History & Accomplishments

2006 Accomplishments

Budget:

1. Twice convinced the Legislature to fully restore all reimbursement cuts to Medicaid and EPIC.
   a. First restoration was from Governor's initial budget
   b. Second restoration was on a Governor"s veto "override."
   c. Governor challenged Legislature's ability to change his budget - PSSNY sued Governor, Budget Director & Commissioner of Health arguing that the state's constitution "specifically" states that the Legislature must create programs for the state's "poor and needy" citizens and that the Legislature is "responsible" for funding these programs. The day we filed and served the suit, the Governor & Legislature came to an agreement that evening restoring more than 90% of the cuts to Medicaid/EPIC.

Legislatively:

1. Passed the "No-Mandatory Mail Order" bill in the Assembly 147-0. - Died in Senate Committee
2. Passed the Pharmacy Benefit Manager Transparency bill in Assembly 146-0 - Died in Senate Committee - Successfully won AARP's support as a top priority
3. Moved Pharmacists as Immunizer legislation by getting the NYS Nurses Association to remove their opposition. PSSNY has been able to pick up
   several key support groups for passage.
4. Successfully killed several pieces of legislation detrimental to the business and practice of pharmacy including the annual "Doctor-based Rx Vending Machine" bill.
5. Monitor on federal legislative & regulatory issues and report to the membership.
6. Got the "Citizenship" one-year waiver extension bill passed but Governor vetoed over "technicality."

Professionally:

1. Continue our work with the Medicaid Pharmacy Advisory Committee to effectuate changes as they relate to audits, MMIS numbers, Supervising Pharmacist Registrations & the unfairness of Medicaid's Disqualified list without "due process." Several of these issues will be going to court soon.
2. Continuously monitor the NYS Board of Pharmacy meetings.
3. Continuously monitor the Medicaid PDL meetings.
4. Continuously monitor the Medicaid/EPIC DUR meetings.
5. Provided successful Mid-Winter Conference and the Annual Conventions & Exhibition.
6. Issued six (6) NYS Pharmacist journals
7. Provided over 125 hours of Professional CE training programs throughout NYS.

2005 Accomplishments:

Budget:

1. PSSNY and our lobbying firm of Capital Public Affairs successfully convinced the Governor's Office NOT to cut pharmacy reimbursements in either the Medicaid or EPIC programs

Legislative:

1. PSSNY gathered dozens of legislative bill sponsors for our Anti-Mail-Order legislation and got one version of the legislation passed out of the Senate Labor Committee;
2. PSSNY was able to have a Assembly Health Committee hearing held on: PBM Abuses in NYC;
3. PSSNY participated in a NYC Council Hearing on Mail-Order only plans for city employees;
4. CDTM and Pharmacists as Immunizers legislation picked up significant support. Immunizer picked NYC, Office of the Mayor endorsement as well as the NYS Association of County Health Officials;
5. PBM Transparency bill introduced by Assemblyman Gottfried late in session;
6. PSSNY was a vocal opponent against federal legislation to cut Medicaid reimbursements to pharmacies;
7. PSSNY responded to all draft regulations and request for comments on Medicare Part D program.

Third Party:

1. PSSNY's Executive Director conducted several PBM 101 Training programs to trade unions, legislative staff and several associations including: NYS Retail Council, Senior Action Coalition, AARP and others.
2. As a direct result of the PBM 101 training and subsequent meetings by PSSNY staff and leadership resulting in the conversion of a 30,000 member police organization from mandatory mail-order back to community pharmacy; a 365,000 member union re-opened it's bidding process and will be coming back to community pharmacy from mandatory mail order July 1, 2006. PSSNY also worked with the president of the 1199 union retirees (thanks to Dan Molino) and they have been moved out of mandatory mail order effective January 1, 2006. PSSNY staff and leadership continues to work to fight against mandatory mail-order only prescription drug programs. Our successes here have caused other unions to contact Innoviant, the PBA that we have been working with to make these transitions.

2004 Accomplishments:

Medicaid, EPIC & ADAP Budget Cuts: PSSNY was again successful in pushing back devastating reimbursement cuts (AWP-15%) to three (3) major prescription drug programs in New York State. Although pharmacies suffered a decrease in reimbursement, it was limited to ¾% for brands taking reimbursement down to AWP-12 ¾% brands and from AWP-12% to AWP-16.5% for non-FUL generics. PSSNY was also successful in convincing the Governor's Office during the summer and fall of 2004 not to include any reimbursement cuts in his 2005 Executive Budget.

