Minnesota Pharmacist Journal March-April 2013

2 Minnesota Pharmacist n March-april 2013

How does your

measure up?Professional Liability

808 Highway 18 W | Algona IA 50511

Coverage BenefitsOur Professional Liability Policy is

specifically designed as excess coverage, yet it can become your first line of defense when

no other coverage is available.

• Additionalprotection for you above that provided by your employer.

• Covered 24hoursaday anywhere in the United States, its territories and possessions, Canada or Puerto Rico.

• Coverscompoundingandimmunizations(if legal in your state).

• On-staff pharmacist-attorneysareavailabletocounsel policyholders.

• Riskmanagementassistance that may reduce pharmacy professional exposure.

ApplyOnline!Go to www.phmic.com,

and choose the Pharmacist Liability Application under

the Online Services tab.

For more information, please contact your local representative:

*Compensated EndorsementNot licensed to sell all products in all states.

Form No. PM PhL 196

Endorsed by*:

Tom Nilsson, CIC, LTCP800.247.5930 ext. 7115

952.949.0617

Sheila Welle, CIC, LUTCF, LTCP800.247.5930 ext. 7110

218.483.4338

Lee Ann Sonnenschein, LTCP800.247.5930 ext. 7148

605.372.3277

Minnesota Pharmacist n March-april 2013 3

Upfront Views and newspresident’s desk: Springing Forward . . . . . . . . . . . . . . . . . . . . . . . . 5

CliniCal issUespharmacy and the law: Do I Have to Fill this Prescription? . . . . . . . . . . 9

Collaborative-practice agreements: Wave of the Future? . . . . . . . . . . 20

electronic tools for ambulatory Care . . . . . . . . . . . . . . . . . . . . . . . . . 22

Define or Be Defined: Duluth Area Pharmacists Engage in Modernization of the Pharmacy Practice Act . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

report of drug insert labeling revisions . . . . . . . . . . . . . . . . . . . . . . 27

pronunciation of active ingredient names . . . . . . . . . . . . . . . . . . . . . . 28

indUstry newsapha advances provider status initiative . . . . . . . . . . . . . . . . . . . . . . 10

pharmacy time Capsules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Health insurance exchanges: What Pharmacists Need to Know . . . . . 18

Minnesota newsMpha annual Meeting: Details and Registration . . . . . . . . . . . . . . . . . . 15

report from the state Capitol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Mpha newsMember Profile: Daniel Miller, PharmD . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Mpha Candidates for president-elect . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Organization Member Profile: Fairview Pharmacy Services . . . . . . . . . . 8

awarxe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

resource directory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

March-April 2013 Volume 67. Number 2, ISSN 0026-5616INSIDE

On the CoverCollaborative practice agreements:Wave of the Future? page 20

Find us on Facebook...Minnesota Pharmacists Association

Need to KnowMpha annual Meeting: Information & Registration page 15

Must-readHealth insurance exchanges: What Pharmacists Need to Know page 18

How does your

measure up?Professional Liability

808 Highway 18 W | Algona IA 50511

Coverage BenefitsOur Professional Liability Policy is

specifically designed as excess coverage, yet it can become your first line of defense when

no other coverage is available.

• Additionalprotection for you above that provided by your employer.

• Covered 24hoursaday anywhere in the United States, its territories and possessions, Canada or Puerto Rico.

• Coverscompoundingandimmunizations(if legal in your state).

• On-staff pharmacist-attorneysareavailabletocounsel policyholders.

• Riskmanagementassistance that may reduce pharmacy professional exposure.

ApplyOnline!Go to www.phmic.com,

and choose the Pharmacist Liability Application under

the Online Services tab.

For more information, please contact your local representative:

*Compensated EndorsementNot licensed to sell all products in all states.

Form No. PM PhL 196

Endorsed by*:

Tom Nilsson, CIC, LTCP800.247.5930 ext. 7115

952.949.0617

Sheila Welle, CIC, LUTCF, LTCP800.247.5930 ext. 7110

218.483.4338

Lee Ann Sonnenschein, LTCP800.247.5930 ext. 7148

605.372.3277


Visit www.mpha.org for more information and registration

2013 Mpha annUal ConferenCeMay 17-18, 2013 | Marriott Minneapolis Northwest, Twin CitiesSee pages 15-17 for more information and a registration form!

MphA BOArD Of DirectOrsExecutive/Finance Committee:

President: Martin Erickson Past-President: Scott Setzepfandt

President-Elect: Jill Strykowski Secretary-Treasurer: Bill Diers

Speaker: Meghan Kelly Executive Vice President: Vacant

Rural Board Members: Eric Slindee Jeff Lindoo

Metro Board Members: Cheng Lo

Brittany SymondsAt-Large Board Members:

Tiffany Elton Tim Cernohous

Keri Hager Amy Sapola Jason Varin

Student Representation: Duluth MPSA Liaison: Brittany Novak

Minneapolis MPSA Liaison: Amy HerbransonEx-Officio:

Bruce Benson, COP MPhA Executive Vice President (vacant)

MSHP RepresentativePharmacy Technician Representative:

Barb Stodola

Minnesota pHarMaCistOfficial publication of the Minnesota Pharmacists Association. MPhA is an affiliate of the American Pharmacists Association, the American Society of Consultant Pharmacists, the Academy of Managed Care Pharmacy, and the National Community Pharmacists Association.

Editor: Laurie Pumper, CAE

Managing Editor, Design and Production: Anna Wrisky

The Minnesota Pharmacist (ISSN # 0026-5616) journal is published six times per year by the Minnesota Pharmacists Association, 1000 Westgate Drive, Suite 252, St. Paul, MN 55114-1469. Phone: 651-697-1771 or 1-800-451-8349, 651-290-2266 fax, [email protected]. Periodicals postage paid at St. Paul, MN (USPS-352040).postMaster: Send address changes to Minnesota Pharmacists Association, 1000 Westgate Drive, Suite 252, St. Paul, MN 55114-1469.Article suBMissiOn/ADvertising: For writ-er’s guidelines, article submission, or advertising opportunities, contact Laurie Pumper at the above address or email [email protected]. Copyright 2013. Bylined articles express the opin-ion of the contributors and do not necessarily reflect the position of the Minnesota Pharmacists Association. Articles printed in this publication may not be reproduced in any manner, either in whole or in part, without specific written permission of the publisher.Acceptance of advertisement does not indicate endorsement.

Upcoming Events

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Update your profile through your online MPhA Member Portal page to continue receiving important association updates.

Mpha Mission: serving Minnesota pharmacists to advance patient care. The Minnesota Pharmacists Association is a state professional association, whose membership is made up of pharmacists, pharmacy students, pharmacy technicians, and those with a business interest in phar-macy. MPhA will be the place where pharmacists go first for education, information and resources to become empowered to provide optimal patient care. MPhA will be the recognized and respected voice of pharmacy with legislators, regulators, payors, media and the public.

Not Your Mother’s MPhA

May 17-18, 2013Marriott Minneapolis

Northwest

2013 MPhA Annual

Conference

Call for ArticlesThe Minnesota Pharmacist accepts articles for publication from its members and from non-members. All content is subject to review by the MPhA Editorial Advisory Committee and MPhA Staff, who will determine wheth-er material is of interest to our readers. To submit an article or an idea/abstract, please send an email to Communication Director Laurie Pumper at [email protected].


President’s Desk

springing forward by Martin A. Erickson, III, RPh, Director of Professional Services and Regulatory Affairs, Fagron

Upfront Views and news

In the January-February issue, I prom-ised to share details of your executive board’s search for our next executive vice president. The application period closed February 22. The search com-mittee, composed of your executive committee, scheduled first interviews with potential candidates from the pool of applicants. Following the first inter-views, the search committee reviewed the results and conducted in-person interviews with the candidates showing the greatest potential to be our next EVP. From these second interviews, the committee has chosen two finalists who will be presented to the full MPhA Board of Directors and comments will be solicited. The final candidate will be presented to the board for affirmation in late March.

The goal is to ask the successful can-didate to begin his or her duties before the Annual Meeting in May.

As in life, all of the foregoing is based upon the expectation that “nothing will go wrong…” So, please be patient.

Our new EVP and all of us, the mem-bers, will embark upon a new adven-ture, a new chapter in the saga of Minnesota pharmacy, a chapter of special importance because the phar-macy practice act changes will be pre-sented and debated in the Legislature during the 2014 session.

Our consultants and lobbyists from Ewald Consulting and our new EVP will need assistance from all of us

as the bill wends its way through the legislative process. Please consider how you might be of unique assistance in this effort. For foundational mate-rial, please be aware of the legislative updates from our lobbyists, the first of which appears in this edition of the Minnesota Pharmacist. In another, related area, I think you will find Rita Tonkinson’s article on health insur-ance exchanges in Minnesota helpful as you speak with patients and legis-lators.

I have pondered this new chapter; I at once am honored and experience some trepidation, sitting in the presi-dent’s position as our story unfolds. I am confident that the broad support of pharmacists in all areas of practice that we have seen developing in the past few years indicates resurgent growth and interest in advancing our profession to a statewide audience as well as to our individual patients. Why am I confident? Minnesota phar-macy has been a leader nationally — for starters, look at the positions held by Minnesotans, most recent-ly APhA President Steve Simenson. And we have been in the forefront of change for the good of our patients. Students are continuing this tradition: Zach Merk’s discussion of collabora-tive practice is an excellent example. After all, our professional business is about making sure each person we encounter — colleague, patient, sup-plier, etc. — receives the full benefit of our professional expertise and our per-sonal care and integrity. The business

side will thrive, paradoxically, when we let go of buying, selling, bottom-lining and make our profession our business. As I learned from my parents and grandparents: take care of the patients and the patients will take care of your business. Our annual meeting theme this year is “Not Your Mother’s MPhA:” the traditions taught by our profes-sional mothers (and fathers) produced remarkable changes in practice and the Association; growth and develop-ment brought us here and will carry us into the future. Hence my confi-dence about pharmacy in Minnesota: we do take care of our patients, we are imaginative, energetic leaders in our profession, we live out our care and concern for humanity in one-on-one encounters at the consulting desk, in patients’ room, and in the halls of the Legislature. Our next leader, our EVP, will bring a mix of all of these qualities, undergirded by professional oath and excellent education and experience.

It’s going to be fun — yes, fun — to participate in the serious business of practicing professional pharmacy in the next chapter of the MPhA story.

We do take care of our patients, we are

imaginative, energetic leaders in our profession.


