JUNE 2010

Skin Care is Key to Fun in the Sun

The Official PublicationOf The Florida Pharmacy Association

2 | F l o r i d a P h a r m a c y T o d a y

J U N E 2 0 1 0 | 3

Vol. 73 | No. 6JUNE 2010 ThE oFFicial PUblicaTioN oF ThEFlorida Pharmacy associaTioNP H A R M A C Y T O D A Y

florida

Departments 4 calendar

4 advertisers

5 President’s Viewpoint

8 Executive insight

29 buyer’s Guide

Featuresskin care is Key to Fun in the sun

Pharmacy Time capsule 2010

What to Expect from the oil spill and how to Protect your health

20

21

22

4 | F l o r i d a P h a r m a c y T o d a y

E-mail yoUr sUggEstioNs/idEas to

dave@fiorecommunications.com

Mission Statements:of the Florida Pharmacy Today JournalThe Florida Pharmacy Today Journal is a peer reviewed journal which serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic is-sues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congru-ent with its expressed mission.

of the Florida Pharmacy Today boardof directors The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capac-ity to the managing editor and executive editor of the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Associa-tion members to secure appropriate advertising to assist the Journal in its goal of self-support.

AdvertisersHeAlTHcAre consulTAnTs ....................... 3KAHAn ◆ sHIr, P.l. ........................................ 11PPsc ..................................................................... 6PHIlADelPHIA college ............................. 12rx relIeF ......................................................... 11

2010

FPA Calendar JUNE

30 –7/4 FPA AnnuAl Meeting And Convention

Marco Island Marriott

JUly

5 FPA oFFiCe Closed indePendenCe dAy

10 – 14 AACP AnnuAl Meeting

Seattle, Washington

30 FPA legislAtive CoMMittee Meeting

Orlando, Florida

30 – 1 FsHP AnnuAl Meeting

aUgUst

6 – 8 soutHeAstern oFFiCers ConFerenCe

New Orleans, Louisiana

8 – 11 27tH AnnuAl soutHeAstern eduCAtionAl gAtHerin

Hilton Sandestin Beach

10 – 11 BoArd oF PHArMACy Meeting

Crowne Plaza Orlando Airport

15 – 17 nABP distriCt 3 Meeting

Blowing Rock, North Carolina

28 – 29 FPA CounCil, CoMMittee And BoArd Meetings

Marriott Orlando Airport

sEptEmbEr

1 deAdline For noMinAtion For FPA President eleCt And regionAl direCtor oFFiCe

6 lABor dAy

FPA Office Closed

11 – 12 FPA CliniCAl ConsultAnt ConFerenCe

PGA National Resort, Palm Beach Gardens

octobEr

2 - 3 FPA MidyeAr CliniCAl ConFerenCe

Renaissance Orlando Airport

23 – 27 nCPA AnnuAl Meeting

Philadelphia, Pennsylvania

NovEmbEr

6 - 7 FPA CoMMittee And CounCil And BoArd Meetings (By ConFerenCe CAll)

cE crEdits (ce cycle)The Florida Board of Pharmacy requires 10 hours lIVe continuing education as part of the

required 30 hours general education needed every license renewal period.Pharmacists should have satisfied all continuing education requirements for this biennial

period by september 30, 2011 or prior to licensure renewal.*For Pharmacy Technician certification Board Application, exam Information and study

materials, please contact ranada simmons in the FPA office.For More Information on ce Programs or events:contact the Florida Pharmacy Association at (850) 222-2400 or visit our Web site at www.

pharmview.com

coNtactsFPA — Michael Jackson (850) 222-2400FsHP — Michael McQuone (850) 906-9333u/F — Dan robinson (352) 273-6240FAMu — leola cleveland (850) 599-3301nsu — carsten evans (954) 262-1300

disclaimEr Articles in this publication are designed to provide accurate and authoritative information with re-spect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association are engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

For a complete calendar of events go to www.pharmview.com

J U N E 2 0 1 0 | 5

I began the process of becoming FPA treasurer for the second time by penning the following position

statement. I will now examine whether the issues listed are still pertinent and if so, what has been done to address them.

candidate position statementI served as treasurer of the FPA a de-

cade ago. At that time, I stated that as cultural, economic, or technological en-vironments change so must organiza-tional design change to keep pace and that those same dynamics may also im-pact an organization’s financial posi-tion.

At that time, many state pharma-cy associations, historically considered bastions of independent pharmacy owners, were experiencing the reality of the marketplace. As the number of independent pharmacies dwindled; so too did monetary contributions above and beyond membership dues for legal and political action purposes. That con-tinues to be true today.

We were also beginning to experi-ence a decrease in donation and grant dollars from the pharmaceutical in-dustry as mergers and consolidations were taking place; dollars that helped support functions that took place at our annual meeting. Those dollars will continue to decrease as PhRMA’s new voluntary code of conduct will begin to change how the industry will mar-ket drugs.

Today, we are faced with another re-ality of the marketplace, the loss of the retrospective DUR program brought about by the state changing its fiscal in-termediary. Thus, we must now go for-ward with significantly less non-dues

revenue than we were accustomed to. We need to reevaluate our financial dynamics. Until we can identify new sources of revenue consistent with the association’s mission statement, we must operate on a much tighter budget.

issue Examination ■ The marketplace changes have con-

tinued to erode the independent practitioner base, particularly here in Florida. According to NACDS statistics, independent drug stores only accounted for 21 percent of Florida pharmacy permittees in 2005. Whereas the percentage in other large states were: 44 percent

in New York, 39 percent in Tex-as, and 35 percent in California. By 2007, those numbers had dropped to: 18.7 percent in Florida, 27.9 per-cent in Texas, and 33.8 percent in California. However, they increased in New York to 46.9 percent.

■ While there are still some donation and grant dollars available from the pharmaceutical industry, obtain-ing those dollars has become very difficult. Additionally, as the phar-maceutical industry has shifted it marketing to direct-to-consumer advertising, the dollars associated with exhibits at our annual meeting has also declined. We may eventu-ally reach point where the funding for the annual meeting will come exclusively from registration dol-lars.

■ As to non-dues revenue, we have not yet identified a program or pro-

Florida Pharmacy Association Financial Report Card

The President’s ViewpointgUEst colUmNist doN bErgEmaNN, rph, mba

As the number of independent

pharmacies dwindled; so too

did monetary contributions

above and beyond membership dues for

legal and political action purposes.

That continues to be true today.

don bergemann, rph, mbaFpa treasurer

6 | F l o r i d a P h a r m a c y T o d a y

The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work deligently all year long on behalf of our members.

Norman Tomaka ....................................Chairman of the Board of DirectorsKaren Whalen ..............................................................................................FPA PresidentHumberto Martinez ...................................................................FPA President ElectDon Bergemann ....................................................................................................TreasurerAlexander Pytlarz .................................Speaker of the House of DelegatesDean William Riffee ..................Vice Speaker of the House of DelegatesPreston McDonald, Director ...........................................................................Region 1Marcus Dodd-o, Director .................................................................................Region 2Al Tower, Director .................................................................................................Region 3 Raul N. Correa, Interim Director ................................................................Region 4 John Noriega, Director ......................................................................................Region 5 Chris Lent, Director ..............................................................................................Region 6Kim Murray, Director ........................................................................................... Region 7Joy Marcus, Director...........................................................................................Region 8Ayala Fishel, Director ..........................................................................................Region 9Peter Iafrate ............................................................................................ President FSHPMichael Jackson .......................................Executive Vice President and CEO

Florida pharmacy today Journal board

Chair Designate ...................................... Betty Harris, beejpharm@gmail.comTreasurer ...................Stephen Grabowski, sgrabowski@seniormmc.comSecretary ..................................................................Stuart Ulrich, Stuarx@aol.comMember ............................................................ Don Bergemann, don@bceinfo.comMember ................................................Joseph Koptowsky, docjik1215@aol.comMember ..............................................Jennifer Pytlarz, jlc_rxdoc@hotmail.comExecutive Editor ...............Michael Jackson, mjackson@pharmview.comManaging Editor ..................Dave Fiore, dave@fiorecommunications.com

2009/2010 Fpa board of directors grams to replace the retrospective DUR program. We did conduct a fa-cilitated ‘think tank’ forum to dis-cuss potential sources on March 27. Once we receive the written report of that forum, we will begin evalu-ating the potential of the ideas put forth.

Financial healthRight now, in the absence of the DUR

program, our primary revenue sources are dues income and continuing edu-cation programming. Those sources of revenue cannot sustain this association and its sizable advocacy campaigns, at the current service level, over the long-term. In order to maintain the current service level, we must increase mem-bership. It is imperative for all current members to recruit new members for this association.

For calendar year 2009, this associ-ation’s board of directors approved a deficit budget. Fortunately, due to sig-nificant cost cutting and a better than forecast year in terms of continuing ed-ucation revenue, we ended up in the black. Again this year, 2010, the board of directors approved a deficit budget. However, this year, it will be very dif-ficult, if not impossible, to end on the positive side.

Thus far, we have avoided tapping into the association’s long-term re-serves. How long we can continue to do so will depend on how effective the membership is in recruiting new mem-bers.

JOIN TODAY!

Florida Pharmacy Association

The concrete bricks are 4x8 and can be engraved with up to 14 characters per line, three lines available, spaces and punctuation count as one character. Please fi nd enclosed my check for $_________ for _________ bricks.

PLEASE PRINT: Please charge my ❑ Master Card ❑ Visa

CARD # EXP. DATE

AUTHORIZED SIGNATURE

NAME

ADDRESS

CITY STATE ZIP

PHONE (W) (H)

O R D E R F O R M

Send to Florida Pharmacy Foundation, 610 N. Adams St., Tallahassee, FL 32301,or fax to (850) 561-6758.

Contributions to the Florida Pharmacy Foundation are tax deductible as a charitable contribution for federal income tax purposes. Consult your CPA for complete details. Fed Emp. I.D. #59-2190074

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-435-7352 WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE.

The Walkway of Recognition

❑ YES, I want to order _______ concrete brick/s at $250.00 each. (Please copy form for additional inscriptions).

Have you been searching for just the right gift or thought of placing your name in perpetuity? If so, then consider purchasing an engraved brick for you or someone else.

The main sidewalk at the Florida Pharmacy Association needs replacing. The Florida Pharmacy Foundation has undertaken the project to repair and beautify the sidewalk with engraved personal bricks purchased by pharmacists or friends of pharmacy.

Engraved 4x8 bricks can be purchased for $250.00 each with the donor’s name engraved (3 lines available) or you could also purchase an engraved brick for someone you feel should be honored or remembered.

The monies earned from this project will be used to fulfi ll the goals and future of the Foundation. There are a limited number of bricks available – so, it is fi rst come fi rst served.

PLEASE PRINT INSCRIPTION

THE WALKWAY OF RECOGNITION

YOUR NAME HERE

FPA OFFICE

FoundationAdBrickes.indd 1 12/23/08 9:44:48 PM

DeaDline:

July 15

8 | F l o r i d a P h a r m a c y T o d a y

Financial statementsThe table below contains a comparative summary of our

Statements of Financial Position as drafted by the Associa-tion’s auditors.

assets2009 2008

Cash & cash equivalents $ 996,745 $ 904,579

Investments $ 722,562 $ 655,604

Accounts receivable $ 3,967

Net property & equipment $ 127,389 $ 128,656

Total assets $1,846,696 $1,692,806

liabilities & net assets2009 2008

Accounts payable $ 5,317 $ 6,178

Accrued expenses $ 41,568 $ 31,444

Deferred revenue $ 234,931 $ 200,232

Net assets (unrestricted) $1,515,516 $1,405,588

Net assets (temporarily restricted) $ 49,364 $ 49,364

Total liabilities & net assets $1,846,696 $1,692,806

KudosThere is good news that the membership needs to know.

