PBA Health/TrueCare Asks For Help In Identifying Other Groups Charging Illegal Pharmacy Fees
The Texas Department of Insurance (TDI) has already told one health benefit group to stop charging prohibited fees to 
Texas pharmacists for filing electronic pharmacy claims.
Now PBA Health/TrueCare is asking Texas pharmacists to help identify any other groups that may be charging the banned fees.
According to TDI, the Texas prompt pay law states that a health benefit plan issued by an insurer or a HMO may not directly or indirectly charge a pharmacy a fee for the adjudication of a claim. In a letter to State Sen. Jane Nelson, R-Flower Mound, TDI informed Sen. Nelson that it had recently told Humana to stop charging a 25 cent pharmacy claim processing fee. Humana had argued that the practice is permitted because pharmacies are not individuals.
TDI also asked Humana for the names of the pharmacies or pharmacists whose claims have been reduced as a result of this fee and Humana’s plan for refunding the fees. Humana agreed to withdraw this language from its notice regarding contract changes for pharmacies in Texas.
If you have been charged this fee, or if you know of any other health benefit groups that are charging fees to pharmacies for electronic pharmacy claims please call PBA Health/TrueCare immediately so that we can help stop these prohibited charges. To report prohibited fees being charged you may call John Heal, TrueCare Legislative Affairs Director, at 512-476-8288. You can also fax your findings to 512-476-3428 or email us at info@truecaretexas.com.
MAJOR PHARMACY CONFERENCE HEADS TO SAN ANTONIO
Saturday, February 20th -- $99 One-Day Registration Includes 5 Hours CE
Registration Includes Breakfast, Lunch And Snacks During Breaks
Register Now For $99 Saturday Special
Pharmacy leaders and experts from across the Midwest will converge on San Antonio later this month is what is shaping up to be one of the top pharmacy conferences in years. The conference schedule will feature legislators, five pharmacy association executives and a presentation on pharmacy reimbursements and surviving the razor thin margins of current pharmacy scripts.
There is still time to register for the event and a special one-day conference special is available for $99. That registration covers Saturday which features an array of important workshops including one on communicating with the legislature, pharmacy reimbursements and an executive roundtable featuring some of the top pharmacy association executives in middle America.
A LOOK AT OBAMACARE AND PHARMACY
Anne Cassity, Senior Director of Federal Government Affairs at the NCPA, will be on
hand to brief all attendees on the intricacies federal health care legislation and its impact on pharmacy.
PHARMACY EXECUTIVE ROUNDTABLE
Ever wanted to call your pharmacy association’s top executive and let him explain the issues facing our industry in the coming years. This is your chance. A Pharmacy Executive Roundtable will feature Joe DaSilva, Texas Pharmacy Association; Ron Fitzwater, Missouri Pharmacy Association; Mike Larkin, Kansas Pharmacists Association; Thomas Temple, Iowa Pharmacy Association; and Mark Riley, Arkansas Pharmacists Association in what is expected to be an eye-opening discussion of the future of pharmacy.
HOW TO COMMUNICATE WITH YOUR LEGISLATORS
Texas State Sen. Jeff Wentworth, R-San Antonio, and State Rep. Todd Hunter, R-Corpus Christi, will talk to community pharmacists on Saturday, Feb. 20, about the importance of knowing your legislators on a personal basis and on how to talk to them about your issues. Both legislators are powerful chairs of legislative committees and worked on important legislation for pharmacy groups, playing a crucial role in moving pharmacy forward during the 81st Legislative session.
PHARMACY REIMBURSEMENTS
Dr. Mark Riley, executive vice president of the Arkansas Pharmacists Association and a national expert on pharmacy reimbursement issues will take a quick look into his crystal ball to see what 2010 has in store for pharmacy reimbursements. Dr. Riley will take winter conference participants through facts and
predictions on the future pricing benchmarks for both brand and generic drugs. He’ll help you understand how you’re going to get paid for filling prescriptions
DEADLINE NEARS FOR MAJOR PHARMACY SUMMIT IN SAN ANTONIO CLICK HERE
The narrow margin of Texas Pharmacist Chuck Hopson’s victory is another example of how one election can make a difference in independent pharmacy’s ability to get its message to the decision makers of the future. We must be ready and able to work with both political parties and with a variety of different lawmakers to ensure that our voice will be heard. Today we must decide if we want to be participants, or spectators in the legislativeand regulatory arenas. Participants have a say in their destiny. Spectators watch from the sidelines and read tomorrow’s newspaper to find out what happened. We must be proactive, and not reactive.
In the past, many of you have shown a commitment to the future of pharmacy by supporting the Texas Pharmacy Survival Fund, which has been instrumental in protecting the interests of independent pharmacy. Today pharmacies continue to reap the rewards from the work of the Survival Fund as it expands its grassroots efforts to educate legislators, opinion makers and the general public on issues important to independent pharmacy. We need your help again. In January we will face another legislative session and we cannot afford to wait two months to begin getting out pharmacy’s message to new legislators and legislative leaders. There is much work to be done and pharmacy needs your help to ensure that we maintain our momentum. Our voices must be heard in Austin. Please make a contribution to the future of independent pharmacy through the Pharmacy Survival Fund. The stakes have never been so high.
Respectfully,
The TrueCare Legislative Council