Member Profile: Daniel Miller, PharmDwalgreens, Minneapolis

“While I love pharma-cy and all that it offers professionally, I have

a second love,” said Daniel Miller, PharmD. “In my small amount of free time, I make stained-glass art. I have sold my small panels and ornaments at the Midtown Farmers Market in Minneapolis. Being a pharmacist helps, I often need lots of bandages, but I enjoy creating bright and colorful pieces that brighten people spaces as well as pharmacies.”

“I began my career in pharmacy as a pharmacy technician at a Walgreens in Coralville, Iowa in January 2003,” Daniel said. As president of his high school’s science club, he invited a pharmacist to talk to the club about careers. Later, he said, when he took inventory of his life goals and where he wanted to be, he realized that he loved chemistry and life-sciences as well as working with people as an educator. That interaction with the pharmacist drove his first steps toward a degree in pharmacy, he said.

Daniel studied pharmacy and earned his PharmD from the University of Iowa, College of Pharmacy in June, 2008. Currently, his job title is Health-Systems Pharmacy Manager, Market HIV Pharmacist. He works at Walgreens Health-Systems Pharmacy at Uptown Row in Minneapolis.

When asked about what is most mean-ingful in his day-to-day pharmacy work he said, “My favorite part of being a pharmacist is having deep, meaningful conversations with patients regarding their pharmaceutical care. Engaging and retaining patients is very fulfilling and, occasionally, I get to walk away after advocating for the patient, know-ing that I have made a big difference and my help was appreciated.“

“I admit I’m very focused on the HIV community! I just saw How to Survive a Plague and it was deeply moving.”

The greatest challenge in his career, Daniel said, is balancing time. “To balance outreach into the HIV com-munity, while managing the business and clinical aspects of the pharmacy, is sometimes difficult. Also, empower-ing six other Walgreens HIV Centers of Excellence, mentoring first-year

students and precepting fourth-year students is also challenging.” Daniel said that keeping a rigid and thorough calendar and depending on his techni-cians and students, who are so much of why his pharmacy works, is how he survives.

“I would like to see the Minnesota Pharmacist provide articles on special-ty pharmacies. While specialty phar-macies may care for specific popula-tions, their work is extremely important to the patients they serve.”

With regard to being a member of MPhA, Daniel said, “I feel strongly that pharmacists need to be represented in the legislative process. Our voices and concerns need to be expressed through the presence of profession-als at the Capitol so that we can have a say in how our own profession is governed.”

Aside from being a leisure-time artist, Daniel said, “Something else that you wouldn’t guess about me is that I also appreciate tattoo artistry. I have 10 of them, discreetly hidden while I perform professional duties.”

Mpha Members:

go online to to mpha.org to vote for your 2014-2015 Mpha president-elect and all

other open Board seats!Voting began on March 15 and will close on tuesday, april 9. Be sure to cast your ballot!


2014-2015 Board of Directorspresident-elect Candidates

randall seifert, pHarMdSenior Associate Dean and Professor, Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota, College of Pharmacy, Duluth, Minn.

Eric Slindee is a respected Community Pharmacist with a strong history of pro-fessional service. Since graduating from the University of Minnesota’s College of Pharmacy in 1978, Slindee has worked in several retail pharmacy settings in the Twin Cities and in southeastern Minnesota.

While in college, Eric interned at Target Pharmacy #3. His first full-time job was in Austin at Osco Drugs. He relocated to work at the Kmart Pharmacy in West St. Paul for another two years. A small-town guy at heart, Eric and his wife, Lori, moved to Harmony, Minn., in 1982. They successfully managed and owned their own pharmacy for 27 years. For many years, Slindee also served as the pharmacist at the Harmony Community Hospital. In 2009, Slindee sold the pharmacy to a group now owned by Sterling Drug. Eric continues to be the pharmacist in Harmony, where he now has provided professional service to four generations.

Slindee brings his strengths to the leadership of MPhA. Through years of business ownership and management, he has a solid working knowledge of budgets, financial statements, advertising, and personnel. In pharmacy practice, Eric says, “I most enjoy patient consultation so that together we can arrive at a plan to improve their therapeutic outcomes so they can live a healthier, happier life.”

Slindee has been an MPhA member since 1980, and has served on the MPhA Board of Directors since 2005. He has represented MPhA at the State Capitol by meeting with legislators on legisla-tive day. He has represented pharmacists in meetings with Blue Cross Blue Shield of MN and Prime Therapeutics at the Attorney General’s office.

At the community level, Eric has been involved in many leader-ship roles. He worked on development of the Harmony-Preston Valley bike trail during a multi-year planning process. Slindee is a 30-year member of the Harmony Lions. He’s been a leader in many community events, promotions and festivals. In his church, He has served multiple terms on the church council, call com-mittees and sings in the choir. Slindee grew up in the northern Minnesota community of Blackduck. He attended Concordia College in Moorhead, Minn., for two years before being accepted into the University of Minnesota’s College of Pharmacy in Minneapolis.

Eric says, “I am committed to and strive to serve Minnesota phar-macists in all practice settings to advance patient care. I would be humbled and honored to serve you as your president of the Minnesota Pharmacists Association.”

Randall Seifert is the Senior Associate Dean and Professor at the University of Minnesota College of Pharmacy on the Duluth Campus. He earned a Bachelor of Science degree in pharmacy at North Dakota State University (NDSU) in 1975. After a short time practicing com-munity pharmacy in Manchester, N.H., he entered the University of Minnesota Doctor of Pharmacy program, graduat-

ing in 1978. He then completed a research fellowship in cardiol-ogy at the university. Dr. Seifert joined the NDSU clinical faculty in 1979 and became the Director of Clinical programs in 1983. He left NDSU in 1987 and entered private practice in Santa Barbara, Calif., where he practiced as a long-term care consultant and pharmacy manager, clinical trials director at California Clinical Trials, and VP of Pharmacy, Clinical Research and Disease Management at Santa Barbara Medical Foundation Clinic. He started Seifert and Associates, a managed care pharmacy consulting company, in 1997. He returned to academics at the University of Minnesota in 2005.

Seifert has extensive experience in pharmacy benefit design, managed care, medical group management and pharmacy services management. He acquired pharmacy benefit manage-ment experience in several settings, including an HMO, medical provider groups, and consulting for employer groups. He serves as a consultant to a large multispecialty and IPA medical group in Southern California. He has been extensively involved in devel-oping medication therapy management benefits for the City of Duluth, City of Superior, St. Louis County, Dakota County and the University of Minnesota U Plan MTM benefit program. He lectures frequently on pharmacy benefit design and medication therapy management. His research development interests are in the areas of benefit design, marketing of pharmaceutical care ser-vices and use of technology to improve access to pharmaceutical care in various settings, including employer operations and rural communities.

Randall says, “It is an honor to be asked to run for president-elect of the association. In the next couple of years we have much work to do in order to secure our professional place within the rapidly changing health care delivery system.

“We start from a good place. I am excited about the efforts that have been made on the part of the association, the Center for Leading Healthcare Change and grassroots members to make substantial and positive changes in our professional practice act.”

eric n. slinDee, BsPhArMSterling Drug Pharmacy 27, Harmony, Minn.


Organization Member Profile: Fairview Pharmacy ServicesContact name: Bob Beacher, RPh

your job title: President, Fairview Pharmacy Services

locations/number of pharmacies in your organization:

Fairview Pharmacy Services (FPS) operates 46 pharmacies with 1,113 employees in the 11-county metro area. Practice sites include retail phar-macy, inpatient pharmacy, home infu-sion therapy, mail order pharmacy, a central compounding pharmacy, specialty pharmacy, long-term care, outpatient infusion centers, multiple Medication Therapy Management sites, and a pharmacy benefits man-agement company.

Brief history of your organization; what makes it unique?

Fairview Pharmacy Services is part of Fairview Health Services, a non-profit health care system that includes both community hospitals and the University of Minnesota Medical Center. The first Fairview Pharmacy was opened in 1990 adjacent to Fairview Southdale Hospital and was opened to fill dis-charge prescriptions at Fairview Southdale Hospital as well as pro-vide home infusion therapy services to Fairview in partnership with Fairview Home Care and Hospice. During the past 23 years, Fairview Pharmacy has evolved into an organization that pro-vides comprehensive pharmacy dis-tribution and medication management services to all of Fairview’s patients, no matter what the treatment setting.

Recently, in the interest of environ-mental stewardship, we introduced the use of biodegradable coolers for temperature-controlled shipping of medications. Use of this eco-friend-ly packing material will prevent an

estimated 44,000 polystyrene coolers from reaching landfills in 2013.

why it’s important to your organiza-tion to support Mpha:

FPS has always had a number of individual pharmacists and technicians who are members of MPhA, many playing an active role in the organiza-tion. We recognize the value — and indeed the necessity — for the pro-fession to have a strong professional organization to serve as an advocate for advancing pharmacy’s interests to government, regulators, and a variety of third-party interest groups. MPhA plays this role and it is vital for orga-nizations like Fairview to support this effort.

What is the biggest benefit of MPhA membership to your employees?

This is a dynamic time within health care. Health care is changing, and with that the practice of pharmacy is changing as well. Pharmacists and technicians need a vehicle to actively engage with other health care pro-fessionals to shape pharmacy’s role on the health care team. It will take a concerted effort to shepherd the profession through the dramatic changes the health care system will undergo in the next few years. MPhA can be the conduit of aware-ness through its variety of effective communi-cations, committees and opportunities for involvement.

what kind of impact do you hope Mpha

will have for your employees?

By providing MPhA membership to all Fairview pharmacists and technicians through the corporate membership option, it is our hope that many will become actively involved in the work of shaping the future of our profession. In essence, we are saying to our staff, “we will assist you by providing mem-bership in a professional organization that can help position pharmacy for successful and rewarding inclusion in the new world of health care. But it is up to you to roll up your sleeves and actively contribute to the effort. Don’t wait for someone else to do it on your behalf.”

Fairview Pharmacy Services thanks MPhA for giving corporations the opportunity to provide a cost-effective way to encourage their professional staff to become involved in their pro-fession. We recognize the benefits of expanding the base of membership and providing opportunities for moti-vated individuals to become advocates for change. We are pleased to have Fairview and its employees play a role in shaping pharmacy’s future.

The recently remodeled Fairview-Riverside pharmacy.



do i Have to fill this prescription?By Don R. McGuire Jr., RPh, JDThis series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

Many pharmacists have asked the question, “I have some doubts about this prescription; do I have to fill it?” We will deal with this question in terms of therapeutics and patient health. We will reserve the topic of conscientious objection for a different time. When I was a young pharmacist, a more experienced colleague at the hospital received a phone order for IV propran-olol, but at an oral dosage. The other pharmacist refused to dispense it, even in the face of verbal threats from the prescriber. In the end, the order wasn’t filled and any potential harm to the patient was avoided. What should you do if faced with a prescription that you believe is harmful to the patient?

