Independent Pharmacies Look Forward to HB3479

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Independent Pharmacies Look Forward to HB3479

Independent Pharmacies Look Forward to HB3479

May 16 – Legislators are working on a bill that could help independent pharmacies receive proper reimbursement for filling Illinois Medicaid patients’ prescriptions.

Dale Colee, owner of Dale’s Southlake Pharmacy and Colee’s Corner Drugs, said HB3479 would require the Illinois Medicaid Managed Care Organizations to pay all pharmacies the same amount for prescriptions. “The PBM [Pharmacy Benefits Manager] is paying certain pharmacies – ones they are actually involved with – a higher rate than they are the independent pharmacies. This bill would require the reimbursement rate for the medication to not be below our acquisition cost and would be the same as what everyone else is getting reimbursed at this point.” He continued to say it costs around ten dollars to fill and process prescriptions and they are “not getting near that for close to 70 percent of those prescriptions.”

The bill has been passed by the House and is now awaiting approval by the Senate. Local State Representatives Sue Scherer and Bill Mitchell are co-sponsors of the bill and Senator Andy Manar is Chief Senate Sponsor. The Senate has a deadline of May 31, 2018 to pass the bill. Colee said if they do not approve the bill, it could have negative consequences for independent pharmacies. “If it doesn’t get passed, you are going to see a lot of independent and smaller pharmacies go to the wayside, especially if they are in an environment where they have a lot of public aid and managed care business.” Colee said he has a store within Crossing Healthcare that would be heavily affected because of the high volume of Medicaid patients.

This issue is not specific to Illinois. Colee mentioned there have been many pharmacies across the country, including Ohio and Arkansas, and the rate has caused independent pharmacy numbers to dwindle. “I’ve talked to a lot of the independent pharmacies and they are all in the same boat. There is a guy I know in the Staunton area where if he doesn’t get some sort of help in getting this turned around, he could lose his store.” Colee said when he started his business in Decatur 40 years ago, there were 18 independent pharmacies and two box stores in Decatur and now his store is the only independent pharmacy in Decatur and Sav-Mor helps to serve the residents of Mt. Zion.

Colee said independent pharmacies are part of the fabric of their communities by employing local people who spend their wages locally and make local donations. He said other stores differ from them because they earn their money in town and then spend the money elsewhere. “You do not see a lot of those organizations really going out and helping the community. You don’t see them doing a lot of donations and a lot of things within the framework of the community. That’s a major part of it. We are a part of the community. We live here and that’s what sets us apart from the big box stores.”

 

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Independent Pharmacies Look Forward to HB3479

Rauner’s reefer madness rules despite overwhelming support for legal pot

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As if anyone needed another reason to oust Bruce Rauner, consider this: there will never be legalized marijuana in Illinois as long as he’s governor.

Just in case his attempts to bankrupt public education weren’t enough of a deterrent to voting for his reelection.

All right, on the week of 4/20, the time has come for me to answer a few questions about the state’s effort to catch up with the rest of the modern world and legalize reefer.

Rauner’s reefer madness rules despite overwhelming support for legal pot

Illinois House likely won’t hear bill to raise penalties for assaulting DCFS workers

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A state bill aimed at delivering a harsher punishment for battering a Department of Children and Family Services or Adult Protective Services worker isn’t likely to be heard by legislators this year.

House Bill 4586 was introduced in February by state Rep. Tony McCombie, R-Savanna, in response to an attack on veteran DCFS worker Pamela Knight, 59, of Dixon in September.

The bill ups the battery charge to felony aggravated battery, punishable by four to 15 years in prison if the batterer, using anything other than a firearm, knowingly attacks a DCFS worker who’s performing his or her official duties, batters a worker to prevent the performance of those duties, or batters a worker in retaliation for performing those duties, causing great bodily harm or disfigurement.

The idea is to give DCFS and Adult Protective Services workers the same protections that are in place for firefighters, police or peace officers.

DCFS workers are not allowed to carry Mace or other weapons on home visits.

This week, the bill was referred to the Judiciary Criminal Committee before being funneled to the Sentencing, Penalties and Criminal Procedure Subcommittee, where McCombie said it unfairly will be buried without consideration for the rest of the year.

“Members of the majority, as well as their staff have stated that they are not willing to hear bills that will increase penalties, as they want to reform our criminal justice system,” she said. “Reform, by definition, means to improve, not ignore.”

The very least the committee members could have done is give their “time and respect” to listen to the concerns of Knight’s husband, Don, McCombie said.

“Pam Knight deserved so much more than what she got when she gave her life for the protection of another,” McCombie said.