Even though we have slashed our expenses by 27 percent and considerably reduced staff, we are still providing the same if not more services and products to the members. Our mem-bers still have access to 12 monthly issues of Florida Pharma-cy Today and are recipients of numerous electronic newslet-ters with current information on the profession and business of pharmacy. The majority of the dues that you pay for mem-bership go toward offsetting the costs associated with advo-cacy before the Florida Legislature and representation before the Board of Pharmacy and other regulatory agencies.

Nearly 100 percent of your PACCE contributions support-ed political campaigns and candidates who understand our profession and our business. While we are far from our PAC-CE fund raising goal, we have strategically placed our sup-port where it would do the most good. We are also beginning to see renewed energy and interest in our legislative cam-

paigns, and our self- funded health fair and legislative day events in Tallahassee were a huge success. Our wins could be significantly greater if you, the member, will reach out and touch those colleagues who are not part of our family.

I want to thank the members of this year’s Budget & Fi-nance Committee for their dedication and insights.

■ Michael Mone’, Vice-Chair ■ Norman Tomaka, Board of Directors Chair ■ Karen Whalen, President ■ Bert Martinez, President-Elect ■ Alexander Pytlarz, Speaker of the House ■ William Riffee, Vice-Speaker ■ Preston McDonald ■ Suzy Wise ■ Mike Bonkowski, student ■ Michael Jackson, Executive Vice President/CEO

Final thought As you may have noted, I mentioned membership more

than once above. Let me share with you the philosophy of a pharmacist that influenced me as a student. He stated that “membership in your state pharmacy association is the price you pay to be a professional.” While those of you who are reading this are believers in what the FPA is doing, I find it disturbing that the majority of Florida pharmacists do not share that philosophy. ■

Thus far, we have avoided tapping into the association’s long-term reserves.

How long we can continue to do so will depend on how effective the membership

is in recruiting new members.

TiCKeTS $20 eaCH OR 3 FOR $50

TiCKeTS SOlD aT BOOTHS 13-14

FPA CONVENTION MARCO ISLAND JUNE 30-JULY4 2010

WIN AN iPAD, Wii OR LAPTOP COMPUTER

J U N E 2 0 1 0 | 9

Fpa advocacy EffortsAt the heart of professional organi-

zations is the need to provide input to state and federal policy makers. The Association wishes to give thanks to our legislative consultants Lori Weems, Manny Prieguez and their staff for their tireless efforts to work our is-sues before the House, Senate, Board of Pharmacy and Governor’s Office. We also would like to thank the staff at Pharmacy Provider Services Corpora-tion for their assistance with the Med-icaid funding issue. In the past, our policywork has concentrated on the Florida Legislature and various state agencies that regulate the profession and business of pharmacy. Perhaps the most compelling issue that we found in this election year is the host of bills that were filed that were not approved. This is not unusual given the upcom-ing election season with a large candi-date pool and incumbents seeking re-election. As we go to press with this report, the Governor has made a de-cision on most of the legislation that passed. We should have more cur-rent information available at the annu-al meeting.

On occasion, members may ask why the FPA continues to monitor issues with Medicare and Medicaid. It is very important that we all understand how pharmacy services are reimbursed. In Florida, this state will spend $8 billion providing health care access to the 2.7 million citizens of this state that are Medicaid eligible. The federal govern-ment will kick in an additional $11 bil-lion. If you look at Medicaid and Medi-care it is quite obvious that the largest payer of pharmacy services is state and federal governments. Major policy de-

cisions in both those arenas have a very significant impact on many sectors of our industry.

This year, the FPA traveled to Wash-ington, DC, on several occasions to en-sure that efforts to reform health care included a viable place for our profes-sion. Hill visits were performed by FPA members and leadership under the guidance of NACDS, NCPA and APhA. While the final legislation that Congress approved is not perfect, a number of corrections to pharmacy is-sues were included in the health care reform bill that passed.

statE lEgislatioN that passEd

sb2272 – regulation of pain management clinics

Senate bill 2272 added pain man-agement clinics to the list of entities

that are regulated under Florida stat-utes 456.037. That list includes but is not limited to dental laboratories, mas-sage establishments and pharmacies. There were some exemptions to the re-quirement for certain clinics to register. These exceptions include the following:

■ Clinics licensed under 395 ■ Clinics where the majority of physi-

cians provide surgical services ■ Clinics owned by entities with large

assets ■ Clinics affiliated with accredited

medical schools ■ Clinics that do not prescribe or dis-

pense controlled substances used for pain

■ Charitable clinics

The Department of Health was also granted authority to investigate possi-ble violations related to pain manage-ment clinics without having to get a patient release or subpoena. The clin-ic must also designate a responsible physician. Physician cannot practice in unregistered clinics. The clinic must

Executive Insightby michaEl JacKsoN, rph

2010 Legislative and Regulatory Report of the FPA

by michaEl JacKsoN, Fpa ExEcUtivE vicE prEsidENt/cEo

michael Jackson, b.pharm

10 | F l o r i d a P h a r m a c y T o d a y

executive Vice President/CeOMichael Jackson

(850) 222-2400, ext. 200Director of Continuing education

Tian Merren-Owens, ext. 120Controller

Wanda Hall , ext. 211Membership CoordinatorRanada Simmons , ext. 110

educational Services Office assistantStacey Brooks , ext. 210

Florida pharmacy today boardChair Designate .......Betty Harris, Lighthouse Point Treasurer ..............................Stephen Grabowski, TampaSecretary ........................Stuart Ulrich, Boynton BeachMember ................Don Bergemann, don@bceinfo.comMember .................................... Joseph Koptowsky, MiamiMember ..................................... Jennifer Pytlarz, BrandonExecutive Editor ........Michael Jackson, TallahasseeManaging Editor ........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2010, FLORIDA PHARMACY JOURNAL, INC.ARTICLE ACCEPTANCE: The Florida Phar-macy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today.

The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board.

FLORIDA PHARMACY TODAY, Annual sub-scription - United States and foreign, Indi-vidual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax.

Florida Pharmacy association

610 N. Adams St. • Tallahassee, FL 32301850/222-2400 • FAX 850/561-6758

Web Address: http://www.pharmview.com

FPA STAFF be owned by a Florida licensed phy-sician with a clear license and has not been convicted or pled guilty to certain crimes. Anyone named in the registra-tion of a clinic that has been revoked could not apply to operate a pain man-agement clinic for 5 years after the reg-istration is revoked. Only a licensed physician and dispense medication on the premises of a pain management clinic. Of interest to our members are provisions of SB2272 that require the following:

■ The physician must perform a phys-ical examination on the same day prior to prescribing or dispensing a controlled substance.

■ Physician must document in the pa-tient record a reason for prescribing or dispensing more than a 72 hour supply of a controlled substance for the treatment of nonmalignant pain.

■ Physicians practicing in pain clin-ics are responsible for the security of prescription blanks or any other method used to prescribe controlled substances

■ The bill appears to require physi-cians to be compliant with the coun-terfeit proof prescription blanks laws in 896.065

■ Physicians are required to notify the Department within 24 hours fol-lowing theft or loss of a prescription blank or any other related breach of prescribing security of pain medi-cations.

■ The Department to adopt rules re-lated to inspection and registration of clinics

■ The bill directs the Department to write rules limiting the number of prescriptions for Schedule II or Schedule III controlled substanc-es or alprazolam written over a 24 hour period.

■ Requires the Department to write rules on standard of practice for physicians in privately owned pain clinics

■ The Department of Health is grant-ed new enforcement authority and the ability to asses penalties for vio-lations

■ Dispensing practitioner (in a regis-tered pain clinic) who is registered under 465.0276 restricted from dis-

pensing more than a 72 hour sup-ply of controlled substances if the patient pays by cash, check or cred-it card.

■ Directs the prescription drug mon-itoring program manager to share information on possible violations with law enforcement agencies.

■ Modifies the public records exemp-tion language in 893.0551 to allow the Department of Health to dis-close confidential information to law enforcement as articulated in the bullet point above.This bill was signed into law by Gov-

ernor Crist

hb5603 – reimbursement for Worker’s compensation prescriptions

This bill revised 440.13 (12) (c) that defined current pharmacy reimburse-ment. The bill applied the current pharmacy reimbursement to all pro-vider types. This likely included dis-pensing practitioners who care for work comp patients. Dispensing providers who used repackaged products would have to bill using the average wholesale price of the original manufacturer and not the AWP price provided by the re-packager. Also if the worker’s compen-sation carrier had contracted for a lower rate the provider would have to bill at that rate. Another provision in the bill required the Division of Risk manage-ment to analyze return to work efforts of state agencies for workers compen-sation patients. This bill was vetoed by Governor Crist.

cs/cs/hb747 – treatment of diabetes for students in schools

This bill was designed to give guid-ance to school districts on their students who have diabetes. Not all schools have nurses or other trained personnel and as such some may have restricted assignment of students with diabetes to schools that did have them. Under this bill, districts could assign students with diabetes to schools without trained per-sonnel if authorized by both the parent and physician. The State Board of Ed-ucation working with the Department of Health is being encouraged by the

J U N E 2 0 1 0 | 11

CONTROL YOUR ASSIGNMENTS,CONTROL YOUR CAREER

The Alternative To A Traditional Career In Pharmacy

Career n.an occupation undertaken for a significant period of a person’s life, usually with opportunities for progress.

• Guaranteed Hours • Professional Pay & Benefits• Special Clients, Flexible Assignments• A Variety Of Bonus Programs• Professional Development Opportunities/Cross Training

Professional Well-Managed Fair

04480 Hensley/RX ReliefFlorida Pharmacy Today—1/4 pg ad (3.5”x4.75”)

A PhArmAcist And A LAwyer

Board of Pharmacy Licensure Disciplinary ProceedingsDefense of Chapter 499, Pedigree Laws Violations

Mergers and AcquisitionsCommercial, Civil and Criminal Proceedings

KAHAN ◆ SHIR, P.L.

Pharmacist AttorneyBrian A. Kahan, R.Ph., J.D.