This harm may come from serious side effects, drug interactions, or pos-sible addiction to controlled substanc-es. Some states deal directly with this question in their regulations. For example, California states that phar-macists can refuse to fill prescriptions that would be against the law or that

could potentially have a harmful effect on a patient’s health.1 Indiana states that the pharmacist can refuse to fill a prescription that is contrary to law, that is against the best interests of the patient, that would aid or abet an addiction or habit, or that is contrary to the health and safety of the patient.2

Two general rules can be formulated from these examples.

1. prescriptions that are illegal or invalid can’t be filled. This is one of the most difficult scenarios for a phar-macist when it comes to controlled substances. The DEA takes the posi-tion that to be valid, a prescription for a controlled substance must be issued for a legitimate medical pur-pose by a practitioner acting in the usual course of professional practice. The DEA believes that the law does not require a pharmacist to dispense a prescription of doubtful, question-able, or suspicious origin. It is difficult for a pharmacist to know when the line has been crossed from legitimate

treatment to addiction. I think it is safe to say that if the current prescription presented to you is causing you to ask the question, then the line is very close or perhaps already crossed.

2. prescriptions that could harm the patient shouldn’t be dispensed. This seems obvious, but is not always easy to apply in the real world. The dosage is on the high side of normal, the patient has had penicillin before, the drug interacts with a previous prescription, or any other scenario that you can imagine where the pre-scriber directs you to go ahead and fill the prescription. However, if you think there is a high probability that the patient will be harmed, no one can order you to dispense the prescrip-tion.

While California and Indiana spell out the responsibility of the pharmacist in these two situations, I believe that the same responsibility exists even in jurisdictions that don’t explicitly cite it.

The AWARxE campaign was founded by the Minnesota Pharmacists Foundation in 2009, in order to educate communities and individuals on the dangers of abuse or misuse of prescription medications.VISIT MPHA.ORG FOR MORE INFORMATION.

pHarMaCy and tHe law

do i Have to fill this prescription? continues on page 12


apha advances provider status initiative

APhA has announced a major effort to obtain recognition of pharmacists as providers in the health care system. A major component of that recognition is the listing of pharmacists as providers in the Social Security Act. Provider listing in the Social Security Act is an important component in the ultimate goal of providing consumers and other health care providers with access to our services. For patients to achieve the full benefit of their medications, pharmacists must be part of the team.

The American Society of Health‐System Pharmacists (ASHP) released a similar statement from its CEO on January 2, following on the heels of an American College of Clinical Pharmacy (ACCP) board action last November and an Academy of Managed Care Pharmacy (AMCP) position statement approved by its board last June. Other national pharmacy organizations have also expressed interest in participating in provider status efforts.

People on all medications, particularly those with complex medical condi-tions, benefit from pharmacists’ clinical services, APhA will tell Congress. “It’s the smart spend that pays” will be the tagline advocated by APhA, which will cite published literature and prac-tice-based experience showing that when pharmacists get involved, overall health care costs go down and quality and patient safety improve.

indUstry news

To optimize our health care spending, Medicare must include pharmacists’ clinical services that are provided in collaboration with physicians and other providers on the health care team. Recognition of pharmacists’ clinical ser-vices in the nonphysician part of Medicare Part B would help to improve patient outcomes and assist physicians and other pro-viders in meeting complex health care needs of patients. Medicare Part B is not the only important user of the Social Security Act provider list, as accountable care organizations, state Medicaid programs, and other payers usually rely on the Social Security Act provider list to determine payment poli-cies and services covered.

“It is time for pharmacists to be recog-nized for the value they bring to improved patient outcomes,” said Steven T. Simenson, BSPharm, FAPhA, FACA, FACVP, APhA President and Chair of APhA’s Provider Status Task Force. “Pharmacist advocacy in legislative and private payer arenas is a critical component to achieve pharmacists being paid, as are all other providers, for their clinical decision making. This should apply to all of pharmacy prac-tice, regardless of practice site.”

“We are pleased to see so many nation-al and state organizations rising up to support provider status, and we will

work diligently to marshal our collective strength into one set of principles that all our organizations can support,” said APhA Executive Vice President and CEO Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA. A state-ment for the pharmacy, medical, and legislative communities was posted on the homepage of pharmacist.com. The APhA Board of Trustees has allo-cated significant financial and human resources to work on this issue.

Although changing the law would liter-ally take an act of Congress, the initia-tive isn’t just about a legislative fix. The profession is exploring all avenues, including working with the private sec-tor and states.

For the past two years, APhA has been in dialogue with stakeholders within and outside of pharmacy regarding ways to advance recognition of phar-macists’ patient care services. Recent discussions among the health care reform pharmacy stakeholders have

apha continues on page 11

“It is time for pharmacists to be recognized for the value they bring to improved patient outcomes,” said Steven T. Simenson, APhA President-Elect. “Pharmacist advocacy in legislative and private payer arenas is a critical component” so that pharmacists are paid for their expertise.

been taking place to come up with a comprehensive and cohesive plan for the profession.

Beyond the national pharmacy orga-nizations, advocacy for provider status has included the U.S. Public Health Service pharmacy report to the Surgeon General a year ago; the Change.org petition started by Sandra Leal, PharmD, CDE, of El Rio Health Center in Tucson, Ariz., on November 15, 2011; and more recently, a White House “We the People” petition, started by student pharmacist Steve Soman of St. John’s University College of Pharmacy and Health Sciences in Queens, N.Y. If the White House petition amasses 25,000 signatures by January 26, 2013, then the White House must issue an official response. These are examples of the types of advocacy needed by a critical mass of the profession in order to attain the desired recognition.

Calling provider status a “top- priority strategic issue,” ASHP CEO Paul W. Abramowitz, PharmD, FASHP, explained ASHP’s involvement in the profession-wide push for provider sta-tus in his From the CEO column in ASHP InterSections, released January 2.

“Achieving provider status under sec-tion 1861 of the Social Security Act is important for the profession. It is essential to recognize pharmacists for the patient care providers that they already are,” Abramowitz wrote. “Achieving provider status will not be easy. It will take a massive grass-roots effort by individual pharmacy practitioners and affiliated state soci-eties leading state‐based coalitions. … Achieving provider status will also require a strong and cohesive national coalition of pharmacy organizations, consumer groups, and other health care organizations that understand the

value pharmacists bring to the care of the American people.”

In November 2012, the ACCP Board of Regents authorized a new initiative to seek provider status for clinical pharmacists working in all practice settings. Its action is focused more narrowly than that of other nation-al groups. “‘Qualified clinical phar-macists’ will possess credential(s) beyond entry level that are com-mensurate with the scope of services being proposed for coverage and that assure the clinical pharmacist’s ability to contribute to team‐based, patient‐centered care,” according to the December 2012 ACCP Report article on the initiative.

The Academy of Managed Care Pharmacy (AMCP) issued a posi-tion statement on Non‐Physician Provider Status for Pharmacists that was approved by the AMCP Board of Directors in June 2012. Provider status would “allow pharmacists to be reim-bursed directly from Medicare Part B for providing cognitive services to patients covered under the program,” accord-ing to the position statement. “Although current Medicare Part D law reimburses pharmacies for pharmacists providing some cognitive services, including medi-cation therapy management (MTM) to a select subset of patients, the program is restrictive and encompasses only a small set of the services pharmacists are capable of undertaking.”

1988—twenty-five years ago:

• Medicare Catastrophic Health Care Act passed by Congress but repealed immediately after a groundswell of negative reaction.

• Board of Pharmacy Specialties (BPS) recognizes Pharmacotherapy and Nutritional Support as pharmacy practice specialties

1963—fifty years ago:

• The first measles vaccine was licensed for use in the U.S. John Enders developed the vaccine from a strain of measles isolated by Thomas Peebles.

• Valium (diazepam) marketed by Hoffman-LaRoche.

1938—seventy-five years ago:

• The Federal Food, Drug, and Cosmetic Act was passed in response to deaths from the use of Massengill’s Elixir of Sulfanilamide.

• Albert Hofmann of Sandoz Laboratories in Switzerland synthe-sized LSD (lysergic acid diethylam-ide).

1913—one hundred years ago:

• Alaska passed territorial practice act.

1888—One hundred twenty-five years ago:

• First class of pharmacy students enrolled in the South Dakota State College (then the State Agricultural College) in Brookings, SD.

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

Pharmacy Time CapsulesBy: Dennis B. Worthen, Lloyd Scholar, Lloyd Library and Museum, Cincinnati, OH

apha continued from page 10


If not, then why bother to require that drug utilization reviews be performed? And if the pharmacist is powerless to act when something is detected, again, why require them? We all know that there are some risks associated with every drug and every treatment. What we are talking about here are the large, severe risks. In the pro-pranolol example given earlier, the pharmacist was convinced that the patient would die if he dispensed that order as prescribed. If the prescriber can overrule the pharmacist’s profes-sional judgment in this situation, then the chances of an irreversible, nega-tive outcome increase. But you can’t make these decisions in a vacuum. Discussion with the prescriber will probably be necessary. Perhaps dis-cussions with the patient also will be necessary. Use the information from these discussions in conjunction with your professional knowledge, experi-ence and judgment.

As I tell pharmacists in these situa-tions, it is much easier to defend a case where the pharmacist refuses to fill a questionable prescription than it is to defend a case where the pharma-cist has doubts about what was dis-pensed. You don’t want your answer to the deposition question, “And what did you do when you became aware of this potential danger?” to be, “Nothing.” We can’t ensure 100% safety, but we want to avoid high probabilities of serious harm.

Pharmacists owe patients their high-est efforts to treat their health prob-lems and try to protect them from avoidable harm. The pharmacist’s duty to a patient does not require the pharmacist to do anything illegal. However, I do believe that it requires pharmacists to use their professional judgment for the patient’s benefit. That may mean refusing to dispense a par-ticular prescription. And that situation

may require some intestinal fortitude on the part of the pharmacist.

Citations:1 California Code of Regulations, Division 17, Title 16, Article 2, Section 1707.6

2 Indiana Code 25-26-13-16

© Don R. McGuire Jr., RPh, JD, is General Counsel, Senior Vice President, Risk Management & Compliance at Pharmacists Mutual Insurance Company.This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with policies and procedures of their employ-ers and insurance companies, and act accordingly.

