Lecture 7

Question 1

differentiate between CMR and CMM

Answer 1

CMM is like an upgraded CMR
CMM has a broader scope – more focused on the PATIENT and not just the meds like CMR

CMM goes beyond just “review”

Question 2

give the definition of CMM

Answer 2

comprehensive medication management

INDIVIDUALIZED care plan that achieves the goals of therapy with appropriate follow up to assess patient outcomes

Question 3

what is the KEY to CMM

Answer 3

developing a care plan

Question 4

true or false

CMM is not legal yet in new york

Answer 4

true

Question 5

which specialized service is the most expansive legally, and is pretty close to acting like a dr?

Answer 5

CDTM

Question 6

explain what pharmacists could do in regards to insurance plans if they were granted provider status in new york

Answer 6

they could bill healthcare plans for the services that they provide

Question 7

there is only 1 federal recognition of pharmacists as providers.
this corresponds to….

Answer 7

part b of medicare
(outpatient care)

Question 8

WHY is provider status about Medicare Part B and not Medicare Part D?

Answer 8

medicare part D offers PDPs — prescription drug plans

medicare part b – supplemental medical insurance (SMI)

medicare part B also covers outpatient drugs. part D is OPTIONAL to those who participate in A and B.

Question 9

prescription drug plans are between….

Answer 9

between medicare part D and private insurance

Question 10

are pharmacists recognized as providers by medicare?

Answer 10

NO

Question 11

What are the 2 laws related to adding pharmacists as providers?
explain them both

Answer 11

ECAPS
Pharmacy and MUA Enhancement Act

ecaps = Equitable community access to pharmacy services act.
was introduced to make our case stronger bc of COVID experience

Pharmacy and MUA enhancement act — adds pharmacists as providers in MUAS (for medicare part B)

Question 12

who published a document in 2004, fighting to add pharmacists as providers?

Answer 12

PSSNY – Pharmacists Society of the state of NY

Question 13

what is CPHA? what did they do?

Answer 13

the california pharmacists association

they made a bill that was signed into law, recognizing pharmacists as providers

also made a new class of pharmacists called ADVANCED PRACTICE PHARMACISTS (APP/APH)

Question 14

what is BPS? it is a division of _____

Answer 14

Board of Pharmacy Specialties.
it is a division of the APHA

Question 15

_____ recognizes ____(how many?) pharmacy specialties

Answer 15

BPS recognizes 14 Pharmacy specialties

Question 16

what is the “umbrella term” for the thousands of CDTM protocols?

Answer 16

CPA

Question 17

name 3 barriers to provider status

Answer 17

-politicans view provider status for pharmacists as a “coster” (costs a lot of $$$)

-politicians view it as FFS

-other HC providers strongly oppose it