Andrew Sucher, 25, faces 20 to 60 years in prison in the death of Knight, who died Feb. 8 in a Chicago hospital of injuries investigators have said Sucher inflicted Sept. 29 when he kicked her in the head, fracturing her skull and causing severe brain damage.

Knight, who was based in the Sterling DCFS office, went to Sucher’s home to take a 2-year-old into protective custody. When he wasn’t home, she went to his parents’ home in Milledgeville to check on the whereabouts of the child; she was attacked shortly after getting out of her car.

McCombie said the bill has more than 40 co-sponsors across both aisles and shouldn’t be brushed off, especially when the group addressed more controversial gun legislation recently that was not heard in committee.

“It has no opponents, but still did not get to be heard,” she said.

A bill mirrored in the Senate, which was introduced in January by state Sen. Tim Bivins, R-Dixon, was referred to the subcommittee on Council on Licensure, Enforcement and Regulation compliance in February, where it has remained.

Illinois House likely won’t hear bill to raise penalties for assaulting DCFS workers

Manar: Gov. Rauner didn’t deliver promised money for Crossing Healthcare

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DECATUR — State Sen. Andy Manar, D-Bunker Hill, is criticizing Republican Gov. Bruce Rauner for what he says is an unacceptable delay in delivering $3 million in promised money to Crossing Healthcare. 

Rauner visited the clinic at 320 Central Ave. in Decatur on Feb. 2 as part of an announcement of funding for the facility. Macon County Sheriff Howard Buffett pledged $3 million from his private foundation, which was to match $3 million provided by the state, officials said at the time. 

But in a statement released Friday, Manar said Rauner’s administration has only approved $750,000 for the clinic. He said Comptroller Susana Mendoza’s office is prepared to release the money once Rauner submits required paperwork. 

“I would hate to think the governor could be so cruel as to dangle money in front of a clinic just so he could get in front of a TV camera,” Manar said. 

The Herald & Review has reached out to the governor’s office and Crossing Healthcare for comment. 

The money in question is tied to construction of the new, larger Crossing facility that opened in September 2015. Half of the $6 million cost was to be paid by the state’s Illinois Jobs Now! capital projects program, and the rest from loans, donations and operating revenues.

But shortly after taking office, Rauner froze all state capital grants. The eventual budget impasse left Crossing with a half-built facility, and its board of directors decided to borrow the $3 million expected from the state so that it could move ahead with construction. 

The lingering debt forced the clinic’s leadership to be extra vigilant about its budget. Joseph Schrodt, president of the Crossing board of directors and a retired orthopedic surgeon, put up his own assets as collateral to make sure the center could borrow the full amount.

That’s where Buffett’s donation came in. He told Rauner in December that he would put up $3 million if the state would match the contribution by releasing the $3 million from the initial grant.

“He liked the idea and he told me he’d get back to me,” Buffett said in February. “So that’s how we ended up with where we are today.”

This story will be updated. 









Manar: Gov. Rauner didn’t deliver promised money for Crossing Healthcare

Guest View: Curbing prescription drug prices: Beware of side effects

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TV commercials for prescription medicines always start with uplifting scenes of people living life to the fullest, and they always end with a litany of side effects and counterindications. It’s no accident these final messages about the harmful side effects rush by so quickly we can barely understand them. But the warnings they convey can make all the difference.

Proposed legislation to address the very real problem of high drug prices should come with similar warnings. Illinois House Bill 4900, sponsored by Will Guzzardi, D-Chicago, and others, is a case in point. The bill states that a manufacturer or wholesale drug distributor shall not engage in price gouging in the sale of an essential off-patent or generic drug.

Sounds good, doesn’t it? But by targeting generics instead of brand-name drugs, this is a prescription that completely ignores the disease.

Brand-name pharmaceutical manufacturers pour billions of dollars into lobbying and marketing — think of all those TV commercials — to keep brands out of legislation like HB 4900. And brand-name pharmaceuticals increase in price every year. Companies like mine, that make affordable generic medicines used in hospitals, produce the same medicines at a fraction of the cost, saving patients and our state, and the nation as a whole, billions of dollars. In 2016, generics saved Illinois $9.6 billion (the latest figure available), according to data compiled for the Association for Accessible Medicines by data and analytics tracker firm IQVIA. That includes savings for Medicaid, Medicare, commercially insured and uninsured patients. Thanks to generics, we all save money in hospitals and at the pharmacy counter.