What’s the best way to let pharmacists and technicians know about my new product or service?

advertise in the newly redesigned Minnesota Pharmacist, the official journal of MPhA.for the first time, all pharmacists throughout Minnesota receive a copy of Minnesota Pharmacist.the Minnesota Pharmacist is the leading pharmacy publication in our state:

Circulation – sent to all 9,000+ pharmacists in MinnesotaValue – best cost-per-thousand among state pharmacy publicationsQuality – professional, four-color printing on coated paperinformative – strong editorial topics drive each issuereader-friendly – new organized layout helps readers find what they wantstrong Voice – covering topics of greatest importance to the Minnesota pharmacy community

This is the publication you should advertise in because…

the Minnesota Pharmacist is the only publication in the hands of every Minnesota pharmacist.• gain exposure• Build brand awareness

Sign up online at www.mpha.org or contact Paul Hanscom at 651-290-6274 or [email protected].

do i Have to fill this prescription? continued from page 9


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the annual Conference takes place May 17-18, 2013 at the Marriott Minneapolis northwest, and includes two days of educational sessions in pharmacy practice and disease-state topics. additionally, Mpha will host Minnesota’s “Pharmacy leaders” and recognize them for service to field of pharmacy.

MPhA ANNUAL MEETING:May 17 – 18, 2013

Marriott Minneapolis NorthwestNot Your Mother’s MPhA

Top reasons to attendlearn

• This conference features more than 20 industry profes-sionals, speaking to the ins and outs of pharmacy.

• Make sure that you are up to date on your CEs. MPhA is offering 9.5 contact hours (4 Friday, 5.5 Saturday) at this conference. Saturday’s sessions are approved for both Pharmacists and Technicians! This isn’t something you want to miss!

• Sessions will be covering timely information that you’ll need to stay up to date in the pharmacy world and all of the changes going on.

• A total of 6 total breakout sessions (made up from 2 tracks each afternoon) representing 2 tracks each day will provide conference attendees with the opportunity to select specific topics of interest. Sessions are available for all levels of experience. Whether you are new to the industry or a seasoned professional, there is something for everyone!

• Trends in Health Systems Setting• Trends in the Community Setting• Anti-Microbial Stewardship Program• Compounding Pharmacy• Transitions of Care• Practice Update• Wellness Program

network

• This event is the premier gathering of Minnesota phar-macists in the industry.

• Network with the who’s who of Minnesota pharmacists across all practice settings.

• Meet industry reps.

• Meet new graduates and students entering the field.

• Share your experiences with others while learning more about the changes in the industry.

not your Mother’s Mpha

• We live in a dynamic world. Things that were true in pharmacy even 5 years ago have changed dramati-cally. This conference will help keep you in the know as you learn about things affecting all pharmacists in the state of Minnesota.

take part in this event – held in the Twin Cities for the first time in more than 15 years! You don’t want to miss this celebration of your colleagues and friends in the industry – now more convenient to attend.

Testimonial:“Outstanding educational sessions – timely and very strong materials to assist pharmacy & pharmacist practice.” – 2012 Pharmacist Attendee

Registration and full details available at mpha.org


MPhA KeYNoTe SPeAKerLOYD V. ALLEN, JR., PhD

MPhA Brings Industry Leaders to Annual Meeting

Registration and full details

available online at mpha.org!

(Or register using the form

on the opposite page.)

MPhA is proud to welcome a world-renowned educator, author and researcher as our keynote speaker at the 2013 Annual Meeting! Loyd V. Allen, PhD, is Editor-in-Chief of the International Journal of Pharmaceutical Compounding, CEO of the Midwest Institute of Research and Technology and Professor Emeritus of the University of Oklahoma College of Pharmacy. He obtained his BS and MS in Pharmacy from the University of Oklahoma College of Pharmacy, respectively.

MPhA KeY SPeAKerS

Mark M. Zipper, PhD, Director of Clinical Operations, Allina Mental Health, Allina Health

AgeNdAFRIDAY, MAY 17, 2013

8:00-8:30am Registration 8:30-10:00am Keynote Speaker: Compounding Pharmacy 10:00-10:30am Break 10:30-11:30am General Session: Anti-Microbial Stewardship Program 11:30am Lunch & Exhibit Hall 12:30-1:00pm General Session: Introduction to New Models Program 1:00-2:00pm Breakouts Track 1: Health Systems Track: New Models: Trends in the Health Systems Setting Track 2: Community Pharmacy Track: New Models: Trends in the Community Setting 2:00-3:00pm General Session: Transitions of Care 3:00-3:15pm Break/Exhibits 3:15-4:45pm General Session House of Delegates 4:45-6:00pm Exhibitor Reception 6:00-8:00pm President's Banquet

SATURDAY, MAY 18, 2013

7:30am Registration 8:00-9:00am Breakfast in Exhibit Hall 9:00-10:00am Keynote Speaker: Wellness Program 10:00-10:30am Break 10:30am General Session: Practice Update -12:00pm 12:00-1:00pm Honors Lunch & Awards 1:00-2:00pm Breakouts Track 1: General Track: Pain Competition - Part 1 Track 2: Technician Track: Board of Pharmacy Detailed Update Track 3:AWARxE Training 2:00-3:00pm Breakouts Track 1:General Track: Pain Competition - Part 2 Track 2: Technician Track:Institutional Drug Diversion: Risk and Prevention 3:00 - 3:15pm Break 3:15 - 4:15pm General Session: Career Roundtables 4:15pm Adjourn

Ruth Lynfield, State Epidemiologist and Medical Director, Minnesota Department of Health


MPhA REGISTRATION2013 ANNuAl MeeTiNg/coNfereNce • MAY 17-18, 2013

full WeeKeNd: fridAY & SATurdAY MPhA Member $325 Non member $425 Pharmacy Student Member $225

fridAY oNlY: ce, KeYNoTe & PreSideNT’S BANqueT MPhA Member $200 Non member $300 Pharmacy Student Member $145

SATurdAY oNlY: ce, KeYNoTe & AWArdS MPhA Member $180 Non member $280 Pharmacy Student Member $145

Late Registration: All registrations received after April 19, 2013 will be charged a $25 late fee.

NAME ORGANIZATION

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PHONE: HOME WORK CELL EMAIL (REQUIRED FOR EVENT CONFIRMATION)

MPhA PAYMeNT BY: Check Visa Mastercard Discover

If paying by credit card, all fields below are required.

CARDHOLDER NAME (PRINT)

CARD NUMBER SEC CODE ExP

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AddiTioNAl gueST(S) I will be bringing a guest(s) with me to the following events: (Do not include yourself)

Friday President’s Banquet $45 x ____ = $_________

GUEST NAME GUEST EMAIL

MPf STudeNT educATioN fuNdYour 100% tax deductible donation to the Minnesota Pharmacists Foundation will reimburse student registration and housing costs, supporting our future pharmacists and leaders.

Full ($215) Day ($105) Other ____

Enclosed is an additional check payable to the Minnesota Pharmacists Foundation.

SESSION HANDOUTS will be available electroni-cally on the MPhA website. Attendees will be notified one week before the conference of their availability.

If you prefer a printed set of handouts to be pro-vided for your use at the conference, please check the box below:

I am requesting printed handouts for an addi-tional charge of $25

Event Registration = $ ________

Additional Guests = $ ________

Printed Handouts = $ _________

MPhA ToTAl = $________

MAil or fAx forM BAcK To MPhA: 1000 Westgate Drive, Suite 252 • St. Paul, MN 55114 651-290-2266 fax • www.mpha.org • Questions? 651-697-1771 • 800-451-8349

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Please do not email credit card information. Fax or mail your registration form to protect this information.

I am a first time attendee. I plan to attend the Welcome Reception on Thursday night from 7:00 – 9:00pm. I plan to attend the President’s Banquet on Friday night from 6:00 – 8:00pm.

If you have special dietary needs, please list here: _____________________________________________


Health Insurance Exchanges:What Pharmacists Need to KnowBy Rita Tonkinson

The Affordable Care Act ushered in a new health care paradigm. To most busy pharmacists, it’s all very confus-ing. Without a doubt, it is complex, dynamic and a source of many ques-tions. However, the most important take-away is that pharmacists have excellent opportunities to become sig-nificant contributors to the success of new primary care teams. There’s enough information online to fill this journal and all journals for the remain-der of the year! This article will touch on the basics:

• Patient Protection and Affordable Care Act of 2010, also referred to as the Affordable Care Act (ACA)

• Essential Health Benefits under Federal Law

• Accountable Health Care Organizations/Medical Homes

• The Role of the Pharmacist on the Primary Care Health Team

the AffOrDABle cAre Act

“In July 2012, the Center for Medicare and Medicaid Innovation released a competitive funding opportunity for states to test innovative payment and service delivery models that have the potential to lower costs for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), while main-taining or improving quality of care for program beneficiaries.” This statement is part of the executive summary of “The Minnesota Accountable Health Model,” published in September 2012

by the Department of Human Services (DHS), Health Reform Minnesota. According to this source, Minnesota submitted a Model Testing proposal for the state’s model on September 24, 2012. In November 2012, Gov. Dayton sent a letter and application to HHS Secretary Sebelius formally submitting Minnesota’s intent to operate a state-based health insurance exchange (minnpost.com, Dayton administration commits to state-run health exchange, November 16, 2012). A task force appointed by the governor provided its recommendations to the governor and to the legislature on December 13, 2012 (minnpost.com, Minnesota task force finalizes plan for implementing federal health care reform, December 14, 2012).

Improved health, improved care and lower costs through changes in health care delivery are being referred to as the Triple Aim; the structure to achieve significant goals in a team-based setting is the Accountable Care Organization (ACO). While all states are working to address the current fragmentation and to integrate ser-vices to achieve the Triple Aim, not all models will look alike. According to a background paper prepared by Alyssa Ferrie, PharmD candidate 2013, for the Minnesota Pharmacists Association, there are three exchange models:

• Market Organizer: This exchange will serve as an information source on health plans and enable consumers to make informed decisions.

• Selective Contracting Model: The state will play an active role and will contract with a limited number of health plans and may require that plans meet certain cost/quality met-rics.

• Active Purchaser Model: The state will actually purchase health insurance on behalf of consumers.

Under the ACA, states have the option to expand Medicaid eligibility to nearly all individuals under age 65 whose incomes fall below 138% of the federal poverty level. The plans must cover all Essential Health Benefits (EHBs) in the Medicaid program. Please refer to the Federal Register listing of the 10 Essential Health Benefits on page 25.

“Minnesota has made significant prog-ress toward the Triple Aim of improved health, improved care, and lower costs through dramatic transformations in health care delivery, led by home grown innovations among our integrat-ed health care systems and payer part-ners,” states the Executive Summary of the Minnesota Accountable Health Model. The document further sums up the challenges yet to be faced: “However, millions of Minnesotans continue to experience fragmented, uncoordinated care. This fragmenta-tion is even more pronounced when individuals have complex health issues and need multiple types of care, such as mental health, substance abuse and long-term supports and services. The lack of coordination between services

indUstry news


results in poorer health and higher costs for families and the state. While these challenges exist statewide, pro-viders that are small, independent, serve as the health care safety net, or are in rural areas face unique barriers to improved care coordination across systems.”

