2011 Notes From the Hill Retrospective
By Debra Wolfe, APA Director of Governmental Affairs

Some people think that lobbying is a four-letter word.  However, lobbyists perform a critical role in shaping policies and laws that get enacted by the state.  As one of the lobbyists for the Arkansas Pharmacists Association, I spend my days building relationships with the great men and women who serve the citizens of Arkansas in the Arkansas General Assembly.

I am happy to report that the relationships that the pharmacists of the state have with their legislators and the relationships that the APA has built and maintained with Arkansas legislators have made pharmacy a strong political force at the Arkansas State Capitol.  This legislative session, pharmacy scored a number of key political victories in Little Rock.  Here is a summary of our legislative successes and how they will impact the practice of pharmacy:

The Pharmacy Audit Bill of Rights – Senator Johnny Key (R - Mountain Home) and Representative Linda Tyler (D - Conway) co-sponsored a bill that protects community pharmacies from the unfair and predatory auditing practices of the Pharmacy Benefit Managers (PBMs).  The new law includes provisions that require a PBM to allow a pharmacist to correct a claim before any money is recouped and any recoupment can only be for the amount in excess of the corrected claim.  This provision will prevent PBMs from finding an insignificant error in a prescription and recouping the entire prescription amount from the pharmacy.  In addition, random audits will be limited to two per year, and each random audit may only include 25 prescriptions.  These provisions will limit the number of times each year that a PBM may conduct a random desk audit, and it places an important limit on the number of claims that they may audit.  Many provisions of the bill become effective on July 1, 2011, with the full implementation occurring on January 1, 2012.

Senator Key also ran a separate bill for pharmacy that protects the pharmacist-patient relationship and prevents a PBM from interfering with this relationship.

Expansion of Pharmacists Ability to Immunize – Senator Percy Malone (D - Arkadelphia) authored a bill that permits Arkansas pharmacists to administer medications down to age seven.  The previous age limit for pharmacists was 18.  In addition, pharmacists may provide flu shots down to age seven under a general protocol.  All other immunizations and medications will require a patient-specific prescription for ages seven to 17.  This expansion of pharmacy practice opens up a new opportunity for pharmacists to provide immunizations to many children who currently go unvaccinated.

Pharmacist-Only Third Class of Drugs – Senator Malone and Representative Mark Perry (D – Jacksonville) co-sponsored a bill that creates the framework for a pharmacist-only third class of drugs.  The new law maintains patients’ ability to access pseudoephedrine products from a pharmacist without a prescription, and it requires a pharmacist-patient relationship and the determination of a medical need by the pharmacist before a sale can be made. 

In short, it prevents non-pharmacist store managers from forcing a professional pharmacist to sell these products and it allows the State Board of Pharmacy to discipline the pharmacy permit holder if someone attempts to force a pharmacist to make a sale.  More importantly, the new law permits the State Board of Pharmacy to add new over-the-counter (OTC) products in the future that should require the specialized knowledge of the pharmacist before a patient may purchase them.

This bill drew many opponents, including the OTC manufacturers, the National Association of Chain Drug Stores, Walgreens, and Wal-Mart.  However, pharmacists from all practice settings overcame this opposition by rallying at the State Capitol on March 15 to help ensure the bill’s passage. 

Prescription Drug Monitoring Bill – Senator Malone also led the effort to create a statewide prescription drug tracking system.  This electronic database will capture all Schedule II, III, IV, and V prescriptions that are filled in the state of Arkansas.  The data will be housed at the Arkansas Department of Health and will be available as a tool for healthcare providers to use when making determinations about patient treatment.  Pharmacists will have access to the system and the legislature hopes that the system will help reduce doctor and pharmacy shopping for controlled substances.

State Board of Pharmacy Appointment Bill – Representative Tommy Wren (D – Melbourne) and Senator Bill Sample (R – Hot Springs) co-sponsored a bill that codifies the long-standing tradition of the Governor receiving input from the Arkansas Pharmacists Association before making a pharmacist appointment to the Arkansas State Board of Pharmacy.  Arkansas governors will now be required by law to appoint pharmacist members to the Board of Pharmacy upon the advice and consent of the APA.

Preserving the Professional Independence of a Pharmacist – Sponsored by Senator Johnny Key (R – Mountain Home) and Representative Fred Allen (D - Little Rock), this bill prohibits a third party from interfering with the pharmacists-patient relationship.  It ensures that a pharmacist is not restricted when talking to a patient about their medical needs or options under any medical plan.

The 88th General Assembly was the most successful session for pharmacy in a long time, and I am particularly proud because it was productive for all of the different sectors of the profession.  The APA is grateful to all of the legislators that helped us advance the profession of pharmacy and we are, most importantly, thankful to you the members for interacting with your legislators and letting them know the important role pharmacists play in today's healthcare team.