Medicaid Regulatory Relief: With the passage of "serialized Rx forms" in the 2004-05 Budget (PSSNY Opposed), we were able to ask for and receive significant regulatory relief as it relates to Medicaid. Phoned-in prescriptions with refills (except controlled substances) or OTC's no longer need a cover from the physician. We had e-prescribing passed in the budget for Medicaid & EPIC (Elderly Rx Drug) programs. The serialized forms can be scanned for serial number input into pharmacy systems. Budget estimated a $100 million savings to Medicaid annually.

Auto-Enrollment for EPIC Participants in the Medicare Cash Discount Card Program: PSSNY worked with the Governor's Office to get special legislation passed very quickly after CMS authorized auto-enrollment for SPAPS. The estimated savings for the state is between $65-$70 million. The first three months of the program showed a $34 million savings.

Value of Lobbying & Networking with Legislators: PSSNY provided a half day Media Training program for our Board members and Affiliate Presidents at our June convention. Participants were given a Media Tool Kit with Issue Talking Points. As new issues arise or are anticipated, additional Issue Talking Points are e-mailed out to the Media Committee to update their binders. PSSNY's Lobbyist conducted a training session at our recent Mid-Winter on the Value of Lobbying & Networking.

Medicaid Grants for Disease State Management and MTM: PSSNY was successful in getting these funded in the Governor's Budget. There is $5 million set aside for RFPs. Any savings from these programs will be rolled back into to expand the grants.

RxPAC of New York: Our RxPAC raised and distributed over $250,000 during the last two-year cycle and PSSNY raised an additional $150,000 (outside of RxPAC) for leadership fundraisers just in 2004.

2003 Accomplishments:

Adult Immunization Coalition: PSSNY has continued to partner with the NYS DOH on their Adult Immunization Initiative and the Medicaid Asthma Project, thereby raising the profile of pharmacy providers within the DOH. The New York State Island Peer Review (IPRO) and the Centers for Disease Control have now publicly stated that pharmacists are an underutilized profession.

Asthma Initiative: PSSNY provided funding in concert with Regional Asthma Coalitions to bring the "Rules of Two" Asthma training program to pharmacists throughout New York State.

Medicaid, EPIC & ADAP Budget Cuts: PSSNY was successful in pushing back devastating reimbursement cuts (AWP-15%) to three (3) major prescription drug programs in New York State. Although pharmacies suffered a decrease in reimbursement, it was significantly less than proposed by the Governor and did not include increases in "co-payments" and the addition of 1.2 million Medicaid Managed Care recipients to co-pay requirements. Most other states did not fair so well.

Price Poster Changes: The final rules were put in place that eliminated the cumbersome price posters and replaced them with a smaller counter sign and a list if requested by consumers. The object of the changes was to reduce the administrative time it took to keep the old poster systems up to speed and to virtually eliminate fines where pricing did not match the computer.

Out-of-State Registrations Begins: PSSNY worked long and hard to get the out-of-state registration of drug manufacturers, wholesalers, distributors and pharmacies that ship drugs into New York State.

Patient Counseling Changes: Counseling regulations were changed that eliminate the need for the pharmacist to ask every patient if they have questions for the pharmacist. Limits "requirement to counsel" to those new patients or patients who are having a new drug therapy added, or their current therapy adjusted for any reason. For those patients receiving refills with no changes, a pharmacy technician or other designee may ask those patients if they have a question for the pharmacist.

Medicaid: PSSNY continues to fight to get the Medicaid/Medicare crossover initiative operational so that pharmacy does not yet again face debilitating reimbursement cuts. PSSNY is also monitoring Medicaid "down time" and reporting directly to Medicaid department heads. PSSNY continues to participate in the Medicaid Pharmacy Advisory Committee to bring outstanding issues to the forefront.

National: PSSNY is connected into national pharmacy organizations and continues to play a crucial role in national legislative and regulatory issues.

2003 Pharmacy Legislation:

• Passed "Whistleblower" protection legislation that protects employee pharmacists (working for publicly traded corporations) from retaliation from employers for reporting unsafe conditions for consumers.
• Passed legislation that moved HCG from schedule II to Schedule III.
• Passed legislation to exempt nursing homes from the one Rx per blank rule. Physicians can now use patient orders.
• Passed legislation that would provide for more harsh penalties and greater enforcement against those practicing a profession without a license.
• It was PSSNY's legislative initiative that convinced the Governor's Office and the Legislature to pass enabling legislation to allow the auto-enrollment of Medicare drug transitional payments for 125,000 qualified EPIC enrollees, saving New York State approximately $65 million and helping PSSNY in its fight to protect current Medicaid and EPIC reimbursements.

2002 Accomplishments:

Adult Immunization Coalition: PSSNY partnered with the NYS DOH on their Adult Immunization Initiative and the Medicaid Asthma Project thereby, raising the profile of pharmacist providers within the DOH. The New York State Island Peer Review (IPRO) and the Centers for Disease Control publicly stated that "pharmacists' are an 'underutilized' profession."