Licensed Florida Pharmacist and Attorney

STATEWIDE REPRESENTATION

561-999-5999bkahan@kahanshir.com

1800 N.W. Corporate Blvd., Suite 200 Boca Raton, FL 33431

The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience.

bill to write rules on personnel training for the management and care of diabe-tes by students. This bill was signed by Governor Crist.

hb1565 – revisions to rulemaking authority

Regulatory entities like the Flori-da Board of Pharmacy and Agency for Health Care Administration are given general authority to write rules defin-ing how laws are implemented. HB1565 further defined rulemaking authority by revising the “Statement of Estimat-ed Regulatory Cost” obligation. When rules are written each agency or board must evaluate the rule to determine if it would have an adverse fiscal impact on small businesses. Added into the bill is a section where if it were found that the rule would create over $200,000 in ex-penses to small businesses over a 5 year period that the rule will need to be rati-fied by the legislature. This bill was ve-toed by Governor Crist.

cs/cs/sb1050 – regulating the sale of Ephedrine

While there are Federal laws gov-erning the sale of Ephedrine the Flori-da legislature has further defined this in SB1050. It is now prohibited to know-ingly obtain or deliver ephedrine or re-lated compounds in excess of the fol-lowing amounts:

■ In any single day, any number of packages that contain a total of 3.6 grams of ephedrine or related com-pounds;

■ In any single retail, over-the-counter sale, three packages, regardless of weight, containing ephedrine or re-lated compounds; or

■ In any 30-day period, in any number of retail, over the-counter sales, a to-tal of 9 grams or more of ephedrine or related compounds

These products as before will need to be kept behind the counter where the public is not permitted or other location not accessible to the public. Employees will be required to go through train-ing on state and federal regulations. It is our understanding that the Feder-al government requires this training to

be done annually. Any person who ob-tains ephedrine related products must:

■ Be at least 18 years of age ■ Produce an appropriate government

issued ID ■ Sign a record of the purchase either

on paper or electronic form

The Florida Department of Law En-forcement (FDLE) is designated with the task of approving the electronic record-keeping system. The bill also requires the electronic record keeping system be provided to pharmacies or retailers without any cost or expense. The bill also requires pharmacies that get this system to use it for purposes of submit-ting sales data to the electronic record-keeping system. This data would have to be submitted before the transaction is completed or in real time. This data in the electronic system would have to be kept for at least 2 years. Pharmacies that lack the ability to use this technol-ogy can file for an exemption through FDLE provided that they do not sell more than 72 grams of ephedrine or re-lated compounds over a 30 day period.

12 | F l o r i d a P h a r m a c y T o d a y

6 2 5 O L D P E A C H T R E E R O A D N W , S U W A N E E , G A 3 0 0 2 4 • 8 6 6 - 2 8 2 - 4 5 4 4

GEORGIA CAMPUS – PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE

PCOM is proud to offer a new Doctor of Pharmacy (PharmD) degree.Providing future pharmacists with the tools for community and hospital practices, long-term and managed care consulting,

pharmacy management, research and academia. PCOM School of Pharmacy – Georgia Campus is now accepting applications.

For more information, e-mail us at PharmDAdmissions@pcom.edu or apply now at www.pcom.edu

Philadelphia College of Osteopathic Medicine’s Doctor of Pharmacy program has applied for accreditation status by the Accreditation Council for Pharmacy Education, 20 North Clark Street, Suite 2500, Chicago, IL 60602-5109, 312/644-3575; FAX 312/664-4652, Web site, www.acpe-accredit.org. For an explanation of ACPE accreditation process, consult the Office of the Dean, or ACPE.

SHAPING PHARMACY EDUCATION FOR TOMORROW’S LEADERS

PCOM School of Pharmacy –Georgia Campus

GAPCOM_PHARMJour-12-09:Layout 1 12/17/09 10:27 AM Page 1

The electronic recordkeeping system must include the following features:

■ The date and time of the transac-tion.

■ The name, date of birth, address, and photo identification number of the purchaser, as well as the type of identification and the government of issuance.

■ The number of packages purchased, the total grams per package, and the name of the compound, mixture, or preparation containing ephedrine or related compounds.

■ The signature of the purchaser, or a unique number relating the trans-action to a paper signature main-tained at the retail premises.

■ Real-time tracking of nonprescrip-tion over-the-counter sales and

■ The ability to block nonprescrip-tion over-the-counter sales in excess of those allowed by the laws of this state or federal law.

Entities that are exempted from this electronic recordkeeping program in-

clude licensed manufacturers, whole-salers, hospitals or facilities licensed under F.S.395, licensed long term care facilities, government operated health departments, physicians’ offices, public prisons or other related facilities, public or private educational institutions with health care programs and government or industry operated medical facilities serving their employees. The electron-ic data in the system can only be dis-closed to law enforcement or used for purposes of managing product recalls. There is some immunity from liabili-ty for releasing this information to law enforcement. This bill was signed into law by Governor Crist.

cs/hb 573 – relaxing of physician assistant law

Before physician assistants could prescribe or dispense there was a re-quirement that they file evidence with the Department of Health that they have taken a minimum of 3 months of clinical experience in the specialty area of their supervising physician. HB573

removed this requirement from Flori-da law. This bill was signed by Gover-nor Crist.

sb1484 – medicaid reformThe House version of Medicaid re-

form was designed to move all of Flor-ida Medicaid into the managed care market greatly expanding the pilot projects in Broward, Duval, Clay, Baker and Nassau counties. The Senate ver-sion which passed is much more con-servative in its approach. Included in this bill are the following:

Directs the Agency for Health Care Administration (AHCA) to request an extension of the current Medicaid Re-form waiver obtained under section 1115 of the Social Security Act and to preserve the Low Income Pool provi-sions of the waiver by no later than July 1, 2010. The AHCA is required to pro-vide the Legislature and the Governor with monthly progress reports on the waiver extension negotiations with the federal Centers for Medicare and Med-icaid Services.

J U N E 2 0 1 0 | 13

Directs the AHCA to develop meth-odologies to maintain the use of in-tergovernmental transfers and certi-fied public expenditures in a Medicaid managed care environment. Requires the Secretary of the AHCA to convene a workgroup of stakeholders that will include individuals representing hos-pitals, counties, medical schools, man-aged care plans, and Medicaid provid-er-service-networks and directs the AHCA to provide a report by January 1, 2011, on the developed methodolo-gies.

Creates the Medicaid and Public Assistance Fraud Strike Force (Strike Force) within the Department of Finan-cial Services (DFS) to develop a state-wide strategy and coordinate state and local efforts and resources to prevent, investigate and prosecute Medicaid and public assistance fraud.

The Strike Force will hold its organi-zation meeting by no later than March 1, 2011, and is required to meet at least four times annually. The Strike Force will consist of 11 members with Chief Financial Officer (CFO) serving as chair, and the Attorney General serv-ing as vice-chair.

Directs the Strike Force to provide recommendations and advice to the CFO on initiatives that include, but are not limited to:

■ Conducting a census of current Medicaid and public assistance fraud efforts;

■ Developing a strategic plan target-ing state and local resources to pre-vent, detect, and deter Medicaid and public assistance fraud;

■ Developing innovative technolo-gy and data sharing among affect-ed entities;

■ Establishing a program that pro-vides grants to state and local agen-cies to implement effective anti-fraud measures;

■ Providing grants, contingent upon appropriation, for multiagency Medicaid and public assistance fraud efforts;

■ Providing assistance to state attor-neys for support services or for the hiring of assistant state attorneys to prosecute Medicaid and public as-sistance fraud; and

■ Providing assistance to judges for support services or for the hiring of senior judges so that Medicaid and public assistance fraud cases can be heard expeditiously.

■ Requires the CFO to develop mod-el interagency agreements to coor-dinate the investigation of Medicaid and public assistance fraud.

■ Transfers the Public Assistance Fraud Division from the Florida De-partment of Law Enforcement to the DFS on January 1, 2011.

■ Authorizes Medicaid related fraud units to be collocated, to the extent possible and requires the Medicaid managed care fraud investigators within the Attorney General’s Office to collocate with the Division of In-surance Fraud within the DFS.

■ Requires the Auditor General and the Office of Program Policy Analy-sis and Government Accountability to review and evaluate the AHCA’s Medicaid fraud and abuse systems and requires a report to the Legis-lature and Governor by December 1, 2011.

■ Requires each Medicaid man-aged care plan to adopt an anti-fraud plan to address overpayment, abuse, and fraud in the provision of Medicaid services and to submit the plan for approval to the Office of Medicaid Program Integrity within the AHCA. The amendment estab-lishes minimum standards for anti-fraud plans and requires each Med-icaid managed care plan to establish a fraud investigative unit or contract with such an entity. In addition, the amendment provides penalties for Medicaid managed care plans that fail to comply with these provisions.

■ Requires all Medicaid managed care plans to report any suspected instance of overpayment, fraud, or abuse to the Office of Medicaid Pro-gram Integrity within 15 days.

■ Revises the requirements for the se-lection of a behavioral health care provider in Broward County for children who have a case open in the Department of Children and Family Services’s HomeSafeNet (HSN, Florida’s child welfare re-porting system), to allow those chil-

dren who are in the custody of the State to enroll in a managed care plan which provides both physi-cal and mental health care services. Authorizes a participating specialty plan to receive an administrative fee for coordination of services based upon the receipt of the state share of the fee from intergovernmental transfers.

■ Allows a provider service network to provide behavioral health servic-es in addition to physical health ser-vices in areas of the state not under Medicaid reform.

■ Extends the guidelines for phasing in financial risk for approved pro-vider service networks and Chil-dren’s Medical Services Networks over the period of the waiver and the extension thereof. This bill was signed into law by

Governor Crist.

cs/cs/cs/hb 1143 – legislation designed to reduce and simplify health care provider regulation

This bill had 137 pages of various is-sues that affect the regulation of health care provider as well as some unrelat-ed health care issues. We will report on those issues that we believe may have a direct effect on or relationship to phar-macy providers.

The bill amends regulation of pre-scription drug wholesale distribu-tion by DOH. The Original version of the bill attempted to eliminate the re-quirement for exempt entities to main-tain separate inventories for drugs pur-chased under the federal 340B discount drug program and other drugs how-ever it appears that was removed. The bill does clarify that claims billed to the state Medicaid program using 340B drugs must have an NDC code and be billed at actual acquisition cost or pay-ment will be denied. The bill replaces the named organization “Joint Com-mission on Accreditation on the Ac-creditation of Health Organizations to “The Joint Commission”. The bill ex-empts sealed medical convenience kits meeting certain specifications from pedigree paper requirements. These specifications are as follows:

14 | F l o r i d a P h a r m a c y T o d a y

1) The medical convenience kit is assembled in an establishment that is registered as a medical device manufacturer with the United States Food and Drug Administration;

2) The medical convenience kit manufacturer purchased the prescription drug directly from the manufacturer or from a wholesaler that purchased the prescription drug directly from the manufacturer;

3) The medical convenience kit manufacturer complies with federal law for the distribution of the prescription drugs within the kit; and

4) The drugs contained in the medical convenience kit are: a) Intravenous solutions

intended for the replenishment of fluids and electrolytes;

b) Products intended to maintain the equilibrium of water and minerals in the body;

c) Products intended for irrigation or reconstitution;

d) Anesthetics; or e) Anticoagulants

The exemptions do not apply to con-venience kits containing any controlled substances.

Tacked onto the bill on the last day of the session was an unrelated issue on abortion ultrasounds. The bill (if not vetoed by Governor Crist) would re-quire physicians to perform an ultra-sound prior to performing the abortion and to share the results with the patient. There is also a section that restricts the use of state or federal funds to pay for elective abortions. This is shared with FPA members not to stir debate but to inform the members that this contro-versial issue may be the reason why the Governor may consider a veto. If vetoed the other pharmacy provisions would not become law.

The bill also grants permission for insurance entities to offer rewards or in-centives for participating in voluntary wellness programs. These awards or incentives could include, but not limited to merchandise, gifts, debit card, modi-fications to copayments etc.

