Groups oppose CMS’ LTC consultant pharmacists proposal

There is one that I almost lost my dinner on when I read this one… I shouldn’t read these things this close after a meal.
CMS Proposal
Here is a quote from the article In addition, the CMS proposal draws on incorrect perceptions about the ethics of consultant pharmacists, according to the American Society of Consultant Pharmacists (ASCP). “I am deeply troubled that CMS has mischaracterized our profession by suggesting that consultant pharmacists don’t serve patients’ best interests as a primary goal of our practice. The ASCP Code of Ethics clearly defines professional conduct that places patients’ needs at the center of care,” said ASCP President Albert Barber, PharmD.

Having worked in LTC for the past 3.5 yrs and having been a LTCF consultant years ago… the issue is not about the ethics of the consultants.. it is the pressure put on them by the LTCF to perform their review of the pt’s records in <7 minutes, including generating a report.

Personally the consultant reports that I see are based on three recommendations… reduce this dose (GDR), eliminate this drug, substitute this less expensive – read CHEAPER – drug.. replace this drug with a non-medical therapy. I can remember once seeing a consultant to recommend ADDING a drug to a pt’s therapy – ASA 81mg… WOW !

From my experience and perspective… any “subjective disease drug” (pain/anxiety/depression/mental health) is off limits… to address those.. they would have to actually talk to a pt and the staff.. and “the book” doesn’t give you a black/while answer about dosing these drugs… remember the “7 minute clock” for each pt is ticking…

If consultants are doing their jobs… why do I get calls for “stat-refills”… really – IMO – a oxymoron … and when I look into the records the pt’s routine order for a 30 days supply… had not been requested for TWO MONTHS ! When I question why it needs to be sent today.. when it would appear the pt has not had the med for several weeks…. the phone typically goes “dead” and I usually get .. “just send it “…

While it is impractical for the RPH – considering the hourly cost – to compare each pharmacy billing against the pt’s MAR… would it be unreasonable for them to do some sampling of comparing A/R to MAR’s?

Unless, all those involved knows that pts don’t get their meds as prescribed and staff are documenting doses being given even when they were not even available to be given.. or do they just note “pharmacy unable to provide” and move on?

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