ESAP: PSSNY supported legislation that authorizes pharmacists to dispense up to 10 syringes and needles without a prescription, as long as your pharmacy is registered with the NYS DOH. Our support for this legislation was solely for its public health implications. Other states that have allowed this have seen intravenous drug user related HIV infections reduced by 50%. This is a volunteer program.

Tobacco Cessation Grant: PSSNY received a three-year grant contract with the NYS DOH, Office of Chronic Diseases to be funded at $200,000 per year. This grant pays pharmacists to conduct Tobacco Cessation classes for NYC Medicaid recipients. We submitted four grant proposals, three statewide and one for NYC only. Cessation programs began in November of 2001 and continueed through to July, 2002.

Pharmacy Asthma Network: This program started as a pilot project in the Bronx, NY for Medicaid children suffering from asthma. PSSNY interceded more than two years ago through the Pharmacy Advisory Committee to Medicaid to get reimbursements boosted for spacers, masks and peak flow meters because reimbursement was below a pharmacy's acquisition cost and therefore, less than 3% of Medicaid patients needing these products had them. In addition, PSSNY contracted with a company to provide deep discounts to pharmacies on these products so that the spread would allow pharmacists to get these devices into the hands of these Medicaid patients and to spend time teaching patients how to use them properly. The pilot project was very successful and now PSSNY is moving this network out statewide. PSSNY brought special Asthma Management training to other parts of the state. We asked Medicaid to track these patients brought into the program so that we can measure pharmacists success at reducing costs to Medicaid.

911 Attack on the WTC: Like so many thousands of others, New York pharmacists responded immediately to the devastating attack on the World Trade Center. Within an hour and a half of the first attack, the NYS Board of Pharmacy granted PSSNY's request to put into place "emergency" practice act rules that authorized pharmacists throughout NYS to dispense up to a three-day supply of medications without a prescription, to transfer prescription medications from one pharmacy to another without a wholesaler's license and allow out-of-state pharmacists to practice in the state during the crisis. These rules were initially for one week and extended to two weeks upon PSSNY's request. These rules were necessitated by the massive dislocation of individuals from their homes in lower Manhattan and by thousands of rescue workers and National Guardsman called up in response to the attack. NY Pharmacists responded to stranded travelers at the NYC airports to see if they needed any assistance with their medications. Cell phones were used to communicate back to their pharmacy if assistance was called for. Hundreds of pharmacists gave blood and money to the American Red Cross. PSSNY, with the generous help of our sister state associations, raised $50,000 for the NYS WTC Relief Fund. PSSNY's e-mail/fax communications system was called upon by the Medicaid program to provide communications to NYC pharmacies concerning an "Emergency Medicaid" assistance program. NYC Medicaid lost its headquarters, computers, phones, etc. in the WTC attack and had to revert to "paper claims."

Mass Immunization/Preparedness Task Force: PSSNY worked closely with the NYS Department of Health and all county health departments in developing a statewide "Preparedness" plan in the event of any future natural or man-made disasters or terrorist attacks. Pharmacist volunteers were asked by local county health departments to be part of their disaster team. Pharmacy gained strong support among health officials as resources in immunizing the masses and volunteering in the event of an emergency.

2002 Pharmacy Legislation:

• Passed out-of-state pharmacy registration this past session. This brings mail order and Internet pharmacy operations under NYS Board of Pharmacy rules and regulations, as well as, NYS's Controlled Substance laws.
• PSSNY had legislation killed that would have permitted physicians to dispense medications for profit. A company was pushing this legislation that would allow pharmacists to be replaced by a vending machine in a physician's office. This would only impact Upstate New York's rural areas.
• Amended legislation to exempt pharmacies from having to be licensed as DME dealers.
• Defeated massive reimbursement cut proposals early in the 2002 legislative session. Reimbursement cuts to Medicaid, ADAP (HIV/AIDS drugs) and our EPIC (senior Rx program) would have totaled $238 million annually. Medicaid remained at AWP-10% + $3.50/$4.50 as did the ADAP program. Our EPIC program did receive a reimbursement cut from AWP + $3.00 to AWP-10% + $3.50/$4.50. Cuts reduced to $25 million.
  