To better understand the scope of changes to take place over the next few years, following is some informa-tion from various resources.

essentiAl heAlth Benefits

On November 20, 2012, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule enti-tled “Patient Protection and Affordable Care Act: Standards Related to Essential Health Benefits, Actuarial Value and Accreditation.” A summa-ry communication from the National Community Pharmacists Association (NCPA) provides a clear, concise overview of the elements of the Act that are moving forward in Minnesota as well as throughout the nation. It states, the “rules will implement stan-dards for health insurance issuers in the small group and individual market to insurance reforms, standards for states relative to the establishment of Exchanges and standards for issue of Qualified Health Plans (QHPs).”

The U.S. Department of Health and Human Services (HHS) has issued two sets of regulations that set the param-eters for the state exchanges. One set outlines how exchanges will be run, while the other defines qualified health plans and essential health benefits. A qualified health plan (QHP) must: be certified or recognized by each exchange, Consumer Oriented and Operated Plan (CO-OP) program or multi-state exchange in which the plan is offered; provide an essential health benefits package; and be offered by an insurer. HHS has decided to allow each state to choose from a set of four plans to serve as the benchmark plan for the state. States can choose a benchmark plan that is: 1) one of

the three largest small group plans in the state; 2) one of the three larg-est state employee health plans; 3) one of the three largest federal employee health plan options; or 4) the larg-est HMO plan offered in the state’s commercial market. These plans must cover 10 bene-fit categories. HHS plans to select the small group plan with the largest enrollment in the state as the default benchmark for states that choose not to select a benchmark plan. States were required to select their bench-mark plan on or before September 30, 2012; otherwise, HHS will select the default benchmark plan. As of October 2, 2012, 25 states, including the District of Columbia, have selected a benchmark plan. Some states have asked for further clarification from HHS before determining their benchmark plan.

A summary provided by NCPA in November 2012 reported that with regard to prescription drug coverage: “Under the proposed rule, plans may have limitations on coverage that dif-fer from the EHB-benchmark plan, but covered benefits, limitations on cover-age (including limits on the amount, duration, and scope of covered ben-efits), and prescription drug benefits must remain substantially equal to those covered by the EHB-benchmark plan. Under the proposed rule, a plan must cover the greater of 1) drugs in every USP category and class; or 2) the same number of drugs in each category and class as the EHB bench-mark plan.”

There is also a provision that “would require health plans to establish a procedure that would allow an enrollee to request clinically appropriate drugs not covered by the health plan.” The NCPA report states that HHS also indicates that it is considering using the most recent version of the USP

classification system as a common organizational tool for plans to report drug coverage and is requesting com-ments on this proposal. This approach to prescription drug coverage is a sig-nificant departure from the Medicare Part D drug plans that are required to cover “substantially all” drugs in the fol-lowing protected classes of drugs: anti-cancer; anti-psychotic, anti-convulsant; anti-depressants; immunosuppressant; and HIV and AIDS drugs.

AccOuntABle cAre hOMes/MediCal HoMes

A fact sheet developed in November 2012 and provided by MPhA considers how individual states may establish exchanges. Several questions were answered:

Should the state establish an exchange or let the federal government step in? As of November 15, 2012, 17 states and the District of Columbia have established a state-based exchange. Tennessee, Pennsylvania, Idaho, New Jersey, Arizona and Wisconsin were still undecided as to whether to create a state run exchange. The remaining states have indicated that they will partner with the federal government to run the exchange or will allow the fed-eral government to run the exchange in their state. On November 15, 2012, the administration announced an exten-sion of the deadline to submit letters of intent to build state-run exchanges to December 14. The original deadline was November 16, 2012.

Improved health, improved care and lower costs through changes in health

care delivery are being referred to as the Triple Aim; the structure to achieve signif-icant goals in a team-based setting is the

Accountable Care Organization (ACO) While all states are working to address

fragmentation and to integrate services...not all models will look alike.

exchanges continues on page 23


By Zach Merk, PharmD Candidate

IntroductionCollaborative practice agreements (CPA) allow pharmacists to practice under the prescriptive authority of other health care providers. CPAs can allow pharma-cists to assume professional responsibil-ity of performing patient assessments; ordering drug therapy-related laboratory tests; administering drugs; and select-ing, initiating, monitoring, continuing, and adjusting drug regimens. There have been many papers written that show positive patient outcomes and financial benefits when pharmacists par-ticipate in CPAs, and CPAs really allow us to practice at the level of our ability as pharmacists.

An interview was completed by ten pharmacists and one physician who were all recommended by their peers as CPA experts to explore the makeup of a successful CPA. They comprised a wide variety of health care systems and

demographics within Minnesota; participants were representa-tives of Fairview Health Services, Park Nicollet, Hennepin County Medical Center, Indian Health

Services, Minnesota Veterans Affairs, Genoa Health Care,

Goodrich Pharmacy, and University of Minnesota Physicians.

Interview ResultsAll interviews were completed by indi-viduals with significant experience developing CPAs, and as several participants stated, “don’t reinvent the wheel.” These experiences can be drawn upon for pharmacists in Minnesota who are interested in initiat-ing a CPA. Here is a summary of their suggestions:When initiating a CPA, one should begin by fully assess-ing the situation. Try to identify the needs of the practice, the needs of physicians, and the needs of the patients. You may be able to get your CPA off the ground by identifying a task that the physi-cian does not have time to do. Once needs are identified, develop relationships with physicians and ask someone who you work

with well to promote your services to other providers. There were many rec-ommendations about where to start — hyperlipidemia, asthma, smoking cessa-tion, and hypertension to name a few — but almost all pharmacists interviewed agreed that it is important to start with one or two disease states.

As you begin your CPA, re-evaluate your practice and ensure you are compliant with all state and federal laws. It is impor-tant to document! Document everything you do in the electronic medical record and document outcomes so that you can prove the value of your CPA to

Collaborative Practice

Agreements: Wave of the Future?


employers and physicians in the future. Explaining to physicians how you make decisions about medications is impor-tant for continued success.

Finally, remember that this is an ongo-ing process. A CPA should be reviewed formally at least annually for ongo-ing appropriateness of communication techniques, documentation, and scope of practice. A very robust CPA can eventually be developed using this pro-cess.

Qualities of Successful Collaborative Practice AgreementsIn reviewing common themes through-out the interviews, three qualities appear to be critical to successful CPAs. The first is communication. It is especially critical before a CPA is agreed upon and when a CPA is initi-ated. Additionally, good communication beyond initial creation of the CPA was also one of the most highly reported suggestions for continued success.

Second, developing a CPA needs to be a gradual process. It should begin with relationship building and learning the physicians’ needs. Then, you can slowly add on additional agreements as the physician becomes more familiar with you. Most of the pharmacists inter-viewed that had robust CPAs started out with a CPA that covered one dis-ease state or one class of medication.

The third necessary quality is cred-ibility. Many participants stated that

as a pharmacist, you should inform physicians how and why you make

decisions. There was also support for becoming credentialed, com-pleting additional certification, or completing a trial period. Documentation showing out-comes is also a great way to establish credibility.

Additional ResourcesA great deal of useful information is avail-able on MPhA’s M e d i c a t i o n T h e r a p y Management R e s o u r c e s page, includ-ing cost of service cal-culators, a list of different documentation systems avail-able, sample presentations and business plans, and several sample CPAs. I hope that this article encourages you to initiate a CPA in your practice!

CPA Guidance Documents:Jump-start your CPA by searching the web for these items:

CDC – Partnering with Pharmacists in the Prevention and Control of Chronic Diseases

NACPB – Model State Pharmacy Act

ACCP – Collaborative Drug Therapy Management

Zach Merk is a fourth-year pharmacy student at the College of Pharmacy - University of Minnesota where he is com-pleting the Leadership Emphasis Area. He is an active participant in the Pharmacy Practice Act Revision process and an HIV educator for the Minnesota AIDS project. Merk is currently seeking a residency in the Twin Cities area and hopes to work in ambulatory care and academia settings.

It is very important to document! Document

everything you do in the electronic health record and document outcomes

so that you can prove the value of your CPA

to employers and physicians in the future.

or Be DefinedDefine

Electronic Tools for Ambulatory Care

by Ann Brigl

A survey published by APhA in 2011 identified several barriers to the imple-mentation of medication therapy man-agement (MTM) services. Some of these barriers were technology, bill-ing, and documentation. During my ambulatory care Advanced Pharmacy Practice Experience (APPE) rotation at several locations of Genoa Healthcare, I learned about some resources to help overcome such barriers. These resources were identified by my pre-ceptor, Julie Gambaiani, a board certi-fied ambulatory care pharmacist. She has started two MTM practices over her career, one in a retail setting and also at Genoa Healthcare.

Minnesota inforMation iMMUnization ConneCtion (MiiC)

MIIC is a free service provided by the state of Minnesota to health care providers to track the immunization history of patients. When registered with this program, pharmacists can determine what immunizations are still recommended and are able to docu-ment immunizations that have been administered. By using this program, pharmacists can identify any vaccines that are missing from the patient’s immunization profile. To register for this program, contact the Regional Coordinator for your area.

Website: https://miic.health.state.mn.us/

Minnesota e-ConneCt

E-Connect is another free online ser-

CliniCal issUes

vice that was granted state funds to promote the use of electronic claims processing in Minnesota. This service allows any provider with an NPI num-ber to file electronic medical claims using current procedural terminology (CPT) codes. By using CPT codes, the pharmacist can charge for MTM ser-vices and vaccinations based on what was provided to the patient. Minnesota E-connect will set up accounts on your behalf with many of the major payers (the E-connect website lists all pay-ers they contract with) to receive and transmit electronic bills. Health care providers must set up their own con-tracts to help ensure reimbursement. Registration for this program can be conducted on the website.

Website: http://www.mneconnect.org/

assUranCe systeMs

Assurance is a fee-for-service soft-ware system that has specifically been designed to bill for MTM services. Assurance Systems bases its billing structure on the Minnesota Medicaid levels of reimbursement for MTM. The system provides a step-by-step pro-cess to ensure the requirements for an MTM billing are fulfilled. It also submits claims for adjudication to designated payers. A unique feature of Assurance is that it provides data to support the use of MTM services. Examples of such data include: outpatient office visits avoided, long-term care visits avoided, lab services avoided, number of medications the patient has discon-

tinued, and costs incurred for MTM ser-vices. This type of data measurement can be calculated similar to return-on-investment or cost-saved-per-person calculations. To register for Assurance Systems, visit their website.