Included in this bill is a declaration

that it is state policy that federal, state or local governments could not compel a person to purchase health insurance or services under certain circumstances. This is likely in response to the feder-al health care reform measures passed by Congress in 2009 requiring insur-ance coverage for everyone including those in public service and high risk oc-cupations. The bill also takes away a requirement for the Agency for Health Care Administration to use certified mail to notify licensees under the Agen-cy banner when the expiration date is nearing. This bill was vetoed by Gov-ernor Crist.

hb5001 – general appropriations bill (medicaid mail order)

Included in this bill is a provision that creates a mail order service for chronically ill patients. The language in this bill reads as follows:

The agency shall issue an invitation to negotiate with a pharmacy or phar-macies to provide mail order deliv-ery services at no cost to the patients who elect to receive their drugs in this manner for patients with chronic dis-ease states including but not limited to congestive heart failure, diabetes, HIV/AIDS, patients suffering from end stage renal disease or cancer in order to assist Medicaid patients in securing prescrip-tions and to reduce program costs. The agency shall select patients appropriate for this mail order project and shall lim-it the number of participants to 20,000 patients statewide.

This issue presented itself in the last week of the legislative session with no committee review. The Florida Phar-macy Association began an immedi-ate campaign to oppose the language including a call to Governor Crist to veto the item. It is very possible that the 20,000 patient population of chronical-ly diseased represents a significant ma-jority of the Medicaid prescription drug spend.

Members need to also note that the Florida House had proposed a signifi-cant reimbursement reduction for phar-macy providers. Prior to the beginning of the legislative session Medicaid phar-macy reimbursement was the lower of:

■ WAC + 4.75% ■ AWP – 16.4% ■ Usual and Customary ■ State maximum allowable cost

(SMAC) or ■ Federal upper limit (FUL)

While the Association was successful in defending against the proposed dras-tic cuts in the House, the legislature did not alter the effect of the First Databank settlement resulting in what was pub-lished as AWP. This means that Flori-da Pharmacy providers will continue to suffer through the 4% dollar reduction since the republishing of AWP back in September of 2009.

Also found in the budget is a provi-sion on page 402 where state employees can get their first 3 fills of certain main-tenance drugs through a community pharmacy with the remainder required to be dispensed from mail order.

The Governor has signed the bill but also has vetoed certain sections including the facility funding for the USF Pharmacy school program in Polk County. The mail order section was not vetoed as this action likely would have negatively affected the entire drug bud-get.

hb5003 – implementing appropriations bill (state Employee prescription benefit)

We found in this bill a revision to the state employee prescription benefit plan copays. The new formulas are as fol-lows:

PLAN New copay

Old copay

For generic drug with card $7 $10

For preferred brand name drug with card $30 $25

For nonpreferred brand name drug with card

$50 $40

For generic mail order drug $14 $20

For preferred brand name mail order drug $60 $50

For nonpreferred brand name mail order drug

$100 $80

The governor has signed the bill but vetoed specific portions.

J U N E 2 0 1 0 | 15

hb5201 – doctor of pharmacy degree program at UsF

House bill 5201 (budget conference report) authorized a doctor of pharma-cy degree program at the University of South Florida. The bill requires that the program be physically located on the new campus of the University of South Florida Polytechnic. The university is authorized to develop and implement the program within existing facilities only until the construction of a phar-macy facility on the new campus of the University of South Florida Polytechnic is completed. This proposal was also introduced in S838 and HB101. While the governor has signed this bill the fa-cility funding on the section associated with the USF pharmacy program was vetoed.

hb5311 – defining medical convenience Kits in F.s. 499 – transfer of Wholesaling to dbpr

This bill eliminates the need for a pedigree for the wholesale distribution of a medical convenience kit if the fol-lowing conditions are met:1) The medical convenience kit is

assembled in an establishment that is registered with the United States Food and Drug Administration as a medical device manufacturer.

2) The medical convenience kit manufacturer purchased the prescription drug directly from the manufacturer or from a wholesaler that purchased the prescription drug directly from the manufacturer

3) The medical convenience kit manufacturer complies with federal law for the distribution of the prescription drugs within the kit

4) The drugs contained in the medical kit are:a) Intravenous solutions

intended for the replenishment of fluids and electrolytes; 1294

b) Products intended to maintain the equilibrium of water and minerals in the body;

c) Products intended for irrigation or reconstitution;

d) Anesthetics; ore) Anticoagulants.

Included in this bill is language that transfers all of the statutory powers, du-ties and functions, records, personnel etc related to the administration and management of Florida Statutes from the Department of Health to the De-partment of Business and Profession-al Regulation (DBPR). This means that DBPR will be regulating prescription drug wholesaling and everything asso-ciation with 499 rather than the Depart-ment of Health. It is likely that pharma-cies that are holding active wholesaling licenses will renew through DBPR. The bill was signed into law by Governor Crist with the effective date of the trans-fer being October 1, 2011.

Fpa moNitorEd bills that did Not pass

h1503 – revisions to general health care regulation

FPA advocates monitored this pro-posed bill very carefully during the closing moments of the 2010 legislative session. This 119 page bill as originally filed appeared to focus on a number of health regulation issues such as but not limited to changes to the requirements for licensing facilities, redefining the term “Joint Commission on the Accred-itation of Hospitals” and further defin-ing the role of the Division of Medical Quality Assurance within the Florida Department of Health. As the session continued a number of amendments were tacked on or tossed at this bill that could have some impact to pharmacy. For example there was language that created a pilot “full service” health and wellness program for state employees through a single vendor. Other amend-ments seemed to define who could own a health care clinic and pharmacists were not listed.

s1064 - resolution on sales tax Exemption on dmEpos products

This bill proposed an amendment to the State Constitution to permanent-ly prohibit the state from imposing a sales tax on the sale of food and medi-cal products and supplies. This bill was never heard in Committee.

s1260 – revision of the Florida controlled substance act

The bill schedules a number of chem-icals as controlled substances. The pro-posed scheduling of these chemicals in S1260 would have moved F.S. 893 to be more consistent with federal scheduling of these chemicals. This bill was never heard in Committee.

s2194, h1149 – audits of pharmacy records

These bills were designed to expand auditing standards in Florida Medicaid as published in 465.188 to make them applicable to all third party administra-tors. These FPA supported provisions were never heard in committee due to our redirected efforts to fight against Medicaid cuts and mandatory mail or-der.

h911, s958 – Electronic health records

These bills as originally filed were designed to future facilitate the use of electronic health records by health care practitioners. While these bills ulti-mately died the FPA was successful in getting licensees under Florida Statutes 465 listed as “health care practitioners” for purposes of unquestionable access to the electronic health records. These bills unfortunately died on the calendar.

s652, h517 – requirement for pharmacies to dispensed contraceptive products without delay

As anticipated this year 2 bills were filed to require pharmacies to dispense contractive products. The bill defined the duties of the pharmacy and re-quired that its employees do not:

■ Intimidate, threaten, or harass a pa-tient in the delivery of services relat-ing to a request for contraception;

■ Interfere with or obstruct the deliv-ery of services relating to a request for contraception;

■ Intentionally misrepresent or de-ceive a patient about the availabili-ty of contraception or its mechanism of action;

■ Breach medical confidentiality with respect to a request for contracep-tion or threaten to breach such confi-

16 | F l o r i d a P h a r m a c y T o d a y

dentiality; or ■ Refuse to return a valid, lawful pre-

scription for contraception upon a patient’s or patient representative’s request.

These bills included language nego-tiated by the FPA during the 2008 legis-lative session that allowed for a basis for refusing to provide a contraceptive such as patient’s inability to pay, lack of a val-id prescription and also on the basis of a professional or clinical judgment of the pharmacists. Additional language was also included to allow for refusal under religions reasons so long as the patient is accommodated by the phar-macy. These bills were never heard in committee.

h275, s516 – required insurance coverage for prescription drugs

These bills required coverage for pre-scription drugs once started at the be-ginning of a plan year to be consistent to the end of the plan year for patients

with preexisting conditions. It appears that the language would prohibit plans from revising their covered formularies and implementing prior authorization program revisions after a patient has enrolled in a prescription drug plan. Neither of these bills was heard in com-mittee.

s330, h135 – Expansion of optometrist prescribing authority

The bill authorizes certified optom-etrists to administer and prescribe cer-tain oral ocular pharmaceutical agents in addition to topical agents. The bill revises requirements for the existing formulary of topical ocular pharma-ceutical agents that certified optome-trists may administer and prescribe to include those topical pharmaceutical agents appropriate to treat and diag-nose ocular disease or disorders within the scope of optometric practice. There also appears to be some language that would permit optometrists to prescribe certain controlled substances. The bill

passed one committee in the Senate but was never heard in the House. Both bills died.

hb225 – controlled substance dispensing restrictions for practitioners

This bill as originally filed would have restricted practitioners registered under 465.0276 (dispensing practitio-ners) from dispensing more than a 72 hour supply of controlled substanc-es. During various committee stops language was added that required pharmacies to connect to a multistate electronic prescribing network as a con-dition of obtaining or renewing a phar-macy permit. The Florida Pharmacy Association prepared 4 pages of writ-ten comment to the staff director of the House Health Regulation Committee and met several times with the House sponsor and his aid explaining the chal-lenges to this part of the bill’s amend-ed language. Additional language was added in an attempt to further regulate pain clinics. At some point during the

I n d e p e n d e n t … B u t N o t A l o n e .P P S C i s Y o u r P a r t n e r f o r S u c c e s s

IncreaseProfits

Every day, pharmacies depend on PPSC to simplify purchasing, reduce costs and identify new revenue sources – making a significant impact on their bottom line.

PPSC can help you:EXPAND use of high-profit genericsCREATE effective store layoutENHANCE third-party profitsCAPTuRE MTM revenue EsTAblisH new business nichesINCREASE your overall margins

For more on how PPSC can maximize the potential of your independent pharmacy, visit www.ppsconline.com or call toll-free 888-778-9909.

J U N E 2 0 1 0 | 17

legislative debate the 72 hour restriction was removed against the objections of the FPA. The FPA was successful in get-ting a version of that language amend-ed onto SB2272. This bill ultimately died on the calendar.

Federal health care reform legislation monitored by the Fpa

IMPACT ON COMMUNITY PHAR-MACY (See Stat News, March 22, 2010)

On March 21st, the U.S. House of Representatives passed H.R. 3590, the Patient Protection and Affordable Care Act. This is the same health care reform bill that cleared the Senate on Decem-ber 24th, 2009. However, the House also passed H.R. 4872, the Health Care Rec-onciliation Bill, which makes amend-ments to H.R. 3590 (the Senate Health Care Reform bill).

The Senate must still act on the rec-onciliation bill, but NCPA wanted to en-sure that pharmacists had current in-formation about the bill’s impact on pharmacy. This document represents NCPA’s best interpretation at this time of the new law, once signed by the Pres-ident. In many cases, new regulations will have to be drafted, and NCPA will assure that the intent of Congress is fol-lowed by the agencies.

medicaid generic drug pharmacy reimbursement (amp Fix)

Background: The Deficit Reduction Act of 2005 (DRA) would have reim-bursed pharmacies below their acqui-sition cost for Medicaid generic drugs. Since 2007, these cuts have been delayed because of a December 2007 court in-junction that was won by NCPA and NACDS. NCPA has advocated a legis-lative solution to permanently reverse these generic drug cuts, and this bill provides that relief in part.

