Archive | September 2013

Walgreen’s Policy on Opioids Leaked to the Press; MSNJ Previously Sought Disclosure

This week a pharmacist employed by Walgreens in Indianapolis leaked the national drug store chain’s policy on filling prescriptions for painkillers. Earlier this year when MSNJ members complained that their patients were being denied refills for pain medications, we sought the policy directly from Walgreens so that we could assist our members who specialize in pain management and other physicians who treat patients with chronic pain. Walgreens would not disclose it to us, or others, based on internal policy. Walgreens did, however, represent that it would reach out to local pharmacies that were refusing to refill prescriptions written by our members.

MSNJ wrote to the Board of Medicine and the Board of Pharmacy alerting them to the situation and expressing our concern about patients being denied access to pain medication. We subsequently convened a panel of stakeholders, including a DEA special agent, former Assistant U.S. Attorney, the Administrator of the NJ Prescription Drug Monitoring Program and physicians who are addiction and pain management specialists, at a Policy & Strategy Panel meeting to find common ground, balancing the risks of diversion and overdose against the legitimate medical needs of patients. We also met with the New Jersey Pharmacists Association in an effort to develop a common guideline on which physicians and pharmacists could agree.  To develop a balanced guideline, we gathered information through a complaint form on our web site. This also allowed us ask Walgreens to reach out to local pharmacies that refused refills.

MSNJ is working with legislators and the Division of Consumer Affairs on legislation to improve the Prescription Drug Monitoring Program. With increased access to and use of the database by pharmacies, physicians and law enforcement, there should be less fear of opioid dispensing by pharmacies. In the larger context of the aim to reduce drug abuse and diversion, MSNJ is also engaging with legislators about proposals for more consumer notice about drug disposal.  We oppose proposals to mandate physicians to check the PDMP.

MSNJ is also working with the New Jersey Pharmacists Association to develop guidelines for pharmacy requests for information from physicians. If pharmacies must ask for information, physicians must have predictability on the scope and triggers of the requests.

Read more.

MNSJ is also partnering with the DEA to educate our members on best practices for opioid prescribing. Please be sure to attend this free event!

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Practice Alert! October 1 Notice Requirement under the Affordable Care Act

Employers covered by the Fair Labor Standards Act are required to provide notice to employees of the existence of the Health Insurance Marketplace (previously Exchange) by October 1. 

Any business with gross revenue of $500,000 or more is covered, so virtually all medical practices will be required to give the notice. Read the Department of Labor’s (DOL) FAQ. The DOL has two recommended forms, one for employers who provide health insurance and one for employers who do not provide health insurance. While some advisors have warned of a per day penalty for failure to report, there is no penalty. This notice is required by the labor laws even though other employer obligations to report and make payments under the Affordable Care Act have been delayed for a year.

Read the DOL guidance document. The purpose of the notice is to inform all employees  of the Health Insurance Marketplace; indicate if the employer plan’s share of the costs of benefits is less than 60% then the employee may be eligible for a premium tax credit; and that if the employee purchases a plan in the Marketplace that he/she may lose the employer’s contribution to the plan offered by it.

Practice Alert! October 1 Notice Requirement under the Affordable Care Act

Employers covered by the Fair Labor Standards Act are required to provide notice to employees of the existence of the Health Insurance Marketplace (previously Exchange) by October 1. 

Any business with gross revenue of $500,000 or more is covered, so virtually all medical practices will be required to give the notice. Read the Department of Labor’s (DOL) FAQ. The DOL has two recommended forms, one for employers who provide health insurance and one for employers who do not provide health insurance. While some advisors have warned of a per day penalty for failure to report, there is no penalty. This notice is required by the labor laws even though other employer obligations to report and make payments under the Affordable Care Act have been delayed for a year.

Read the DOL guidance document. The purpose of the notice is to inform all employees  of the Health Insurance Marketplace; indicate if the employer plan’s share of the costs of benefits is less than 60% then the employee may be eligible for a premium tax credit; and that if the employee purchases a plan in the Marketplace that he/she may lose the employer’s contribution to the plan offered by it.

Dense Breast Legislation Update

A bill which MSNJ has been working on in great detail requires insurance companies to cover certain screenings and requires physicians to provide information to  certain patients. The bill was amended this week so the lay letter that physicians must distribute to certain patients reads as follows: A facility that provides a mammography report pursuant to the federal Mammography Quality Standards Act, 42 U.S.C. s.263b, shall include the following information, at a minimum, in the mammography report sent to the patient and the patient’s health care provider:

“Your mammogram may show that you have dense breast tissue as determined by the Breast Imaging Reporting and Data System established by the American College of Radiology.  Dense breast tissue is very common and is not abnormal.  However, in some cases, dense breast tissue can make it harder to find cancer on a mammogram and may also be associated with a risk factor for breast cancer. Discuss this and other risks for breast cancer that pertain to your personal medical history with your health care provider.  A report of your results was sent to your health care provider.” You may also find more information about breast density at the website of the American College of Radiology, www.acr.org.”

In addition, three sections were added that would (1) clarify that the bill does not impose a standard of care obligation upon a patient’s health care provider (2) require the Mandated Health Benefits Advisory Commission to prepare a report regarding the implementation and administration of the bill, including analyses of social, medical and financial impact and (3) requires the Department of Health, in conjunction with the Medical Society of New Jersey, to convene a work group to review and report on strategies to improve the dialogue between patients and health care professionals regarding risk factors for breast cancer and breast imaging options.  MSNJ continues to work with legislators on this bill.