Website: http://www.medsmanage-ment.com/index.html

The above resources are just a select few that can help a MTM pharma-cist create an effective practice. While there are barriers to the implementa-tion of MTM services in mainstream health care, there are many helpful tools available for health care provid-ers. To effectively utilize these tools, pharmacists must be made aware of the services. MTM practitioners also need to communicate with one another to make these tools easier to imple-ment and utilize.

Citation:

American Pharmacists Association. Medication therapy management digest: perspectives on MTM service implementa-tion. Accessed in November 2012 at http://www.pharmacist.com/sites/default/files/files/mtm_2011_digest.pdf

Ann Brigl is a fourth-year pharmacy student at the College of Pharmacy - University of Minnesota, Twin Cities cam-pus.


The Duluth Area Pharmacists (DAP) is a grassroots group encompassing all interested pharmacists, pharmacy technicians, pharmacy students and other colleague health care providers that convenes monthly. The group has goals of improving patient health out-comes and advancing the practice of pharmacy. The DAP group, comprised of persons from northern Minnesota, gathers to engage in discussion of proposed amendments to modernize the Minnesota Statutes governing the practice of pharmacy.

The amendments were proposed by a Working Group, which was brought together under the leadership of the Center for Leading Healthcare Change at the University of Minnesota College of Pharmacy. The group consisted of a chairperson and 12 members from var-ious pharmacy backgrounds and was responsible for producing the document, “Enabling Pharmacists to Respond to the Health Needs of Minnesota Communities: Recommendations for the Modernization of MN Statutes, Chapter 151.”

After becoming aware of the recom-mendations set forth by the Working Group, and the critical importance of legislation that would free Minnesota pharmacists to fully participate in new health care delivery systems and not be limited by the language of the 1937 Act, the DAP gathered to engage in discussion. This dialogue, led by ambulatory care pharmacy residents and attended by one of the members of the original Working Group, was entitled “Define or Be Defined.”

Duluth Area Pharmacists Engage in Modernization of the Pharmacy Practice Act

By Laura Palombi, PharmD, MAT; Maggie Kading, PharmD; Keri Hager, PharmD

The lively and fruitful discussion that occurred at the first “Define or Be Defined” meeting stretched into three consecutive meetings as local phar-macists debated the language and proposed changes of the Working Group and the implications that this language could potentially have on pharmacy practice. In working through the Practice Act and the proposed changes section by section, pharma-cists and technicians from settings that included health system pharma-cy, academic pharmacy, independent retail pharmacy, long-term care phar-macy and large chain retail pharmacy weighed in and offered their feedback. Some of the more contentious issues included the details of how a pharmacy should be defined so as to not limit a pharmacy to merely a dispensing location, as well as the critical topic of how to define a pharmacist and address concerns that the “practice of pharmacy” could be taken over by those outside of the profession. Much discussion ensued about who is responsible for the actions of phar-macy technicians, if technician ratios need to be adjusted, and if so, who should set the technician ratios. The question of whether issues such as pricing and reimbursement even have a place in a practice act was discussed at length. Key issues including the cur-rent and future scope of practice and the expanding role of pharmacists in collaborative practice were debated. Lastly, DAP members weighed in on the very timely topic of drug quality as addressed in Minnesota statute, especially as it pertains to products from compounding facilities, and what

measures Minnesota pharmacists might take to help ensure their patients receive only products meeting stan-dards of strength, quality, and purity.

DAP members’ overall consensus on statutory change is to move pharmacy practice forward to meet the health care needs of patients, and to have a statute flexible enough to keep up with dynamic health care delivery models and the evolving role of pharmacists in patient care.

This discussion and feedback was captured and will be forwarded to state pharmacy organizations, the College of Pharmacy, the Board of Pharmacy, and other health professionals as this proposed legislation is shaped.

DAP members plan to remain involved with this iterative process moving for-ward and hope other pharmacists, pharmacy students, and pharmacy technicians will engage, discuss, and unite on this very important issue …our practice.

Editor’s Note: MPhA is also dedicated to addressing the proposed changes to the Minnesota Pharmacy Practice Act and has a steering committee that meets monthly. Their aim is “to ensure that future phar-macists are able to fully apply their knowl-edge and skills to improve patient health.” The meetings are open to all members, and we encourage you to attend or call in to help define your Practice Act.

CliniCal issUes

or Be DefinedDefine


What will the governance structure of the exchange be? States are decid-ing whether to run their exchanges partnering with or creating a new state agency, as an independent public enti-ty or as a nonprofit. A state agency run exchange can leverage estab-lished administrative systems and pro-cedures, while a quasi-governmental or nonprofit exchange could be less influenced from politics because it is isolated from government and interest groups. Law requires exchanges that are established independently from a state government to be governed by a board that is overseen by the state.

What will be the rules regarding car-rier participation? Health insurance plans that want to be offered through the exchange must provide one of four levels of coverage for essential ben-efits or provide catastrophic coverage for those under 30. The four levels are platinum, gold, silver or bronze. These four levels are defined by the actuarial value coverage.

How will the exchange mesh with the existing commercial market? In order for a health insurance plan to be offered in the state exchange it must meet the minimum standards that are offered in the essential benefits health plan.

How will the exchange eligibility pro-cesses interface with Medicaid/CHIP? The Supreme Court ruling on June 28, 2012 upheld the ACA’s Medicaid expansion, but the authority of the Secretary of Health and Human Services to enforce Medicaid expan-sion was limited by establishing that the secretary cannot reduce current Medicaid funding if a state decides to not expand Medicaid. The ACA expands eligibility, beginning January 2014, to all persons under the age of 65 with incomes at or below 138% of the federal poverty level (FPL). In January 1, 2012, this would be an individual

exchanges continued from page 19 who earned a maximum of $15,415. The ACA also expands Medicaid for children ages 6-18 in households with an income of up to 138% FPS. The Supreme Court’s decision does not affect this expansion. States are cur-rently required to cover children who live in households with an income of up to 100% FPL, and the ACA will expand this to 138% FPL, in 2012. The ACA also requires states to maintain current eligibility standards, method-ologies and procedures for Medicaid under the state’s current plan or waiv-er. Secretary Kathleen Sebelius stated in a letter of July 2012 that the only provisions affected by the Supreme Court’s decision regard the expansion of Medicaid eligibility for adults with an income up to 138% FPL.

tHe role of tHe pHarMaCist on tHe priMary Care HealtH teaM

This is an opportunity for pharma-cists to “get in on the ground floor!” An article, “Affordable Health Care Act: It’s Here to Stay so Buckle in,” written by Julie K. Johnson, PharmD, (Minnesota Pharmacist, Vol. 66, No. 3, Fall 2012) indicates that there are and will be opportunities for pharmacists to expand their practices. Among the important statistics cited, it was noted that 3.7 billion prescriptions were filled at retail pharmacies in 2010 and that number is expected to rise as states have the option of expanding Medicaid eligibility. She also noted that with the expansion of Medicaid under ACA, pharmacists will be “required to partici-pate in direct patient care to positively impact quality measures.” She also urged pharmacists to discover how to become integral to the success of accountable care organizations (ACOs) and medical homes.

In an issue brief prepared by MPhA, the expansion opportunities include:

• Providing medication therapy management (MTM) services

exchanges continues on page 24

for prescription and over-the-counter medications;

• Reducing the risk of adverse events by screening for drug interactions, identifying unnec-essary or suboptimal medica-tions and suggesting additional or alternative drug therapy;

• Becoming a drug therapy resource providing evidence-based recommendations on the safest, most effective treat-ments;

• Enhancing patient outcomes with decreased overall health care cost.

“The pharmacist is the best health care provider to manage drug com-plexities,” said Dean Marilyn Speedie, PhD, College of Pharmacy, University of Minnesota. In a presentation to the Minnesota Health Care Task Force Work Group in Summer 2012 (and shared on the American Pharmacists Association website), Speedie stated that the time has come for finding opportunities in the emerging health care scene: “Pharmacists are not being fully utilized to the extent of their edu-cation.” Over the past 20 years, drug therapy has become more complex, she said. “Modern pharmacists are prepared to provide medication man-agement to optimize health outcomes as part of the health care team.”

In her presentation, Dean Speedie provided the following workforce strat-egies and recommendations:

• Include a pharmacist as an integral component of the med-ical/health home team.

• Include pharmacists as accountable providers in ACOs, compensate for role in improving health outcomes.


exchanges continued from page 23

• Utilize pharmacy technicians as a cost effective way to dis-tribute product.

• Incentivize pharmacists to seek advanced clinical skill develop-ment.

• Educate more pharmacists who have a population health orientation to guide ACOs in the use of medications and pharmacist provided care.

• Incentivize more pharmacists and physicians to participate in collaborative practice agree-ments.

Three ACOs driven by Walgreens were among the 106 new ACOs announced by CMS on January 10, 2013. The first pharmacy to create any ACO, Walgreens approached the affili-ated physicians’ group in New Jersey, Florida and Texas. These innovations are clearly indications that ACA is opening doors — doors not yet imag-ined by some.

“By offering more services, more affordable services, and with the con-venience of pharmacy locations, phar-macists are serving more than just the community as they are working closely with a growing number of hospitals and health systems on coordinated care programs like ACOs, with phar-macists serving as an integral part of patient care teams — and helping to improve patient care and satisfaction, while also lowering health care costs,”

The Affordable Health Care Act (ACA) directs that the essential health benefits (EHB) reflect the scope of benefits cov-ered by a typical employer plan and cover at least the following 10 general catego-ries of items and services: 1) ambulatory patient services; 2) emergency services; 3) hospitalization; 4) maternity and new-born care; 5) mental health and sub-stance use disorder services, including behavioral health treatment; 6) prescrip-tion drugs; 7) rehabilitative and habilita-tive services and devices; 8) laboratory services; 9) preventative and wellness services and chronic disease manage-ment; and 10) pediatric services including oral and vision care. EHB will promote predictability for consumers who purchase coverage in these markets, facilitate com-parison across health plans and ensure that individual and small group subscrib-ers have the same access to the same scope of benefits provided under a typical employer.