The health care reform bill improves the definition of Average Manufactures Price (AMP) so that it includes only manufacturers’ sales to retail pharma-cies. It directs the Center for Medicare and Medicaid Services (CMS) to set Medicaid Federal Upper Limit (FUL) for reimbursement of generics a rate of “no less than 175% of average weighted

AMP.” NCPA secured report language to the bill that encourages the Secretary to increase the reimbursement even higher for small independent commu-nity pharmacies.

This increase in the FUL is especially important now because the bill also ex-pands Medicaid coverage – starting in 2014 - to individuals up to 133% of the Federal poverty level. This is expected to add 16 million more individuals to the Medicaid program.

What this mean for YOU: The bill re-quires the Secretary to implement the new Medicaid generic rates as early as October 2010. This means that pharma-cies in some states may see a reduction in generic drug reimbursement at that time. However, this new law mitigates the impact of the more draconian gener-ic drug cuts that would have gone into effect had these changes not been made, saving pharmacies approximately $3 billion in Medicaid generic drug cuts.

AMPs for brand and generic drugs will be made public later this year. This will give payers access to more AMP data, which are generally assumed to be close to retail pharmacy’s acquisition costs for drugs.

pharmacy benefit manager (pbm) transparency in health Exchanges

Background: PBMs continue to oper-ate in relative secrecy, with payers and the Federal government having little in-formation on whether PBMs actually reduce drug costs, or pass through re-bates and discounts to plan sponsors. To begin to rectify unacceptable sit-uation, the health care reform bill re-quires the PBMs to confidentially dis-close important financial information to the Secretary of Health and Human Services for those health plans operat-ing in new health insurance exchanges and Medicare Part D plans. These new state-based exchanges are set to begin in 2014. This is the first federal require-ment for oversight and accountability in the PBM marketplace. These provi-sions also establish an important initial Federal framework for the regulation of these unregulated entities, which can be enhanced in the future.

What this means for YOU: Transpar-

ency helps to level the playing field be-tween mail order and community phar-macy by encouraging plans to hold PBMs accountable for excessive profits and the tactics used to drive those prof-its up.

This new law creates an impor-tant foundation for future federal reg-ulation. As federal officials learn more about the games PBMs play, they may strengthen disclosure requirements or apply them to additional federal health programs. Hopefully, the private sector will follow suit.

pharmacists Exempted from medicare dmE accreditation requirement

Background: The bill provides an ex-emption for most pharmacies from the burdensome accreditation requirements to provide Medicare DME, and changes current law so that pharmacy accredita-tion requirements are not effective un-til January 2011. (Pharmacies that want to competitively bid would still be re-quired to be accredited regardless). A pharmacy can be exempt from the ac-creditation requirements if the pharma-cy:

■ Has total Medicare DME billings that are 5 percent or less of total pre-scription sales.

■ Has had no adverse fraud or abuse determination against it for the last 5 years

■ Submits an attestation that its to-tal Medicare DMEPOS billings are and continue to be less than a rolling three year average of five percent of total pharmacy sales.

■ Submits documentation to the Sec-retary (based on a random sample of pharmacies) that would allow the Secretary to verify the information.

What this means for YOU: If you’re already accredited under current CMS guidelines, you are exempt from the re-accreditation requirements if you meet the criteria above. This will save you thousands of dollars and countless hours to comply.

If you’re not accredited now, you are required to be accredited after January, 2011, but only if you do not meet the cri-teria above. Most pharmacies are likely

18 | F l o r i d a P h a r m a c y T o d a y

going to meet the criteria above and will not have to be accredited. If you have al-ready stepped down from selling DME, anticipating that Congress would enact an exemption, we expect CMS to allow pharmacies to step back up soon. This will likely require the submission to the NSC of an application to “step up”.

pharmacist-delivered medication therapy management services

Background: The health care reform bill envisions an expanded patient care role for pharmacists in new health care system models. These new responsibil-ities will help assure more appropri-ate use of prescription medications, es-pecially for those patients who have chronic illnesses. These include phar-macist roles in accountable care organi-zations, medical homes, “transitions of care” teams, and medication reconcilia-tion activities.

The bill also includes a Medication Therapy Management (MTM) grant program that will help test new and in-novative methods to provide medica-tion therapy management, which will help to reduce the estimated $290 bil-lion in health care expenditures that re-sult from inappropriate medication use or non compliance with taking medica-tions.

What this means for YOU: Com-munity pharmacies may be eligible for grant funding to help provide MTM services, though the government’s pro-cess for establishing grant criteria, ap-plications, etc. will take many months and will be subject to the annual appro-priations process.

closes the medicare part d “donut hole”

Background: The health care reform bill closes the Medicare Part D “donut hole” over the next ten years (2010-2020), through new Federal funds as well as discounts from pharmaceutical manu-facturers on brand name drugs. Bene-ficiaries that hit the donut hole in 2010 would receive a one-time $250 rebate. Beginning January 1 2011, beneficia-ries would also automatically receive a 50 percent discount off the negotiat-ed price for brand-name prescription

drugs that are covered under Part D and covered by their plan‘s formulary or are treated as being on plan formu-laries through exceptions and appeals processes. These discounts would be provided by the pharmacy at point of sale.

The discount increases to 75% on brand-name and generic drugs by 2020. The bill also allows 100% of the negoti-ated price of discounted drugs (exclud-ing dispensing fees) to count toward the annual out-of-pocket threshold that is used to annually define the coverage gap. Beginning in 2020, the 25% copay applies until Medicare’s catastrophic coverage kicks in.

What this means for YOU: Medi-care patients who previously strug-gled financially when in the “donut hole” should be able to purchase their full medication regimen as prescribed – leading to increased adherence. How-ever, the law requires that these brand name manufacturer discounts be paid to the pharmacy by a third party entity under contract with the Secretary. The new prompt pay provisions apply to the payments that these third party enti-ties would have to make to pharmacies, which means that pharmacies should be paid within 14 days of dispensing the brand name drug.

New requirements for long term care pharmacies

Background: The health care reform bill requires Part D plans to use specific dispensing techniques to reduce phar-maceutical waste in long term care fa-cilities. In order to reduce waste associ-ated with unused medications, starting in 2012, Medicare Part D drug plans and MA-PD plans must have in place utili-zation management techniques such as daily, weekly, or automated dose dis-pensing to reduce the quantities of part D drugs dispensed to enrollees residing in long-term care facilities.

The Health and Human Services Secretary will consult with appropriate stakeholders, including State Boards of Pharmacy and pharmacy and physician organizations, to study and determine additional methods to reduce waste.

What this mean for YOU: You may have to provide dispensing services to

long term care facilities more frequent-ly, with no statutory requirement that there would be corresponding increases in dispensing fees. NCPA is already ad-vocating with the Centers for Medicare and Medicaid Services (CMS) that full dispensing fees be paid for an increase in the frequency of providing medica-tions to residents of long term care fa-cilities.

small business provisionsBackground: The health care reform

bill includes provisions that would pe-nalize businesses that do not provide health insurance and whose employees purchase plans through the exchange. However, there are no penalties on busi-nesses with 50 or fewer employees that do not provide health care coverage. The bill also includes small business tax credits to encourage small employ-ers to purchase insurance for their em-ployees, but NCPA is concerned about the income caps and other eligibility re-quirements.

What this means for YOU: You are not required under law to provide health insurance for your employees:

■ If you do not provide health insur-ance coverage for your employ-ees and have more than 50 employ-ees, you may be subject to a $2,000 fine for some of the employees if any of the employees is subsidized to obtain coverage through the new health insurance exchanges.

■ If you have fewer than 25 employees you may be eligible for tax credits to provide health insurance coverage to your employees.

340b provisionsBackground: The health care reform

bill substantially expands the number of entities eligible to obtain pharmaceu-tical discounts under the 340B program. These 340B entities are supposed to pro-vide discounted prescription medica-tions to uninsured individuals. How-ever, many NCPA members report that eligible entities are using these 340B drugs for ineligible patients, such as a hospital’s own employees and for pa-tients that have good insurance.

The final bill prevents the extension of 340B discount pricing to inpatient

J U N E 2 0 1 0 | 19

services provided by a hospital, which will reduce the number of discounted prescriptions dispensed to potentially inappropriate patients.

What this means for YOU: While the bill’s expansion language will mean that an increasingly larger number of covered entities will be able to provide discount 340B drugs, NCPA members also have an increased opportunity to participate in the 340B program due to a recently issued HRSA guidance that allows 340B covered entities to contract with multiple pharmacies to provide pharmacy services.

proposed board of pharmacy rule changes

Two issues that the Florida Phar-macy Association is monitoring at the Board of Pharmacy include further de-velopment of the Board’s technician training program rules and a request to consider modification of the rule requir-ing Florida permitted community phar-macies to be open 4 hours per week.

technician training rulesThe Florida Board of Pharmacy has

been in rule development since passage of Senate bill 1360 during the 2008 leg-islative session. This bill required phar-macy technicians to register with the Florida Department of Health. Rule drafts have been exchanged at a num-ber of Board of Pharmacy meetings along with requests for workshops and hearings by interested stakeholders. All individuals who are presenting as phar-macy technicians in Florida must wear a name badge with the words “Reg-istered Pharmacy Technician” on it. These individuals must also have reg-istered with the Florida Department of Health by December 31, 2009. Regis-tered Florida technicians will have until December 31, 2010 to do one of the fol-lowing three things:

■ Completed a Board approved train-ing program or

■ Have completed a certification pro-gram approved by NCCA or

■ Have worked a minimum of 1,500 under a licensed pharmacist

Beginning January 1, 2011 the only way that an individual can function as

a pharmacy technician in Florida is to complete a Board approved technician training program and register with the Department of Health or be current-ly enrolled in a Florida Department of Health approved technician training program. After January 1, 2011 the op-tion to use certification or work experi-ence to become eligible for registration will cease to exist as the grandfather period would have ended December 31, 2010. Members need to be aware that rule 64B16-26.351 will take effect on June 23, 2010. The FPA will be look-ing at ways to assist our members with the training of their technician candi-dates. A copy of the current rule draft has been published on the FPA web site. We also understand that the Board will continue revising this rule at their next meeting.

requirement for community pharmacies to be open 40 hours

The Florida Pharmacy Association filed a request before the Florida Board of Pharmacy for consideration and re-view of rule 64B16-28.1081 which re-quires community pharmacy permits to be open a minimum of 40 hours and 5 days per week with certain excep-tions. The Florida Pharmacy Associa-tion through the House of Delegates has since 1995 been supportive of removing regulations that dictate the operating hours of pharmacies. We are not aware of any regulations that define the hour-ly operating standards for other critical health care providers such as physicians or dentists. The Board agreed to agen-da this issue at meetings of the rules committee. This rule was discussed at their meetings in Jacksonville, Ft. Lau-derdale and Orlando. The FPA also pre-sented results of a survey where 71% of 28 states that responded indicated that they had no regulations that govern the number of hours that a pharmacy should be open.

summaryMembers need to be aware of the

need for an ever watchful eye on the policy making process. In many cas-es a policy decision may have a posi-tive or negative effect on our ability to

care for our patients. Many decisions are also made that could adversely (or positively) affect a pharmacy’s financial posture. Members who know who their state and federal legislators can have a significant impact on health care rules and regulations.

We are also very excited about the new opportunities for services that our profession can get into. With the need for medication therapy management, adherence and disease management the Florida pharmacist is key to a healthi-er population. Members networking with other members can build lasting relationships with the entire industry through collaborative care.