When confronted with the issue of runaway prices, the brand-name companies inevitably cite the cost of research and development for new drugs, but 9 out of 10 of these companies spend more on marketing than on research. Pharma industry group PhRMA spends tens of millions to influence lawmakers and protect the government-sanctioned monopolies that keep prices high, and growing higher every year, while generic medicines on average decrease in price every year. Brand-name drug companies also lobby hard to artificially extend patents for drugs that would drop steeply in price if generics were permitted to enter the marketplace on schedule.

According to the U.S. Food and Drug Administration, “Increasing the availability of generic drugs helps to create competition in the marketplace, which then helps to make treatment more affordable and increases access to health care for more patients.”

In other words, the existence of generic drugs keeps prices down, and HB 4900 could unintentionally make it harder for companies like mine to remain competitive and sustainable. Manufacturers of generic medicines do not enjoy the high margins of branded drugs, and if manufacturers can’t increase prices when the cost of raw materials increase, they may stop producing the generic alternatives altogether, and this reduces consumer choice, reduces competition and ultimately leads to higher costs for patients.

So beware the unintended side effects of H.B. 4900: reduced choice and higher prices for patients and families in Illinois.

John Ducker is president and chief executive officer of Lake Zurich-based Fresenius Kabi USA, which conducts research and development, and manufacturing for medicines and technologies use to care for critically and chronically ill patients. The company specializes in generic injectable medicines used to treat cancer and many other conditions.

Guest View: Curbing prescription drug prices: Beware of side effects

Guest View: Curbing prescription drug prices: Beware of side effects

https://ift.tt/2GVjiVI


TV commercials for prescription medicines always start with uplifting scenes of people living life to the fullest, and they always end with a litany of side effects and counterindications. It’s no accident these final messages about the harmful side effects rush by so quickly we can barely understand them. But the warnings they convey can make all the difference.

Proposed legislation to address the very real problem of high drug prices should come with similar warnings. Illinois House Bill 4900, sponsored by Will Guzzardi, D-Chicago, and others, is a case in point. The bill states that a manufacturer or wholesale drug distributor shall not engage in price gouging in the sale of an essential off-patent or generic drug.

Sounds good, doesn’t it? But by targeting generics instead of brand-name drugs, this is a prescription that completely ignores the disease.

Brand-name pharmaceutical manufacturers pour billions of dollars into lobbying and marketing — think of all those TV commercials — to keep brands out of legislation like HB 4900. And brand-name pharmaceuticals increase in price every year. Companies like mine, that make affordable generic medicines used in hospitals, produce the same medicines at a fraction of the cost, saving patients and our state, and the nation as a whole, billions of dollars. In 2016, generics saved Illinois $9.6 billion (the latest figure available), according to data compiled for the Association for Accessible Medicines by data and analytics tracker firm IQVIA. That includes savings for Medicaid, Medicare, commercially insured and uninsured patients. Thanks to generics, we all save money in hospitals and at the pharmacy counter.

When confronted with the issue of runaway prices, the brand-name companies inevitably cite the cost of research and development for new drugs, but 9 out of 10 of these companies spend more on marketing than on research. Pharma industry group PhRMA spends tens of millions to influence lawmakers and protect the government-sanctioned monopolies that keep prices high, and growing higher every year, while generic medicines on average decrease in price every year. Brand-name drug companies also lobby hard to artificially extend patents for drugs that would drop steeply in price if generics were permitted to enter the marketplace on schedule.

According to the U.S. Food and Drug Administration, “Increasing the availability of generic drugs helps to create competition in the marketplace, which then helps to make treatment more affordable and increases access to health care for more patients.”

In other words, the existence of generic drugs keeps prices down, and HB 4900 could unintentionally make it harder for companies like mine to remain competitive and sustainable. Manufacturers of generic medicines do not enjoy the high margins of branded drugs, and if manufacturers can’t increase prices when the cost of raw materials increase, they may stop producing the generic alternatives altogether, and this reduces consumer choice, reduces competition and ultimately leads to higher costs for patients.

So beware the unintended side effects of H.B. 4900: reduced choice and higher prices for patients and families in Illinois.

John Ducker is president and chief executive officer of Lake Zurich-based Fresenius Kabi USA, which conducts research and development, and manufacturing for medicines and technologies use to care for critically and chronically ill patients. The company specializes in generic injectable medicines used to treat cancer and many other conditions.

Guest View: Curbing prescription drug prices: Beware of side effects

IHSA giving high schools the chance to buy concussion insurance for their athletes

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For high school athletes and their loved ones, concussions can bring a fear of the unknown.

How many blows are too many? What are the short-term financial costs of treatment? What are the long-term costs of returning to action before the brain has healed?