  
  

Past Accomplishments:

• 1879 - A convention for pharmacists/druggists convened in Utica. As a result, the New York State Pharmacists Association is formed. Its goal is to achieve formal recognition of Pharmacy as a profession.
• 1884 - The New York State Pharmacists Association has its first victory. Like other recognized professions, pharmacy will have a State board.
• 1884 - Governor Grover Cleveland (who was also elected President that same year) appoints the first members to the New York State Board of Pharmacy.
• 1906 - The State Legislature passes and the Governor signs legislation making New York the first state to require a college degree in order to obtain a pharmacists license.
• 1927 - The New York Pharmacists magazine founded.
• 1931 - The Association is established sufficiently to create a full-time position for its Executive Secretary.
• 1932 - The Association achieves another victory for the profession under a new law that prohibits anyone from practicing pharmacy without a diploma from a pharmacy or medical college. A licensing exam is also established. (The law was not strictly enforced and applied only to New York City.)
• 1934 & 1935 - Two important Association bills pass. Medicines containing poisonous, deleterious and/or habit forming drugs can be sold only at registered pharmacies.
• 1951 - Federal law known as the Durham/Humphrey Act creates legend drugs.
• 1957 - The New York State Pharmacists Association changes its name to the Pharmaceutical Society of the State of New York (PSSNY).
• 1960 - State law mandates five years for professional education.
• 1967 - NYS Medicaid program is established; fee is $1.60.
• 1968 - NYS Medicaid fee increases to $1.80.
• 1971 - PSSNY establishes House of Delegates.
• 1971 - Federal Justice Department rules that state associations of pharmacists may not negotiate directly with third parties, as this constitutes a violation of antitrust laws.
• 1972 - NYS enacts the two line prescription blank for physicians to specify brand or generic.
• 1972 - PSSNY's first mail ballot was sent out.
• 1977 - Medicaid fee increases to $2.60 as a settlement to PSSNY vs. Perales.
• 1977 - PSSNY and the state enter into a "Stipulation of Agreement" that establishes the Pharmacy Advisory Committee, annual hearings on dispensing fees and surveys to determine average wholesale price.
• 1977 - 'Substitution Permissible' if written by a physician on script allows substitution of cheaper brand.
• 1985 - PSSNY moves headquarters to Albany.
• 1987 - PSSNY challenges and wins in state court the legal point that like physicians and lawyers, pharmacists practice a profession and are therefore exempt from New York's antitrust laws which apply to business.
• 1987 - PSSNY wins provisions in EPIC legislation; mandatory unwaivable co-payment, community pharmacy network and fees higher than Medicaid.
• 1987 - Pharmacy laws now require "Dispense as Written" (DAW) for brands.
• 1988, 1989 & 1991 - PSSNY wins important victories in both Federal District Court and Second Circuit Court of Appeals which uphold the Stipulation of Agreement between the Society and the NYS Department of Social Services. (Keeping Medicaid reimbursement higher than the State wants to pay.)
• 1990 - PSSNY-sponsored legislation passes eliminating physician dispensing for profit.
• 1990 - OBRA '90 passes in Washington, creating prospective and retrospective DUR in Medicaid, mandating manufacturer rebates, and prohibiting reductions in dispensing fees for five years.
• 1991 - PSSNY defeats Governor Cuomo's .6% gross revenue tax on pharmacy.
• 1992 - PSSNY supports enactment of mandatory patient counseling regulations.
• 1992 - PSSNY sponsored legislation is enacted prohibiting physician ownership of a pharmacy and restricting the physician from dispensing quantities larger than a 72-hour supply.
• 1992 - PSSNY again defeats Governor Cuomo's Medicaid budget.
• 1993 - PSSNY suggests changes to professional discipline reform law.
• 1993 - PSSNY again defeats Medicaid budget cuts in pharmacy.
• 1993 - President Clinton proposes Health Care Reform. PSSNY joins NARD in support.
• 1993 - PSSNY defeats legislation that would have required expiration dates on prescription labels.
• 1993 - PSSNY fights Medicaid co-payments in federal court and prevents enactment of state law.
• 1994 - PSSNY fights Medicaid co-payments in state court and prevents enactment of state law; PSSNY appeals to Supreme Court Appellant Division.
• 1995 - Medicaid changes reimbursement formula to brand drugs AWP-10% plus $4.50 and generics MAC+$5.50.
• 1995 - Pharmaceutical Society of the State of New York changes its name to Pharmacists Society of the State of New York.
• 1995 - NYS Medicaid program implements co-payments.
• 1996 - Governor Pataki signs PSSNY supported bill mandating continuing education for pharmacists. New York becomes the 48th state to enact mandatory CE.
• 1996 - Professional Discipline reform with new Statute of Limitations passes Senate and Assembly.
• 1996 - PSSNY successful in NYS Legislature passing bill that carves out the Medicaid pharmacy benefit program from mandatory managed care.
• 1997 - Governor Pataki agrees to sign Medicaid Pharmacy Carve-Out bill after a technical amendment.