Section 2707 of the Public Health Service Act, as added by section 1201 of the Affordable Care Act, directs that, for plan years beginning on or after January 1, 2014, health insurance issuers offering non-grandfathered plans in the individual or small group market ensure such cov-erage includes EHB as described in

section 1302(a) of the Affordable Care Act, Section 1302, to be defined by the Secretary. The law also directs that EHB reflect the scope of benefits covered by a typical employer plan and cover at least the 10 general categories of items and services previously listed. Section 1302(b)(4) of the Affordable Care Act Further established that the Secretary define EHB such that it:

• Sets an appropriate balance among the 10 general categories;

• Does not discriminate based on age, disability, or expected length of life;

• Takes into account the health care needs of diverse segments of the population; and

• Does not allow denials of essen-tial benefits based on age, life expectancy, disability, or degree of medical dependency and qual-ity of life.

Section 1302(b)(4) of the Affordable Care Act further directs the Secretary to con-sider the provision of emergency services

and dental benefits when determining whether a particular health plan covers the EHB. Finally, sections 1302(b)(4)(G) and (H) of the Affordable Care Act direct the Secretary to periodically review the EHB, report the findings of the review to the Congress and to the public, and update the EHB as needed.

Source: Federal Register/Vol. 77, No. 140/Friday, July 20, 2012/ Rules and Regulations

Essential Health Benefits Required by ACA

said Michelle Aytay, RPh, CDE, Market 21 Clinical Services, Walgreens, and chair of the MPhA Public Affairs and Policy Committee.

“Pharmacists are playing an important role in health care today, and as the most accessible health care providers in communities throughout the country, they are uniquely positioned to help bridge critical gaps in care.”

Rita Tonkinson is the Communication Director (retired) of the Minnesota Pharmacists Association.

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Mpha news

report from the state Capitolby Patrick Lobejko, MPhA Lobbyist

The 2013 Minnesota leg-islative ses-sion has begun and is off to a relatively quiet beginning. The item that has kept the atten-

tion of most legislators is Governor Dayton’s budget recommendations for the next two years. The proposed revenue increase totals $732 million in order to solve the $1.1 billion bud-get deficit the state is facing. Some key provisions include a new Fourth Tier income tax rate on the top 2% of income earners, increasing the tax on tobacco by $.94 per pack (to match the tax in Wisconsin), and extending the state sales tax to internet purchases (the so-called “Amazon tax”).

The governor’s budget has a couple of items relating to pharmacies. Under the health and human services budget, there is a recommendation to expand SMAC pricing to cover drugs admin-istered in a clinical setting. Governor Dayton also recommends making changes to drug reimbursement rates for providers enrolled as 340B covered entities with the Department of Human

Services to create a more consistent reimbursement methodology.

The lone piece of legislation that has moved rather rapidly is the bill imple-menting Minnesota’s health exchange. The exchange, a key part of the fed-eral Affordable Care Act, will create an insurance marketplace for consum-ers and small businesses to compare and purchase health insurance. This would work much like an online trav-el site such as Expedia and Kayak. Questions remain on a number of provisions of the bill, including who will be tasked with administering the exchange. The current language calls for a new state agency instead of the Commerce Department which current-ly oversees health insurance. The cost of the implementation and data privacy concerns are also being discussed. Opponents of the bill worry that trying to push the bill through this session simply because a deadline is in place is a poor way to pass such a large-scale reform in state health care deliv-ery. Under federal law, the state must put an exchange bill into law by March 31. The exchange must be operational by the beginning of 2014.

On the House side, the bill has passed through a variety of committees and was passed by the full House in early March. The Senate also approved its version of the bill; because the Senate version was different from the House bill, a Conference Committee was assigned to work out the differences. A vote on the Conference Committee bill will take place while this issue of the Minnesota Pharmacist is in pro-duction. It is likely that the governor will sign it well in advance of the March 31 deadline.

The Legislature is holding hearings on the governor’s proposed budget. The February budget forecast showed con-tinued improvement in the state’s tax receipts since the previous forecast in November. Gov. Dayton released a revised budget proposal in March reflecting the improved forecast. The House and Senate leaders will likely find it easier to come to a consensus on the legislative budget proposal with the February budget forecast numbers in hand.

If you have questions about MPhA’s leg-islative platform, please contact Patrick Lobejko at [email protected] or 651-290-7473.

For a full list of all Minnesota legislators and their contact information, visit the MPhA website

at www.mpha.org


report of drug insert labeling revisions Based Upon New Efficacy Information

By Kent T. Johnson, MSPharm

Recent revisions to drug product insert labeling that might be of interest and importance to pharmacists are noted in the accompanying Table. The entries are selected from the many supplements to approved drug applications approved each month by FDA for marketed drugs and biologics. Specifically, entries to this Table are largely based upon supplements cat-egorized: “Efficacy supplement with clinical data to support”, “New or modified indica-tion”, or “Patient Population Altered”. These would typically be the type to provide new or revised: Indications and Usage and/or Dosage and Administration changes in the professional labeling. The entries chosen for inclusion are the majority, but not all, efficacy supplements. It is also important to note that the short descriptions of the changes provided in the Table may not provide all information associated with the revision. Additional supporting changes may also be in the revised labeling (for example, new safety information). Readers should consult the new labeling when the changes cited are important to their spe-cific need.

Different presentations and extent of restat-ing the revised information are noted in this report. Variation comes about by extent of the change and ease of understanding the changes in different presentations, or the wording used in the FDA approval letter. It is anticipated that format and descrip-tion of the changes will be refined in future reports. Consult the FDA website to obtain or review FDA’s approval letter and/or revised insert labeling:

h t t p : / / w w w . a c c e s s d a t a . f d a . g o v /s c r i p t s / c d e r / d r u g s a t f d a / i n d e x .cfm?fuseaction=Reports.ReportsMenu

If you have questions about this article, please contact the author at [email protected]

PROPRIETARY NAME

ACTIVE INGREDIENT(S)

NEW INFORMATION DATE

Tamiflu o s e l t a m i v i r phosphate

Indications: Expand the patient population to include patients 2 weeks to one year of age for treatment of influenza. [Note: Not prevention]

Dec. 21

Kineret anakinra New Indication: Use of anakinra in the treatment of Neonatal Onset Multisystem Inflammatory Disease (NOMID).

Dec. 21

Alvesco ciclesonide Labeling now states efficacy in children 6 months to 4 years of age.

Dec. 17

Zytiga a b i r a t e r o n e acetate

New Indication: In combination with predni-sone for the treatment of patients with meta-static castration-resistant prostate cancer.

Dec. 10

Promacta e l t r o m b o p a g olamine

New Indication: Treatment of thrombocy-topenia in patients with chronic hepatitis C to allow the initiation and maintenance of interferon-based therapy.

Nov. 16

Viramune xR nevirapine New Indication: For the treatment of HIV-1 infection in pediatric patients 6 to less than 18 years of age.

Nov. 8

xarelto rivaroxaban New Indication: Provide for the treatment of deep vein thrombosis, the treatment of pulmonary embolism, the reduction in risk for deep vein thrombosis, and the reduction in risk for pulmonary embolism.

Nov. 2

table of efficacy supplements, november and December, 2012

CliniCal issUes


This column provides a guide to pronunciation of the nonproprietary name of active ingredients in drug products recently approved by FDA under a new drug application (NDA) or a biologics license applica-tion (BLA). The list is not exhaustive for every recent approval. For example, some newly approved drug products have active ingredients found in previously approved products. Also, there is some editorial privi-lege exercised to not include selected products in this list because the product may not have great impact upon traditional pharmacy services, e.g., a new radio-pharmaceutical, or for other reasons. The pronuncia-tion guide comes from: 2012 USP Dictionary of USAN and International Drug Names. Additional information on how pronunciation is established will be seen in future editions of the Minnesota Pharmacist.

proprietary naMe

nonproprietary naMe of aCtiVe ingreDient(s)

pronUnCiation date approVed

Fulyzaq crofelemer kroe fel’ e mer Dec. 31

Sirturo bedaquiline bed ak’ wi leen Dec. 28

Eliquis apixaban a pix’ a ban Dec. 28

Juxtapid lomitapide mesylate loe mi’ ta pide Dec. 21

Gattex teduglutide te” due gloo’ tide Dec. 21

Iclusig ponatinib poe na’ ti nib Dec. 14

Signifor pasireotide diaspar-tate

pas” i ree’ oh tide Dec. 14

Cometriq cabozantinib s-malate

ka” boe zan’ ti nib Nov. 29

xeljanz tofacitinib citrate toe” fa sye’ ti nib Nov. 6

FURTHERING PHARMACY

ADVANCINGCAREERS

Find the best jobs and highly qualifiedpharmacists Minnesota has to offer.

ONLINE CAREER CENTERwww.mpha.org

PHARM.MN_print_half_7.5x4.75.indd 1 12/13/12 5:00 PM

pronunciation of active ingredient namesof recently approved drug products

By Kent T. Johnson, MSPharm


united states house & senate/MinnesotaPlease note that mail delivery to Washington can be delayed by up to 10 days due to security screening. If your message is urgent, fax your letter to Washington, contact their district office, or send an email through their website.

Congressman tim walzFirst Congressional Districtwalz.house.govwashington, dC1034 Longworth House Office BuildingWashington, DC 20515202-225-2472rochester1130-1/2 Seventh St NW, Room 208Rochester, MN 55901 • 507-206-0643Mankato 227 E. Main St., Suite 220Mankato, MN 56001 • 507-388-2149

Congressman John klineSecond Congressional Districtkline.house.govwashington, dC2439 Rayburn House Office BuildingWashington, DC 20515 202-225-2271 • fax 202-225-2595Burnsville350 W. Burnsville Pkwy, Suite 135Burnsville, MN 55337952-808-1213 • Fax 952-808-1261

Congressman eric paulsenThird Congressional Districtpaulsen.house.govwashington, dC127 Cannon House Office BuildingWashington, DC 20515 202-225-2871 • fax 202-225-6351eden prairie250 Prairie Center Drive, Suite 230Eden Prairie, MN 55344952-405-8510 • fax 952-405-8514

congresswoman Betty MccollumFourth Congressional Districtmccollum.house.govwashington, dC1714 Longworth House Office BuildingWashington, DC 20515 202-225-6631 • fax 202-225-1968st. paul165 Western Ave. N., Suite 17St. Paul, MN 55102651-224-9191 • fax 651-224-3056

Congressman keith ellisonFifth Congressional Districtellison.house.govwashington, dC1027 Longworth House Office Building

Washington, DC 20515 202-225-4755 • fax 202-225-4886Minneapolis2100 Plymouth Ave. N.Minneapolis, MN 55411612-522-1212 • fax 612-522-9915Twitter @KeithEllison

congresswoman Michele BachmannSixth Congressional Districtbachmann.house.govwashington, dC2417 Rayburn House Office BuildingWashington, DC 20515 202-225-2331 • fax 202-225-6475anoka2850 Cutters Grove Ave., Suite 205Anoka, MN 55303763-323-8922 • fax 763-323-6585