The Florida Pharmacy Association is proud to be the catalyst behind the de-velopment of state and national lead-ers. Running for APhA trustee is Mer-ritt Island pharmacist Mark Hobbs, past president FPA. Also in the leadership pipeline for the National Community Pharmacists Association is Lynn Ha-ven pharmacist DeAnn Mullins who is serving as secretary treasurer. Your current Chair of the FPA Board of Di-rectors was honored by APhA with the Good Government of the Year award. Past FPA President Kathy Petsos re-ceived her fellow status with APhA.

Finally we all witnessed history this year with our own Ed Hamilton, FPA past president, concluding his term as president of the American Pharmacists Association. Ed is only the second Flo-ridian to ever reach that goal. During Dr. Hamilton’s leadership APhA facili-tated the renovation and move into its new building. Congratulations Ed from your FPA family.

20 | F l o r i d a P h a r m a c y T o d a y

Smart Summer skin care is Key to Fun in the suncenters for disease control and prevention

Protection from sun exposure is im-portant all year round, not just during the summer or at the beach. Ultraviolet (UV) rays can reach you on cloudy and hazy days, as well as bright and sunny days. UV rays also reflect off of surfaces like water, cement, sand, and snow.

The hours between 10 a.m. and 4 p.m. daylight savings time (9 a.m. to 3 p.m. standard time) are the most haz-ardous for UV exposure in the conti-nental United States. UV rays are the greatest during the late spring and early summer in North America.

CDC recommends easy options for sun protection1—

■ Use sunscreen with sun protective factor (SPF) 15 or higher, and both UVA and UVB protection.

■ Wear clothing to protect exposed skin.

■ Wear a hat with a wide brim to shade the face, head, ears, and neck.

■ Wear sunglasses that wrap around and block as close to 100% of both UVA and UVB rays as possible.

■ Seek shade, especially during mid-day hours.

sunscreenThe sun’s UV rays can

damage your skin in as lit-tle as 15 minutes. Put on sun-screen before you go out-side, even on slightly cloudy or cool days. Don’t forget to put a thick layer on all parts of exposed skin. Get help for hard-to-reach places like your back.

How sunscreen works. Most sun protection prod-uc ts work by absorb -ing, reflecting, or scatter-ing sunlight. They contain chemicals that interact with the skin to protect it from UV rays. All products do not have the same ingredients; if your skin reacts badly to one product, try another one or

call a doctor.SPF. Sunscreens are assigned a sun

protection factor (SPF) number that rates their effectiveness in blocking UV rays. Higher numbers indicate more protection. You should use a sunscreen with at least SPF 15.

Reapplication. Sunscreen wears off. Put it on again if you stay out in the sun for more than two hours, and after you swim or do things that make you sweat.

expiration date. Check the sun-screen’s expiration date. Sunscreen without an expiration date has a shelf life of no more than three years, but its shelf life is shorter if it has been ex-posed to high temperatures.

Cosmetics. Some make-up and lip balms contain some of the same chem-icals used in sunscreens. If they do not have at least SPF 15, don’t use them by themselves.

clothingLoose-fitting long-sleeved shirts

and long pants made from tightly wo-ven fabric offer the best protection from the sun’s UV rays. A wet T-shirt offers

much less UV protection than a dry one. Darker colors may offer more pro-tection than lighter colors.

If wearing this type of clothing isn’t practical, at least try to wear a T-shirt or a beach cover-up. Keep in mind that a typical T-shirt has an SPF rating lower than 15, so use other types of protection as well.

hatsFor the most protection, wear a hat

with a brim all the way around that shades your face, ears, and the back of your neck. A tightly woven fabric, such as canvas, works best to protect your skin from UV rays. Avoid straw hats with holes that let sunlight through. A darker hat may offer more UV protec-tion.

If you wear a baseball cap, you should also protect your ears and the back of your neck by wearing clothing that covers those areas, using sunscreen with at least SPF 15, or by staying in the shade.

The hours between 10 a.m. and 4 p.m. daylight savings time (9 a.m. to 3 p.m. standard time) are the most hazardous for UV exposure in the continental United States.

J U N E 2 0 1 0 | 21

1985twenty-five years ago:

■ The Campbell University School of Pharmacy is founded in Buies Creek, NC.

■ Pharmacy Directors of Pediatric Hospitals (PDPH) formed in 1985. Name changed to Pediatric Phar-macy Administrative Group (PPAG) in 1987.

Pharmacy Time Capsule 2010

By: Dennis B. Worthen Lloyd Scholar, Lloyd Library and Museum, Cincinnati, OH

One of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to

assuring that the contributions of your profession endure as a part of America’s history. Membership offers the satisfaction

of helping continue this work on behalf of pharmacy, and brings five or more historical publications to your door each year. To

learn more, check out: www.aihp.org

1960Fifty years ago

■ Enovid (Searle) was the first combination (norethyn-odrel with ethynylestradiol 3-methyl ether) oral con-traceptive approved by the FDA.

■ The 1960 Lilly Digest reported that the average pre-scription price was $$3.19.

1935seventy-five year ago

■ Property owned by the American Pharmaceuti-cal Association in the District of Columbia where the headquarters was to be erected, was exempted from general taxes as long as it was to be used by the Association.

■ The Rockefeller Foundation developed the first vaccine for Yellow Fever, once prevalent in the southern United States. It was tested and released the following year.

1910one hundred years ago

■ The Carnegie Foundation supported Abraham Flexner’s study of the state of medical education in the United States and Canada thus changing medical education forever. Pharmacy leaders later approached Flexner to do a similar study. He re-fused noting that pharmacy was not a profession.

■ Sir Edward Albert Sharpey-Schafer hypothesized that diabetes was the consequence of deficit of a pancreatic chemical which he called insulin—11 years before the discovery of Banting and Best.

22 | F l o r i d a P h a r m a c y T o d a y

People can be exposed to hazard-ous substances related to the spill by breathing them (air), by swallowing them (food, water), or by touching them (skin). People should avoid close contact to the spill and fumes from any burn-ing oil.

air Quality: ■ Smell: People may be able to smell

the oil spill from the shore. The odor comes from chemicals in the oil that people can smell at levels well below those that would make most people sick. However, exposure to low lev-els of these chemicals may cause ir-ritation of the eyes, nose, throat, and skin. People with asthma or other lung diseases may be more sensitive to these effects.

■ Burning oil: When responders burn some of the oil, some “Particulate Matter” (PM) may reach the shore. PM is a mix of very small particles and liquid droplets found in the air. PM may pose a greater risk for peo-ple who have a chronic condition such as asthma or heart disease.

If you smell gas or see smoke or know that fires are nearby, stay indoors, set your air conditioner to reuse indoor air, and avoid physical activities that put extra demands on your lungs and heart.

Food:

The Food and Drug Administration (FDA) and National Oceanic and At-mospheric Administration (NOAA) are monitoring the oil spill and its potential impact on the safety of seafood harvest-ed from the area. Although crude oil has the potential to taint seafood with flavors and odors caused by exposure to hydrocarbon chemicals, the public should not be concerned about the safe-ty of seafood in the stores at this time. For more information about seafood

and the oil spill, visit http://www.fda.gov/Food/ucm210436.htm.

Water: Drinking water and household wa-

ter are not expected to be affected by the spill. However, water used for rec-reation may be affected. Swimming in water contaminated with chemicals from the oil spill could cause health ef-fects. For more information about water and the oil spill, visit http://www.cdc.gov/nceh/oil_spill/information_resi-dents.htm#5.

Follow local and state public health

guidelines and warnings about the use of beaches and coastal water for swim-

ming, boating, and fishing. For more information about beach safety, vis-it http://www.deepwaterhorizonre-sponse.com/go/doc/2931/542551/.

Dispersants: Oil spill dispersants break an oil slick into small drops. For most people, brief contact with a small amount of oil spill dispersants will do no harm. However, longer contact can cause a rash and dry skin. Dispersants can also irritate your eyes. Breathing or swallowing dispersants can also cause health effects.

If you are concerned that you have been exposed to oil or dispersants, see your doctor. Health care providers can find more information on CDC’s oil spill web site at http://emergency.cdc.

What to Expect from the Oil Spill and How to Protect Your Health centers for disease control and prevention

this image from video provided by bp plc

Oil spill dispersants break an oil slick into small drops. For most people, brief contact with a small amount of oil spill dispersants will do no harm. However, longer contact can cause a rash and dry skin.

120th Annual Meeting and Convention

Florida Pharmacy Association

Marco Island Marriott Resort, Golf Club & SpaMarco Island, FL

June 30 - July 4, 2010

patient’s quality of life. FPA would like to educate, equip and enhance pharmacists’ therapeutic knowledge with practical tools as they collaborate with other healthcare professionals and make a difference in patient care.

FPA’s mission is to “serve, represent and assist pharmacists and pharmacy technicians to advance the profession and practice of pharmacy.” This year’s convention will offer a variety of important topics that will be applicable to your pharmacy practice setting. We are offering consultant and general continuing education hours, in addition to a pre-convention conference on Current Trends in Medication Therapy Management. Come and Collaborate at FPA’s 120th Annual Meeting and Convention!

Mark Your Calendar!

ollaboration

ollaboration

CCcommon goals. Pwith healthcare professionals in order to provide optimal patient care. Pharmacists are an integral part of the healthcare delivery system and make a powerful impact on improving

harmacists collaborate

Collaboration is a prtwo or morwor

e people or organizations k together in an intersection of

ocess where

24 | F l o r i d a P h a r m a c y T o d a y

General InformationRoom Rates $149 (rate cut off date is Friday, June

11, 2010) The special Florida Phar-macy Association Group room rate is $149 single/double occupancy plus tax per night. Please be sure to ask for the Florida Pharmacy Association group rate. The check-in time is after 4:00pm and the checkout time is be-fore 11:00am. Room reservations can be made by calling (800) 438-4373 or calling (239) 394-2511. Valet parking is $18 per car per day. Guest self park-ing is $12 per car per day.

Keynote Speaker Tom E. Menighan, is Executive Vice Presi-dent and Chief Execu-tive Officer of APhA, a position he assumed July 2009. Mr. Me-nighan received his Bachelor of Science in Pharmacy from West

Virginia University School of Phar-macy and a Masters in Business from Averett College. He represents and is the chief spokesman for the American Pharmacists Association. Throughout his career, Menighan has served volun-teer roles within the profession of phar-macy, including president of APhA from 2001 to 2002 and a member of the APhA Board of Trustees between 1995 and 2003. Also, he was a senior staff member of APhA from 1987 to 1992.

General Education Track Thursday - Sunday The general education track will offer

courses designed to educate pharma-cists on a wide variety of important topics pertaining to the profession of pharmacy practice. Specific courses being offered are Reducing Medica-tion Errors, Third Party audits, and a Board of Pharmacy Update as well as the always-popular offerings of Florida Regulatory and Legislative Update.

Consultant Education TrackThursday- Sunday The consultant education track will

provide pharmacists with the most cur-rent information available on various disease states and focus on collabora-tion with other healthcare profession-als. Some specific therapeutic topics being offered include Diabetes Man-agement, HIV/AIDS, Cardiovascular Disease, Neurological Disorders, and Oncology. There are 18 hours available for consultant pharmacists.