In an attempt to assuage the monetary concerns, the IHSA is in the process of making concussion insurance available to its member schools beginning in the 2018-19 school year.

Schools will be offered the opportunity to purchase this insurance at the rate of $1.50 per athlete regardless of how many sports each athlete plays. The insurance will only be available on a school-by-school basis, and not to individual families.

Craig Anderson, executive director of the IHSA, emailed athletic directors with information about the concussion insurance during the last week of March.

“This is another tool to provide peace of mind and provide a barrier against serious injury,” said Darren Howard, the lead athletic director for Oswego Community Unit School District 308 and the person who first contacted the IHSA and suggested it offer concussion insurance.

The policy, which is called the HeadStrong Concussion Insurance Program and is sold by Kansas-based Dissinger Reed, provides accident medical concussion coverage, including neurological follow-up, according to the company website.

The HeadStrong policy requires a minimum of 3,500 student-athletes, covers medical bills up to $25,000 per injury for concussion-specific care for 12 months after the injury and requires no copays, deductibles or out-of-pocket costs for the parents, according to Dissinger Reed owner and CEO Christian Reed.

If not for the WIAA, it’s possible the IHSA would not be offering HeadStrong next year.

Howard, who oversees athletics at Oswego and Oswego East high schools and five junior highs, was reading Coach & Athletic Director magazine in the fall of 2017 when he came across a blurb about the WIAA becoming the fourth state athletic association in the U.S. to provide concussion insurance to 100 percent of its student-athletes. Now, a total of six state associations have HeadStrong for all student-athletes.

Howard was the athletic director and boys basketball coach at Immaculate Conception — now called IC Catholic — from 2003-12. He said he had heard stories of parents of high school athletes, not necessarily in his district, getting blindsided when injury-related medical care for their children turned out not to be covered, or not fully covered, by existing insurance policies.

In an effort to prevent such occurrences, and to help ensure there are no financial barriers in the way of high school athletes seeking concussion care, Howard said he contacted Craig Anderson to find out if Illinois could adopt a similar concussion insurance program.

“My first thought was, ‘This is an opportunity for a family to have coverage for such a low amount of money, and it can give them some peace of mind.’ I thought, ‘That’s fantastic,'” Howard said.

At a rate of $1.50 per student-athlete, the WIAA pays approximately $121,000 annually for concussion insurance. Dave Anderson said the federation pays for the coverage with state tournament gate receipts and corporate sponsorship dollars.

This is the first year the WIAA has had concussion insurance and there have been 101 claims, according to Dave Anderson. He said the insurance has resulted in $30,000 in preferred-provider savings and paid out in excess of $25,000 through Jan. 31.

“It has helped 101 kids and 101 families to fill in the holes,” Dave Anderson said.

Craig Anderson said the IHSA does not have the budget to purchase the insurance for the schools.

In the meantime, the IHSA will follow the model of the Missouri State High School Activities Association, which governs high school athletics in that state.

The MSHSAA is in its second year of offering HeadStrong on a per-school basis, and there appears to be more interest in the insurance among rural schools, according to Jason West, communications director for the association.

“It’s mostly out-state schools and a few metro-area schools (that are participating),” West said. “In rural areas, they may not have a lot of industry, and (many families don’t have) added (insurance) benefits to their jobs. We have a number of schools where maybe it encompasses an entire county, and in those areas, you have a lot of farming and family ranches, and things like that, and there may not be the various options (for insurance).”

West said the fear of exorbitant medical bills could lead young athletes in these areas to refrain from seeking diagnoses and treatment for head injuries. That would just add another risk factor in places where high schools may already lack dedicated athletic trainers, and top medical facilities may be many miles away.

West said 166 schools in Missouri have purchased HeadStrong for their student-athletes. The MSHSAA has 739 member junior high and high schools, including 590 high schools, according to its website. He was not able to offer the specific breakdown of rural versus metro schools participating in the program, but said participation in the program has increased in its second year.

Catalano said concussion insurance came up briefly during a meeting of Central Suburban League athletic directors March 8, and that the topic also likely will be discussed when a few hundred of the state’s athletic directors meet for a conference in Peoria in early May.

Catalano said many athletic directors likely still have to familiarize themselves with the details of concussion insurance.

Howard said athletic directors should avoid rushing to judgment on the insurance and might want to take the time to review the coverage offered to their student-athletes.

“Some (athletic departments) don’t completely understand what insurance covers and does not cover for their student-athletes as it pertains to concussions,” he said.

Dan Shalin is a freelance reporter for Pioneer Press.

Twitter @Pioneer_Press

IHSA giving high schools the chance to buy concussion insurance for their athletes