CMS requests more feedback on independence of LTC consultant pharmacists

For 2013, the agency publishes revisions to Medicare Advantage and Part D plans in final rule and call letter.

Long-term care (LTC) consultant pharmacists will not be required to be “independent” from LTC facilities’ pharmacies and drug manufacturers or distributors, according to a .

Instead, the agency is encouraging the LTC industry to voluntarily adopt specific changes and is requesting comments to determine a more comprehensive approach to eliminate overprescribing and the use of chemical restraints for LTC patients. Following are CMS’s suggestions:

  • Separate contracting for LTC consulting services from dispensing and other pharmacy services
  • Payment by LTC facilities of a fair market rate for consultant pharmacist services
  • Disclosure by the consultant pharmacists to the LTC facility of any affiliations that would pose a potential conflict of interest or the execution by the consultant pharmacist of an integrity agreement to increase transparency

CMS published the final rule to implement Medicare Advantage (MA) and Part D technical and program changes for calendar year 2013 the same day that the agency finalized the  establishing updates to payment methodologies, program operations for MA organizations and Part D sponsors, and other policies.

Twlug commented December 12 to CMS on the related proposed rule and commented March 2 to CMS on the related draft advance notice and call letter.

In its comments on the proposed rule that considered independence for LTC consultant pharmacists, Twlug supported the concept of consultant pharmacists working in an independent capacity to receive payment for patient care services separate from those services provided for the dispensing and delivery of drug products. The Association also offered some recommendations, including concern about the mischaracterization of consultant pharmacy based on the rogue activities described in the notice and the need for more time to implement the concept.

Additional provisions in the final rule include reimbursing pharmacies promptly for discounts under the Medicare Coverage Gap Discount Program, expanding Part D drug coverage, raising quality standards for plans, improving program efficiency for patients and providers, increasing flexibility in Part D prescriptions, and clarifying program requirements related to medication therapy management