Student and Technician TrackThursday – Sunday Students and Technicians will ben-

efit from interacting with practicing pharmacists and attending student and technician focused continuing educa-tion programs. The technician track offers several hours of continuing edu-cation on a variety of topics, including a course on What Technicians Can and Cannot Do in Pharmacy. The student track consists of 10 hours of fun and exciting continuing education. Some specific courses being offered include Pharmacy Law, The Career Forum, and the NASPA/NMA Game Show.

Pre-Convention EducationWednesday Only Our traditional Wednesday program

will discuss current trends in Medica-tion Therapy Management (MTM). This outstanding MTM Program will offer 6 hours of live continuing educa-tion credit. Register for these programs and walk away with valuable informa-tion for your pharmacy practice. A sep-arate registration fee is required for the pre-convention program.

Special Events Exhibits: Participate in our grand

opening reception in the exhibit hall! Poster Presentations: Browse submis-sions from students. Contact Tian Merren Owens in the FPA office for more information if you would like to submit a poster presentation. Awards Ceremony Reception entitled An

Evening in Margaritaville: Honor outstanding practitioners during the awards presentation. The dress code is resort wear casual or evening beach at-tire. President’s Breakfast: Attend the Sunday morning installation of new of-ficers. Receptions: Enjoy catching up with your colleagues as the Universi-ties entertain their alumni and friends, and as the FPA Foundation thank their supporters at a reception. House of Delegates: Be a delegate or observer and see how important member partic-ipation is to the direction of the Asso-ciation. Student Events: Students will benefit from interacting with practic-ing pharmacists, attending student fo-cused continuing education programs and learning first hand about the FPA and how involvement can improve their chosen profession. Call the FPA office and offer to mentor or sponsor a student. PharmPACCE Wine and Cheese Reception: Purchase a ticket to this reception to support your Politi-cal Action Committee. Golf Tourna-ment: Join us Friday morning for the PACCE Golf Tournament. Please reg-ister early to save your space.

Waiver of LiabilityEach individual attending FPA’s An-nual Meeting assumes all risks asso-ciated with his/her attendance and participation in all on-and off-site ac-tivities that occur during this time. By registering for this meeting, you agree to indemnify and hold harmless, FPA and its governing bodies, officers and employees from all loss, damage or li-ability arising out of or related to your attendance and participation at FPA’s Annual Meeting.

Cancellation PolicyIf cancellation is made in writing 30 days prior to the program a refund will be made less a $10 service charge. If cancellation is made 29-10 days prior to the program, a refund will be made, less a $50 service charge. Cancellation requested in writing after that date will result in credit for another FPA CE program or service valid for one year.

General Information

J U N E 2 0 1 0 | 25

Florida Pharmacy Association 27th Annual Southeastern Gatherin’

August 8-11, 2010 Hilton Sandestin Beach Golf Resort & Spa, Destin, FL

Meeting Site Location: Hilton Sandestin Beach Golf Resort & Spa 4000 Sandestin Boulevard South ~ Miramar Beach, FL 32550 For Room Reservation Call: (800) 367-1271 or (850) 267-9500 Sleeping Room Reservation Deadline: July 16, 2010

FPA room rate is $129 / $179 / $229 / $279 plus tax (single/double occupancy). The sleeping room reservation deadline is July 16, 2010. Thereafter, reservations will be taken on a space availability basis and group rate may not be offered. Check in time is 4:00pm. Check out time is 11:00am. There will be complimentary self parking. Valet parking is $20 per night.

Registration Form (Deadline: Friday, July 23, 2010)

Name: Badge Name:

Address: City, State, Zip:

Phone (Hm): Phone (Wk):

Fax number: Email address:

License Number : PS: PU: RPT: ___________________________

Printed booklets for our CE “Handouts” will no longer be available on-site at the conference. The

“Handouts” will be posted on our website- www.pharmview.com - the week of the conference

for you to print out and bring with you to the meeting. Printed booklets of the Handouts are

available to purchase for $25.00.

Target Audience: Community Pharmacists, Hospital Pharmacists Consultant Pharmacists, Pharmacy Technicians

Manage Care Pharmacists Long-term Care Pharmacists

Registration Fees Before July 23 After July 23 Member Non Member Member Non Member

Full Registration Pharmacists $250 $310 $280 $350 Includes all CE, Exhibits, Final Night Party, & a T-shirt

One Day Registration (includes CE & exhibit) $150 $190 $160 $200 Select the day you will attend ◊ Sunday ◊ Monday ◊ Tuesday ◊ Wednesday

Full Registration Technicians $110 $145 $140 $175 Includes all CE, Exhibits, Final Night Party, & a T-shirt One Day Registration (includes CE & exhibits) $40 $55 $60 $75 Select the day you will attend ◊ Sunday ◊ Monday ◊ Tuesday ◊ Wednesday Guest Registration $120 $120 Includes Exhibits, Final Night Party, & a T-shirt

Names: __________________________________________________________________________________

Children from Ages 5-12 # @ $50= Includes Exhibits & T-shirt

Exhibit Hall Pass # @$30=

Golf Tournament # @$80=

Name: Handicap:

Final Night Party # @$65=

Gatherin’ T-shirts Adult # @$15=

(Included w/Full & Guest Reg.) Child # @$10=__________________

Handouts # @$25=

Payment Method (accounting code: 6522 class 230) Total Amount Due: ________________ Visa MasterCard AMEX Discover or Check payable to FPA

Card # Security Code__________ Exp Date_________

Signature_________________________________________________________________________________

Cancellation Policy: If cancellation is made in writing 30 days prior to the program a refund will be made less a $10 service charge. If cancel-lation is made 29-10 days prior to the program, a refund will be made, less a $50 service charge. Cancellation requested in writing after that date will result in credit for another FPA CE program or service. Credits are valid for one year from date of original cancellation.

Policy on Industry Support: The FPA Ad-heres to the US Food and Drug Administrator’s policy on industry supported educational activi-ties. The FDA policy requires, among other things, that we conduct the educational pro-gram supported by any corporate educational grants independently and without control by the grantor of the program’s planning, content or execution. Furthermore, the programs must be free of commercial bias for or against any product.

Tax Deduction: The expense of continuing education, when taken to maintain and improve professional skills is tax deductible. Please contact your accountant for complete details.

Four ways to register: PHONE (850) 222-2400

FAX (850) 561-6758 MAIL 610 North Adams St.,

Tallahassee, FL 32301 ONLINE at www.pharmview.com

Brochure Revised_aLTERED... page 4

Spot 1: PANTONE Process Blue C

Spot 2: PANTONE 353 C

Spot 1: PANTONE Process Blue C

Spot 2: PANTONE 353 C

Wednesday, June 02, 2010 17:13

Sunday, August 8th 5 hours GCE/TECH

11:00-6:00 PM Registration Desk Open

1:00-1:15 PM Welcome

1:15-2:15 PM Education 1 hour GCE/TECH Keynote Address: Advancing Pharmacy Practice Through Your Leadership and Involvement Harold N. Godwin, BS Pharm, MS, FAPhA, FASHP, Profes-sor and Chair of Pharmacy Practice, Associate Dean, Uni-versity of Kansas, School of Pharmacy, Current President of the American Pharmacist Association (APhA) Upon completion pharmacists and technicians will be able to: Describe the traits that are characteristics of great leaders; Identify the actions and support that the national pharmacy organizations have developed to achieve Health Care Reform; Describe the value of involvement in Phar-macy Organizations and their influence in creating change; Describe the status of Health Care Reform relative to the action steps that our national pharmacy organizations are taking to implement an effective Medication Therapy Management program for patients. UAN: 0165-0000-10-053-L04-P UAN: 0165-0000-10-053-L04-T 2:15-3:15 PM Education 1 hour GCE/TECH Disaster Preparedness for Healthcare: The Role of Pharmacy in Natural and Manmade Disasters Dwayne Steele, PharmD, MS, FABC, Chief Operating Officer, St. Theresa Specialty Hospital Upon completion pharmacists will be able to: Discuss the importance of natural and manmade disaster preparedness; Assess the current readi- ness status of their organization; Create checkpoints and timelines for purchases of equipment and materials that may be needed in the event of a disaster; Implement a successful natural or manmade disaster prepared- ness training program; Explain to clinicians and administrators on how to prepare their facility in order to ensure patient safety, staff readiness, and minimize potential financial losses. Upon completion technicians will be able to: Define natural and man made disasters; Assess the current readi- ness of their facility; Identify necessary tools that are needed in the pharmacy in case a disaster strikes. UAN: 0165-0000-10-054-L04-P UAN: 0165-0000-10-054-L04-T (Pending Approval from Georgia State Board of Pharmacy) 3:15-3:30 PM Break 3:30-4:30 PM Education 1 hour GCE/TECH HIV/AIDS Update 2010 Antonio Carrion, PharmD, Florida A & M University, Leon County Health Department Upon completion pharmacists will be able to: Review current modes of transmission; Identify high risk behaviors; Discuss the pharmacist role in providing care for HIV infected patients; Describe the mechanism of action of antivirals; Describe the rationale behind combination therapies; Interpret current Florida law on HIV/AIDS. Upon completion technicians will be able to: Define HIV and AIDS; List methods of transmission of HIV/AIDS; Iden-tify high risk behaviors. UAN: 0165-0000-10-012-L02-P UAN: 0165-0000-10-012-L02-T 4:30-6:30 PM Education: 2 hours GCE/TECH Reducing Medication Errors Through Implementing a Continuous Quality Improvement Program Michael Jackson, RPh, FPA EVP & CEO

Upon completion pharmacists will be able to: Define elements of a Continuous Quality Improvement Program; Restructure a pharmacy practice to address quality related events; Analyze some common causes of quality related events; Imple-ment an action plan to address quality of care in pharmacies with a goal towards

27th Annual Southeastern Gatherin’ General or Consultant Recertification Continuing Education

August 8-11, 2010 error reduction and prevention; Recite quality improvement regulations for Florida Pharmacies. Upon completion technicians will be able to: Define CQI; List the most common medication errors; Employ techniques used to reduce medication errors by using CQI. UAN: 0165-0000-10-025-L05-P UAN: 0165-0000-10-025-L05-T 6:30-8:30 PM Exhibit Hall Grand Opening Monday, August 9th 4 hours GCE/RC/TECH

7:00-8:00 AM Continental Breakfast (Exhibit Hall)

7:00-1:00 PM Registration Desk Open

8:00-10:00 AM Education 2 hours GCE/RC/TECH Current Trends in Peptic Ulcer Disease, Diagnosis and Management Patricia Lieveld, PharmD, M.P.H., Professor, Pharmacy Practice, Feik School of Pharmacy, University of the Incarnate Word Upon completion pharmacists will be able to: List the major causes of PUD and recognize its multifactorial nature; Describe the proposed mechanisms by which H. pylori is transmitted; Discuss the procedures used in the diagnosis of PUD and H. Pylori infection; Discuss the clinical manifestations of PUD and H. Pylori infection; Compare and contrast the pharmacological agents and therapeutic strategies used in the manage-ment of PUD and H. Pylori; Explain the importance of managing H. pylori infections along with PUD. Upon completion technicians will be able to: Define PUD and H. Pylori; List the major causes of PUD; Identify medica-tions used to treat PUD and H. Pylori. UAN: 0165-0000-10-055-L01-P UAN: 0165-0000-10-055-L01-T

10:00-10:15 AM Break

10:15-12:15 PM Education 2 hours GCE/RC/TECH Hapless Against Heartburn No More! GERD Assessment and Treatment Katherine Heller, PharmD, Walgreens Health Initiatives, Clinical Director Upon completion pharmacists will be able to: Discuss the epidemiology of gastro esophageal reflux disease (GERD); Define and differentiate GERD; List lifestyle changes linked to reduction of GERD symptoms; List and dif-ferentiate effective empirical drug treatments for GERD; Discuss potential patient concerns related to long-term acid suppression therapy; Recommend appropriate treatment and triage strategies based on patient presentation. Upon completion technicians will be able to: Define gastro esophageal reflux disease; Identify signs and symptoms associated with GERD; List drug treatments used for GERD. UAN: 0165-0000-10-056-L01-P UAN: 0165-0000-10-056-L01-T

12:15 PM Afternoon On Your Own 1:00 PM Golf Tournament (Links Course)

Exhibit Hours: Sunday Evening, 6:30-8:30PM; Monday Morning, 7:00-8:00AM; Tuesday Morning, 7:00-8:00AM. Exhibit Information: The exhibitors are a very important part of Florida Pharmacy Association’s conferences. These companies send their representatives to educate you about their products and services at great expense. Please show them your appreciation! Visit with them, introduce yourself, shake their hands, tell them you appreciate them and invite them back next year!