Congressman Collin petersonSeventh Congressional Districtcollinpeterson.house.govwashington, dC2109 Rayburn House Office BuildingWashington, DC 20515 202-225-2165 • fax 202-225-1593detroit lakes714 Lake Ave, Suite 107Detroit Lakes, MN 56501218-847-5056 • fax 218-847-5109Marshall1420 East College Drive, SW/WCMarshall, MN 56258507-537-2299 • fax 507-537-2298Montevideo100 N. First St.Montevideo, MN 56265320-235-1061 (Willmar office)red lake falls2603 Wheat DriveRed Lake Falls, MN 56750218-253-4356 • fax 218-253-4373redwood falls230 E Third St.Redwood Falls, MN 56283507-637-2270willmar324 Third St. SW, Suite 4Willmar, MN 56201320-235-1061 • fax 320-235-2651

Congressman rick nolanEighth Congressional Districtnolan.house.govwashington, dC2447 Rayburn House Office BuildingWashington, DC 20515 • 202-225-6211 BrainerdBrainerd City Hall, 501 Laurel St.Brainerd, MN 56401 • 218-545-4078

duluth515 W First St., Room 235Duluth, MN 55802218-464-5095 • fax 218-464-5098

senator amy klobucharklobuchar.senate.govwashington, dC302 Hart Senate Office BuildingWashington, DC 20510202-224-3244 • fax 202-228-2186twin Cities Metro1200 Washington Ave. S., Room 250Minneapolis, MN 55415612-727-5220 • fax 612-727-5223southern Office1130-1/2 Seventh St NW, Room 208Rochester, MN 55901507-288-5321 • fax 507-288-2922northwestern/central Office121 Fourth St SMoorhead, MN 56560218-287-2219 • fax 218-287-2930northeastern OfficeOlcott Plaza, Room 105, 820 Ninth St NVirginia, MN 55792218-741-9690 • fax 218-741-3692

senator al frankenwww.franken.senate.govwashington, dC309 Hart Senate Office BuildingWashington, DC 20510202-224-5641twin Cities Metro60 East Plato Blvd, Suite 220St. Paul, MN 55107651-221-1016duluth515 W First St., Suite 104Duluth, MN 55802218-722-2390nW Mobile Office218-230-9487st. Cloud916 W St. Germain St., Suite 110St. Cloud, MN 56301320-251-2721st. Peter Office208 S Minnesota Ave, Suite 6St. Peter, MN 56082507-931-5813


resoUrCe direCtory

Minnesota pharmacy resources UniVersity of Minnesota cOllege Of PhArMAcy, tWin CitiesCollege of Pharmacy University of Minnesota 5-130 Weaver-Densford Hall 308 Harvard Street SE Minneapolis, MN 55455 612-624-1900 • 612-624-2974 fax www.pharmacy.umn.eduDean Marilyn K. Speedie, PhD 612-624-1900

UniVersity of Minnesota cOllege Of PhArMAcy, DuluthUniversity of Minnesota College of Pharmacy, Duluth 232 Life Science Building 1110 Kirby Drive Duluth, MN 55812-3003 218-726-6000 • 218-726-6500 fax www.pharmacy.umn.edu/duluth

Randall Seifert, PharmD

Senior Associate Dean and Professor, Pharmacy Practice and Pharmaceutical Sciences

MinnesOtA BOArD Of PhArMAcyThe Minnesota Board of Pharmacy (BOP) exists to protect the public from adulterat-ed, misbranded, and illicit drugs, and from unethical or unprofessional conduct on the part of pharmacists or other licensees, and to provide a reasonable assurance of professional competency in the practice of pharmacy by enforcing the Pharmacy Practice Act M.S. 151, State Controlled Substances Act M.S. 152 and various other statutes. The board strives to fulfill its mission through a combination of regu-latory activity, technical consultation and support for pharmacy practices through the issuance of advisories on pharmacy practice issues, and through education of pharmacy practitioners.

The Board of Pharmacy consists of seven

board members, appointed by the gover-nor; five board members must be phar-macists, and two members must be public members. The board regulates pharma-cists, pharmacies, pharmacy technicians, controlled substance researchers, drug wholesalers and drug manufacturers. The board approves licenses or registrations for these individuals or businesses, and also decides when to impose disciplinary action.

Minnesota Board of PharmacyCody C. Wiberg, Executive Director2829 University Ave SE, Suite 530Minneapolis, MN 55414651-201-2825 • 651-201-2837 fax800-627-3529 hearing impairedwww.pharmacy.state.mn.us

MinnesOtA BOArD Of PhArMAcy MeMBers

President: Laura J. Schwartzwald Vice President: Stuart Williams (Public Member) Pharmacist Members: Karen Bergrud, Bob Goetz, Kay Hanson, Rabih Nahas Public Member: Justin Barnes

Minnesota departMent of HUMan serViCesThe Minnesota Department of Human Services (DHS) helps provide essential services to Minnesota’s most vulnerable residents. Working with many others, including counties, tribes and non-profits, DHS help ensure that Minnesota seniors, people with disabilities, children, and oth-ers meet their basic needs and have the opportunity to reach their full potential.

DHS programs include Medical Assistance (MA), MinnesotaCare, Minnesota Family Investment Program (Minnesota’s ver-sion of the federal Temporary Assistance for Needy Families program), General Assistance (GA), the Prescription Drug

Program, child protection, child support enforcement, child welfare services, and services for people who are mentally ill, chemically dependent or have physical or developmental disabilities.

www.dhs.state.mn.us

Drug utilizAtiOn revieW BOArD (dUr): The DUR selects specific drug enti-ties or therapeutic classes to be targeted for provider and recipient educational inter-ventions, and provides guidelines for their use. The DUR board is comprised of four licensed physicians, at least three licensed pharmacists and one consumer repre-sentative, with the remaining members being licensed health care professionals with clinically appropriate knowledge in prescribing, dispensing, and monitoring outpatient drugs. DUR board meetings are held four times a year. Appointing author-ity: Commissioner of Human Services. Compensation: $50 per member per meet-ing plus mileage. (Minnesota Statutes 256B.0625, subd. 13a)

Drug fOrMulAry cOMMittee (dfC): The DFC is charged with reviewing and recommending which drugs require authorization. The DFC also reviews drugs for which coverage is optional under fed-eral and state law. (For possible inclu-sion in the Medicaid fee-for-service for-mulary.) The DFC is comprised of four physicians, at least three pharmacists, a consumer representative, and knowl-edgeable health care professionals. DFC meetings are open to the public and public comments are taken for an additional 30 days following a DFC recommendation to require prior authorization for a drug. The Department of Human Services provides the DFC with information regarding the impact that placing a drug on authorization will have on the quality and cost of patient care. Appointing authority: Commissioner of Human Services. Compensation: None. (Minnesota Statutes 256B.0625, subd. 13)


MPhA Member Benefits

The Minnesota Pharmacists Association’s number one priority is its members. MPhA strives to provide services and benefits to our members that not only promote the profession of pharmacy in Minnesota, but the professional lives of our members as well. Ranging from advocacy and com-munication to discounted professional and business programs, we are always on the search for benefits that are valuable to you as pharmacy professionals.

Many of our benefits can be accessed eas-ily through our website. From online dues renewal, conference registration and mem-ber searches, we strive to not only make membership valuable, but easy to use and navigate. Not able to find what you are looking for? Contact our office and we can help point you in the right direction.

MeMBershiP Dues:Check with your employer to see if they cover a portion of MPhA membership. Membership dues can be renewed online and a portion of your dues are tax deduct-ible (consult your tax adviser with ques-tions). We offer a variety of options to make payment more convenient, including a monthly debit program that will debit your credit card, checking or savings account each month (call the MPhA office to set up this feature).

adVoCaCy MPhA works to provide members with a “voice” in pharmacy at the state and nation-al levels. The association puts a “face on pharmacy” through media and outreach to health care entities that rely on MPhA for information and resources related to phar-macy services.

Through legislative representation, policy planning, and lobbying, the association ensures that issues pertaining to pharmacy are not overlooked or undercut. We fight for the rights of pharmacists and pharmacy professionals to provide the highest level of care to the patients they serve. MPhA encourages members to become involved

in this process by being active in grass-roots actions and events. As a member, you will have access to important updates and resources made possible by your sup-port.

professional deVelopMent and edUCation MPhA provides a variety of events through-out the year to keep members involved in pharmacy issues while offering continuing education, networking opportunities and fun! Events are listed on the MPhA web-site and are open to all. Members receive a discount on selected event program-ming, such as Annual Meeting, Fall Clinical Symposium, and Midwinter Conference.

prodUCts and serViCesMembers benefit from discounted rates and prices on both professional and busi-ness related services.

Professional Services• Pharmacists Letter• Pharmacists Mutual Insurance• Technician Manuals

Business Services• Coupon Redemption Program• PAAS 3rd-Party Audit Services• Credit Card Processing Services• Pharmacists Financial Service• Discounted AAA Automotive

Membership

CoMMUniCationCommunication is our cornerstone of keep-ing you informed of association, state and national news and action.

Minnesota PharmacistThe Minnesota Pharmacist is the asso-ciation’s journal that contains articles and features on today’s pharmacy topics. It mails to all pharmacists in Minnesota, reaching approximately 9,000 pharmacists, technicians, and students. The journal is published six times per year.

CAPSCAPS is our monthly faxed/emailed news-letter that keeps pharmacy professionals abreast of timely pharmacy issues and happenings. The newsletter is faxed to all pharmacies in the state, and is emailed to all MPhA members.

Small DosesOur Small Doses email newsletter goes out to all subscribed members. Weekly e-news shares upcoming events, business topics, important legislative or regulatory issues, and other news.

Pharmacy News FlashOnce a week, Pharmacy News Flash is delivered by email to members. These updates include news about national issues affecting pharmacists, along with local headlines and job openings.

Career CenterTailored to both our job seekers and employers, our Career Center allows you to browse openings or post opportunities at your convenience. Search for Minnesota locations, or broaden your search to out-side states. The center holds a variety of options to tailor results to your needs.

resoUrCesMembers receive special online access to pharmacy resources. From MTM templates and brochures to information on immuniza-tions, we save you valuable time by having these resources readily available to you for use in your practice.

Call today or visit the Mpha website to join this leading pharmacy association!651-697-1771 or 800-451-8349www.mpha.org

not a member? visit mpha.org and join today!

Not Your Mother’s MPhA

Conference Sponsors (as of March 8):

Registration Now Open!See pages 15-17 for details

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Minnesota Pharmacist Journal March-April 2013

Documents

Transcript of Minnesota Pharmacist Journal March-April 2013