Community Pharmacists Set Agenda, Tap New Chief

Posted October 27, 2010 at 10:35am

The National Community Pharmacists Association outlined its legislative priorities this week at its annual convention, but already the group’s critics have said the agenda won’t help eliminate waste, fraud and abuse in the drug market.

In particular, the Pharmeutical Care Management Association has criticized the PBM Audit Reform and Transparency Act, a bill the NCPA supports.

Mark Merritt, who heads PCMA, said that the audit reform bill the community pharmacists are pushing would give pharmacies a heads-up that an audit is coming. PCMA’s membership conducts such audits.

‘In pharmacy, like in other areas, public and private payers are going to demand more, not less, accountability and watching where every penny goes,’ he said. ‘What the country wants is lower health care costs. The key to lower health care costs is more accountability and more competition, not restrictions on anti-fraud efforts, not fewer audits.’

He added, ‘the independent pharmacists are going to need to replace their current agenda with one that actually lowers costs for consumers and allows more transparency.’

But the NCPA said that criticism should have little sway since it’s coming from its members’ chief marketplace rival, pharmacy benefit managers. The pharmacy benefit managers don’t have a lot to stand on, said NCPA senior vice president of government affairs John Coster.

‘The PBMs are competitors to pharmacies, direct competitors,’ he said. ‘The irony is, these folks have a direct interest in trying to eliminate us. Independent pharmacies tend to be easy pickings.’

Coster added that the pharmacies aren’t looking to cover up fraud and abuse with the audit bill, which was introduced earlier this year by Rep. Anthony Weiner (D-N.Y.).

‘A lot of these auditors are showing up on Mondays, where the pharmacy ‘ as much as they wanted to cooperate with the audit ‘ found it difficult’ because they were so busy, he said. ‘All we asked for was some notice that an audit was going to occur.

‘You never know what they’re going to audit. If you were engaging in fraudulent activity, you can’t go back and cover your tracks.’

Knowing that an audit is coming would also allow pharmacies to make sure that past records, which may be in storage, can be available to the auditors.

‘We’re trying to create some standardization among audits,’ Coster added. ‘All these guys have a vested interest in making audits as hard as possible, because they want to drive us out of business.’

Coster also said independent pharmacies had a good year last year. ‘That should be celebrated,’ he said. ‘But they always find ways to knock down the fact that small businesses like ours were doing OK.’

NCPA also used its annual conference to announce its new CEO. Kathleen Jaeger, who most recently ran the Generic Pharmaceutical Association, will be leading the group.