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Carey Potter Sueper, CPNP Government Affairs Consultant

The electronic version of this article provides online links to the many comment letters and bills referenced below.

Many things are in the works for CPNP Government Affairs. Most exciting is the planning of a “Comprehensive Medication Management (CMM) Hill Briefing.” A Hill briefing is a meeting set for members of Congress, their staff, and possibly representatives from federal agencies that would find relevance to the update. In the Briefing, our pre-selected panel of participants will provide insight as to how their CMM practice looks and works, and to give real-life examples to the audience. Because mental health issues are at the very forefront of many issues in front of Congress, the CPNP Board has allocated a minimal budget to allow a CPNP member practicing CMM, and his/her sponsoring physician, to join as participants on the panel. The date has not been set prior to this update going to print, however the May 10-16 timeframe is probable. Your ACCP/CPNP coalition is working with our lobbyist to secure one or two members of Congress who will agree to “host” us. This will be the very first public discussion about CMM and its ties to reimbursement under Part B. It is a very exciting time, and this Briefing will be a big step toward legislative success.

Also of interest on the Government Affairs front is the Partnership for Part D Access. CPNP has received verbal permission to join this coalition consisting of many stakeholders working together to protect patient access to Part D medications, amongst other concerns. More about the stakeholder partners is here.

In addition to the ACCP/CPNP CMM coalition and Part D Access, CPNP members and leaders continue to participate in issues and workgroups dealing with USP 797 and 800 and the Chronic Condition task force while simultaneously pursuing new opportunities to advance the practice. A summary of legislative issues is below.

CMM. Chronic Conditions Care. Payment Reform.

On March 23, HR 4878 was introduced by Representatives Paulsen and Welch. The bill proposes the “Better Care Program” to provide integrated care for Medicare Beneficiaries with chronic conditions. The bill was referred to the Energy and Commerce and also the Ways and Means Committees. The bill has an implementation deadline of no later than January 2019, requiring the Secretary to implement an integrated care delivery program. CPNP has reached out to sponsors previously, and as efforts are underway, the CPNP Government Affairs Committee will consider how to craft comments to incorporate CMM and clinical pharmacy services to the proposal. Your ACCP/CPNP Coalition continues to work on relationships with both Paulsen and Welch and to expedite implementation of any CMM services included as part of the legislation.

Also on our radar has been the Senate Finance Committee (SFC) task force efforts surrounding Chronic Conditions. Your coalition has been in contact numerous times with members of the SFC, and has responded to the Chronic Conditions Task Force twice. As the SFC looks at the impact of comprehensive care for patients with multiple chronic conditions, CPNP’s issues remain at the forefront of discussions. We have been assured that the ideas of “enhanced MTM” and “CMM” are the direction that reformation is headed. CPNP’s comments can be found on the website.  

Along the same lines of payment for CMM, earlier this month the Administration issued a press release in support of Alternative Payment Models (APM). The report cites the success that is being achieved in bundled payment and ACO models. Information about the CMS Better Care. Smarter Spending. Healthier People: Improving Quality and Paying for What Works can be found at

There has been ongoing discussion about whether payment reformation for pharmacy services should fall to Part D and the prescription drug reimbursement, or to Part B, as a Medicare service. CMS has efforts afoot to examine payment. Based on a MedPAC report, they are now pursuing a controversial overhaul. More about this, the report and opposition can be found here. The Rule announcement from CMS is here.

Mental Health. Integrated Behavioral Health

Much discussion about integrated behavioral health continues among members of Congress and SAMHSA. While not specifically identifying pharmacists as behavioral health providers, this is a good first step in addressing that physical and mental health treatment together improve outcomes and eventually saves money. In line with our CMM messaging about “getting the medications right,” the coalition continues to work this angle of including qualified clinical pharmacists wherever they can be relevant to improving patient outcomes. SAMHSA’s Integration Care report should be reviewed here.

Substance Use and Opioid Abuse

On March 10, the Senate approved S.524, the Comprehensive Addiction and Recovery Act (CARA), authorizing funding for evidence-based prevention treatment and recovery programs for patients with heroin and other opioid addictions. The bill passed with bipartisan support, 94-1, and moves to the House. Your ACCP/CPNP coalition remains in contact with supporters, as this effort is another example of how CMM with clinical pharmacists in the mix, could be useful.

Likewise SAMHSA has provided their Advisory document on buprenorphine and opioid addiction. While the HELP committee and others continue discussions around opioid abuse and addiction therapies, pharmacists are not immediately involved in the conversation.

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