an excellent time to start downsizing our military and intelligence expenditures and start spending it on health care for all of us. We have passed the point of diminishing returns on national defense. Currently, 21% of the national budget goes to the military-industrial complex. Yet, we are no safer and our perception of power is a drug that encourages Presidents to inject our forces into regions and problems that are insolvable by force and extremely expensive.

The Medicare system and VA system can be improved and they are capable of providing excellent administration for a single-payer national health care system. Will it happen? I honestly don't think it will, even though it makes total sense and is really needed. I think a watered-down and consequently doomed bill will pass. And then, the opponents to national health care will say they were right when the doomed plan fails.

I sure hope I am wrong about this prediction.

Monday, July 13, 2009

New Posting Soon

A quick note- I will post a new article shortly.

It will address some of my thoughts on the current health care debate.

Monday, June 29, 2009

Newsletter Sign Up

We are preparing the newsletter and preparing the delivery system for emailing it.

Just a reminder to send you name, address and email to cpencak@pharmacylawpro.com to receive a copy of the newsletter.

Wednesday, June 24, 2009

Newsletter Ideas

I am preparing a new newsletter to be ready in July.

Are there any topics that readers would like to see covered? Any new developments in pharmacy which you would like to see addressed?

If you have any ideas, please send me an email with it at cpencak@pharmacylawpro.com

Thursday, June 18, 2009

Planning for the Future

I will probably speak more about this topic in my upcoming newsletter, but I want to remind everyone of the importance of planning for the future. We all work so hard to provide for our families. Yet, we don't spend the time to plan for the "What if?".

I urge everyone, especially pharmacists who might be "too busy for death", to spend some time and ensure your families future.

Monday, June 15, 2009

Newsletter

The office has been so busy lately and fly fishing season has arrived.

Nevertheless, I am working to put out a new newsletter for this summer. It will probably be distributed solely online through email and posted on my website.

Email me at cpencak@pharmacylawpro.com to ensure that you are included!

Updates to my Website are Coming

I am working on the language and design to update my website.

We hope the updates will improve the experience and use of the website to better serve you.