Golf Tournament: The tradition continues! If you are a golfer, you can’t come to this beautiful resort and not take advantage of at least one of the many outstanding golf courses in the area. FPA will once again organize a golf tournament at the Links on Monday, August 9. Tee times from 1:01PM-1:27PM!

Brochure Revised_aLTERED... page 2

Spot 1: PANTONE Process Blue C

Spot 2: PANTONE 353 C

Spot 1: PANTONE Process Blue C

Spot 2: PANTONE 353 C

Wednesday, June 02, 2010 17:13

28 | F l o r i d a P h a r m a c y T o d a y

Wednesday, August 11th 4 hours GCE/RC/TECH

7:00-8:00 AM Continental Breakfast in Foyer

7:00-1:00 PM Registration Desk Open 8:00-10:00 AM Education 2 hours GCE/RC/TECH Inflammatory Bowel Disease & Irritable Bowel Syndrome: Where are We Now? Ann Snyder, PharmD, BCPS, Clinical Specialist, Internal Medicine Professor, UF College of Pharmacy Upon completion of this activity, pharmacists will be able to: Differentiate between ulcerative colitis (UC) and Crohn’s disease (CD); Design a treatment plan for varying stages of UC and CD; Design a treatment plan for irritable bowel syndrome (IBS); Identify specific considerations for each of these therapeutic treatment plans including efficacy, adverse events, and monitoring parameters. Upon completion technicians will be able to: Define ulcerative colitis; Define Crohn’s disease; Define irritable bowel syndrome; Distinguish the differences among each disease; List medications used to treat UC, CD, and IBS. UAN: 0165-0000-10-060-L01-P UAN: 0165-0000-10-060-L01-T 10:00-10:15 AM Break

10:15-11:15 AM Education 1 hour GCE/RC/TECH Drug Induced Hepatotoxicity and Nephrotoxicity Mara Poulakos, PharmD, RPh, Assistant Professor of Phar-macy Practice, Lloyd Gregory School of Pharmacy, PBAU Upon completion of this activity, pharmacists will be able to: Identify the most common offending pharmacologic agents that can cause renal and hepatic toxicities; Recognize the clinical presentation, pathogenesis and risk factors of drug-induced kidney disease; Implement strategies for prevention of drug-induced acute kidney injury, including the selection of pharmacologic alterna-tives that do not affect kidney function; Describe the several different clinical presentations and mechanisms of drug-induced liver disease; Design a phar-macist-directed strategy for assessment and monitoring of drug-induced hepatotoxicity. Upon completion technicians will be able to: Define hepato-toxicity; Define nephrotoxicity; List the most common agents affecting the kidney and the liver. UAN: 0165-0000-10-061-L01-P UAN: 0165-0000-10-061-L01-T 11:15-12:15 PM Education 1 hour GCE/RC/TECH Etiology, Pathophysiology and Treatment of Non-Viral Hepatitis and Cirrhosis Mara Poulakos, PharmD, RPh, Assistant Professor of Phar-macy Practice, Lloyd Gregory School of Pharmacy, PBAU Upon completion of this activity, pharmacists will be able to: Describe hepatic anatomy and vascular supply as well as the functions of the liver; Discuss the different pathologies of the liver: jaundice, cholestasis and cirrhosis; Describe the anatomic and physiologic effects of cirrhosis, including ascites, portal hypertension and varices, hepatic encephalopathy, coagulopathy and spontaneous bacterial peritonitis; Identify signs, symptoms & laboratory abnormalities of cirrhosis and associated complications; Recommend treat-ment strategies for cirrhosis and common complications of cirrhosis: Portal HTN and Variceal Bleeding; Ascites and Spontaneous Bacterial Peritonitis; Hepatic Encephalopathy; Coagulopathy. Upon completion technicians will be able to: Identify the functions of the liver; List diseases that affect the liver; Recognize sign and symptoms associated with liver disorders. UAN: 0165-0000-10-062-L01-P UAN: 0165-0000-10-062-L01-T 12:15 PM PROGRAM ENDS

9:00-10:00 AM Education 1 hour GCE/RC/TECH Celiac Disease: Life Without Wheat Melissa Murfin, PA-C, PharmD, Assistant Professor, Department of Pharmacy Practice, LECOM Bradenton School of Pharmacy

27th Annual Southeastern Gatherin’ General or Consultant Recertification Continuing Education

August 8-11, 2010

Tuesday, August 10th 4 hours GCE/RC/TECH

7:00-8:00 AM Continental Breakfast (Exhibit Hall)

7:00-1:00 PM Registration Desk Open

8:00-9:00 AM Education 1 hour GCE/RC/TECH Gastroparesis: When Good Stomachs Go Bad Melissa Murfin, PA-C, PharmD, Assistant Professor, Department of Pharmacy Practice, LECOM Bradenton School of Pharmacy Upon completion of this activity, pharmacists will be able to: Define gastroparesis; Explain pathophysiology and causes of gastroparesis; Discuss dietary changes for gastroparesis; Discuss drug and surgical treatments for gastroparesis; Apply knowledge to patient cases; Counsel patients on living with gastroparesis. Upon completion technicians will be able to: Define gastroparesis; List the causes of gastroparesis; List some dietary changes for the gastroparesis. UAN: 0165-0000-10-057-L01-P UAN: 0165-0000-10-057-L01-T

Upon completion of this activity, pharmacists will be able to: Define celiac disease; Explain pathophysiology and causes of celiac disease; Discuss dietary changes for patients with celiac disease; Discuss treat-ments for celiac disease; Apply knowledge to patient cases; Counsel patients on living with celiac disease. Upon completion technicians will be able to: Define celiac disease; List the causes of celiac disease; List some dietary changes for the celiac patient. UAN: 0165-0000-10-058-L01-P UAN: 0165-0000-10-058-L01-T 10:00-10:15 AM Break

Upon completion pharmacists will be able to: Investigate strategies to proactively combat nutrition related gastrointestinal conditions; Discuss nutritionally mediated health issues; Prioritize the three most common nutrition induced gastrointestinal health issues. Upon completion techni-cians will be able to: Identify the role of nutrition in gastrointestinal disor-ders; List the three most common health issues affected by nutrition; Identify ways to improve nutritional eating habits. UAN: 0165-0000-10-059-L01-P UAN: 0165-0000-10-059-L01-T 12:15-6:30 PM Afternoon on Your Own 7:00-10:00 PM Final Night Party

Final Night Party: Join the crowd the last night we are all together for fun, food, dancing and a room full of Gatherin’ friends.

Hotel Information: In an effort to better serve your needs, the following are included in the room charge: resort membership with discounted pricing on golf, tennis, marina and bicycle rentals; complimentary transportation to any facility on the Sandestin resort; complimentary use of Serenity by the sea’s fitness facility; and complimentary newspaper each day.

10:15-12:15 PM Education 2 hours GCE/RC/TECH Nutrition and Gastrointestinal Disorders Angela Clauson, PharmD, Assistant Professor of Pharmacy Practice, Lloyd Gregory School of Pharmacy, Palm Beach Atlantic University

Brochure Revised_aLTERED... page 3

Spot 1: PANTONE Process Blue C

Spot 2: PANTONE 353 C

Spot 1: PANTONE Process Blue C

Spot 2: PANTONE 353 C

Wednesday, June 02, 2010 17:13

J U N E 2 0 1 0 | 29

pharmacy rEsoUrcEs

PPSCretAil PHArMACy PurCHAsing ProgrAM

(888) 778-9909

pharmacy coNsUltaNts

HCC Pharmacy Business SolutionsdeAn PedAlino

(800) 642-1652MoBile: (727) 460-1855

iNsUraNcE

MeadowbrookWorkers CoMP insurAnCe endorsed By FPA(800) 825-9489

lEgal assistaNcE

Kahan ◆ Shir, P.l.BriAn A. kAHAn, r.PH., And Attorney At lAW

(561) 999-5999

pharmacEUtical WholEsalEr

McKesson Drug CompanyJiM sPringer

(800) 804-4590 FAX: (863) 616-2953

tEmporary pharmacists –

staFFiNg

HealthCare Consultants Pharmacy StaffingBoB Miller

(800) 642-1652

Medical Staffing network(800) 359-1234

Rx Relief(800) rXrelieF

bUyEr’s GUidEADVERTISERS: This is a special section designed to give your company more exposure and to act as an easy reference for the pharmacist.

P H A R M A C Y T O D A Yflorida

advertising in Florida pharmacy todaydisplay advertising: please call (850) 264-5111 for a media kit and rate sheet. buyers’ guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. professional referral ads: FPA Members: $50 per 50 words; Non-members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt.

Support Our Advertisers! Use the “Buyer’s Guide”

aHCa MeDiCaiD PHaRMaCy SeRViCeS2727 Mahan Drive

Tallahassee, FL 32308(850) 487-4441www.fdhc.state.fl.us/medicaid/pharmacy

aMeRiCan PHaRMaCiSTSaSSOCiaTiOn (aPha)Washington, D.C. (800) 237-2742www.pharmacist.com

aMeRiCan SOCieTy OF HealTH SySTeM PHaRMaCiSTSBethesda, MD (301) 657-3000www.ashp.com/main.htm

DRug inFORMaTiOn CenTeRPalm Beach Atlantic University(561) 803-2728druginfocenter@pba.edu

FlORiDa BOaRD OF PHaRMaCy4052 Bald Cypress WayBin #C04

Tallahassee, FL 32399-3254(850) 245-4292www.doh.state.fl.us/mqa

FlORiDa POiSOn inFORMaTiOn CenTeR neTWORK1-800-282-3171http://ora.umc.ufl.edu/pcc/fpicjax.htm

naTiOnal COMMuniTy PHaRMaCiSTS aSSOCiaTiOn 100 Daingerfield Road Alexandria, VA 22314703.683.8200703.683.3619 faxinfo@ncpanet.org

ReCOVeRing PHaRMaCiSTS neTWORK OF FlORiDa(407) 257-6606 “Pharmacists Helping Pharmacists”

FrEQUENtly callEd NUmbErs