States making some headway on uniform prescription card

COMMUNITY PRACTICE

States making some headway on uniform prescription card

The Dakotas, North and South, have climbed on the national bandwagon for uniform prescription plan identification cards to eliminate some of the third-party hassles that are driving community pharmacy staffs to distraction.

The governors of North Dakota and South Dakota recently signed bills mandating that insurers issue beneficiary ID cards that present Rx drug plan information in a uniform way. The goal is to cut the phone time and frustration levels of pharmacists and technicians struggling to cope with ever-increasing Rx volumes. Similar bills have been introduced in other states, including Minnesota, Pennsylvania, and Wyoming.

With a little tweaking for local conditions, individual states are basing their legislation on the national model regulation developed by the National Association of Chain Drug Stores and National Community Pharmacists Association and endorsed by the American Pharmaceutical Association. The initiative grew out of a white paper the three groups issued a few years ago that identified Rx ID cards as a major source of headaches for pharmacists and patients alike. In addition, an Arthur Andersen study commissioned by NACDS found that pharmacists spend 20% of their time on administrative duties.

Getting with the national game plan was the reason the South Dakota Pharmacists Association opted to sponsor the ID card bill signed by the governor, said executive director Bob Coolidge. The law takes effect on July 1, 2002. "We wanted to help keep the national momentum," he said. "We had a few opponents, but we tried to work with them. We reached out to everyone with education, using local pharmacists who deal with this on a daily basis."

North Dakota's path to passage of the uniform ID card bill was eased when the state's largest insurer, Blue Cross-Blue Shield, bought into the concept, said Galen Jordre, North Dakota Pharmaceutical Association executive v.p. Like most other bills, the state's law mandates the new format the first time a card is issued, when it's reissued, or when the information changes.

Across the country, North Carolina pharmacists are being urged by the North Carolina Association of Pharmacists to report violations of the state's ID card law that went into effect last July, said executive v.p. Dan Garrett, Pharm.D. "We are still in the process of implementing it and trying to work with the state agency responsible for enforcement," he said. "Not everyone is using the cards, and we're encouraging our members to report them to the department of insurance, which has told us it will do its job. One of the outcomes of our recent meeting of state pharmacy leaders was a major recommendation that these insurance plans and pharmacy benefit managers need to come up with a page of bullet points to tell what their plan is about. The problem we all face is everyone gets their book and it's 30 pages long and you can't understand it, and the physician is confused, the pharmacist is confused, and mostly the patient is confused."

It seems that more and more fed-up pharmacists are handing questions about Rx coverage back to patients. And they have the law on their side in North Carolina, the only state with a regulation protecting pharmacists from being forced to deal with managed care problems. "We have a lot of pharmacists in our state who do just that," said Garrett. "In fact, some of them have a speaker phone so that all the other customers can hear what's going on."

Gaining passage of Rx ID card legislation has not been easy, commented John Rector, NCPA general counsel. "Pharmacy is plodding forward, but it's been more difficult than some people expected. They were pretty naive about the willingness of the [insurance] crowd to go along with it. They are, in fact, opposing it. There are more than 1,500 different companies they can interact with through contracts. But it's a nightmare for people in the pharmacy."

Carol Ukens

Carol Ukens. States making some headway on uniform prescription card.

Drug Topics

2001;7:35.