January 2023 Issue

New year, new momentum ... the fight for recognition for medical-at-home services continues

Recognition and payment for medical-at-home services have been the top priority of NCPA's Long-Term Care Division. Over the last several months, NCPA's LTC Division has worked diligently behind the scenes to form a new industry-wide coalition to advocate for greater expansion of long-term care pharmacy services to home- and community-based patients. The coalition, formed alongside the American Society of Consultant Pharmacists and the Senior Care Pharmacy Coalition, is called the Alliance for Long-Term Care Pharmacy At Home and is an ad hoc coalition of long-term care pharmacies, patient groups and stakeholders devoted to expanding access to long-term care pharmacy services to medically complex individuals living in our communities. Over the last few months, we have made great progress in outlining our policy goals and advocacy mechanisms to advance them. Now, we are in a position to start engaging supportive groups representing patients who will be critical to our success. Be on the lookout in the next two weeks for more information on how you can engage in this important coalition effort.

In addition, we submitted comments to Sen. Bill Cassidy's (R-La.) office regarding the bipartisan congressional effort to improve care for patients jointly enrolled in Medicare and Medicaid. NCPA's LTC Division urges that Congress pass legislation requiring CMS to recognize long-term care pharmacy services to home- and community-based beneficiaries and issue Part D plan guidance formally recognizing these services at the same level as other LTC services received by facility-based beneficiaries. NCPA's LTC Division also urges that Congress recommend to CMS that it issue recommendations to states to include medical-at-home pharmacy services as part of their Home Community-Based Services benefits package.

Dates announced for 2023 Business of Long-Term Care Workshop

Get the tools needed to grow from a few to a few thousand beds at the Business of Long-Term Care Workshop in Alexandria, Va. from April 19-20 and Orlando from Oct. 12-13. Our industry-expert faculty will share benchmarks for operational efficiencies, workflow solutions, and tactical relationship-building tips to expand your LTC footprint. Space is limited, so reserve your seat today. Use code LTCDIV to take $235 off the NCPA member rate.

Project PAUSE appreciates HHS initiative to strengthen nursing home safety and transparency, raises concerns with implementation and patient care

Recently, the White House and CMS announced new transparency and oversight efforts to determine if nursing homes are properly assessing and coding residents diagnosed with schizophrenia. NCPA's LTC Division, as part of the Project PAUSE coalition, has previously expressed to CMS concern about the growth of schizophrenia diagnoses.

However, the announced effort is a punitive decision to address behaviors likely driven by the poor design and incentives inherent in the current antipsychotic measures utilized by CMS, which stigmatize clinically appropriate use of these medications. As a result, there are incentives baked into the measure to misdiagnose patients to permit antipsychotic use without inclusion in the quality metric's measurement. Without CMS dealing with the root issue of fixing the quality measure and ensuring the agency can distinguish between inappropriate and appropriate use of antipsychotics, progress toward improved and safer resident care will remain out of reach. To read more about the announcement and Project PAUSE's response, click here. Project PAUSE will continue to work with CMS to guide them to meaningful solutions moving forward.

Project PAUSE (Psychoactive Appropriate Use for Safety and Effectiveness) is an ad hoc coalition of national patient and professional organizations collectively advocating on clinical and regulatory and legislative issues in long-term care.  


Steve Moore, PharmD, owner of Condo Pharmacy in Plattsburgh, N.Y., and chair of the NCPA LTC Committee, and Bri Morris, PharmD, NCPA senior director of education and the long-term care division, sat down to discuss capturing community-based long-term care with your pharmacy on the latest episode of the Happier at Home PRN Podcast. Watch here.

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