CMS Eases Short-Cycle Fill Rules for LTC, Consultant Pharmacists

By Gebhart, Fred | Drug Topics, May 2011 | Go to article overview

CMS Eases Short-Cycle Fill Rules for LTC, Consultant Pharmacists


Gebhart, Fred, Drug Topics


Pharmacists complained and the Centers for Medicare and Medicaid Services listened. The agency has eased rules on short-cycle dispensing of Part D medications in long-termcare (LTC) facilities that had raised objections from consultant pharmacists, community pharmacists, long-term-care facilities, and other stakeholders.

Instead of 7-day fills, pharmades and facilities will be dealing with 14-day fills. Implementation has been pushed back a year to January 1, 2013, And pharmades no longer have to take back unused medications for credit and reuse or disposal.

What hasn't changed is the planning and coordination needed to implement the change.

"The move to short- cycle fills is not just a pharmacy issue, it's a facility issue, too," said Gene Memoli, president 0^ tne Connecticut chapter of the American Society of Consultant Pharmacists, "When it comes to preparing for the change, you have to ensure that facilities are part of the process and work with the pharmacy to ensure success. It has to be a partnership with your fadlity/'

Memoli is also a member of the Drug Topics editorial board.

Short- cycle fill is mandated as part of the Patient Protection and Affordable Care Act, The goal of shorter fill cydes is to reduce the likelihood of pharmaceutical waste resulting from unused drugs, noted ITC pharmadst Carol Sirianni, vice president, customer programs and solutions for pharmacy wholesaler AmerisourceBergen, With only minor exceptions, Part D fills for LTC residents must be for 14 days or fewer, starting January 1, 2013.

Pharmacies will also have to collect data on drugs not used by LTC residents and report the information to Part D plans. ITC facilities and pharmades are free to use 9- day or shorter fill cydes and Part D plans are free to incentivize fill cydes shorter than 14 days.

The move from the current 30-day fill cyde will be complicated under the best of circumstances, Sirianni said, Pharmades can expect more fills for the same number of patients, Pharmades must also track unused medications and report the details to Part D plans. The combination could mean more staff, more automation, more pressure, and more communication with facilities. Pharmades, consultant pharmacists, facilities, and Part D plans must all work out the roles that each will play in creating shorter fill cydes and operating the new systems effidently and cost-effectively. …

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