Thriving on Nutrition Support
Vol. 1, #11
Letter From the Director It’s been a busy summer. We’ve traveled around the country celebrating our 10th anniversary with our ThriveRx teammates. Hopefully, you’ve seen the pictures from our Boston, Cincinnati, and Carlsbad parties on Facebook. We were also honored to celebrate at our Iowa location, which opened its TPN cleanroom this spring. This fall, ThriveRx will expand to Dallas, Texas, and Greensboro, North Carolina. I’d like to extend a huge “thank you” to our pharmacy partners for their expertise in nutrition support and compounding. They are the backbone of our business, and their passion for consumer care and safety is unmatched. Deb Pfister, Director of Nutrition
Stay informed. Stay involved.
Ann Weaver, Senior Consumer Advocate
PRESERVING PATIENT ACCESS TO COMPOUNDED MEDICATIONS
MEDICAL NUTRITION EQUITY ACT OF 2017
HR 2871 was introduced by House members Morgan Griffith and Henry Cuellar. According to the National Home Infusion Association, this bipartisan legislation will ensure patient access to lifesaving compounded medications dispensed from an out-of-state pharmacy. For more information about HR 2871, visit nhia.org. To see if your legislator is a co-sponsor of this bill, visit govtrack.us/congress/bills/115/hr2871.
For individuals with digestive and inherited metabolic disorders, HR 2587 and S1194 would require public and private insurance coverage for medically necessary foods (including vitamins) prescribed by the patient’s provider. For more information about this bill, visit naspghan.org.
CALENDAR EVENTS Fourth Cured Research Conference and Patient Education Program Oct. 20–22, 2017
UMDF Regional Symposium Nov. 3–4, 2017
The Campaign Urging Research for Eosinophilic Disease (CURED) invites families, individuals, and medical professionals to attend. The event will be held at Cincinnati Children's Hospital. Register at curedfoundation.org.
The event will be held at the University of Texas Health Science Center in San Antonio, Texas. For more information, visit umdf.org/symposium/central.
What are people saying about ThriveRx? “I was elated to finally get on service [with ThriveRx], and it has been everything that I expected it to be— and so much more.” —Sarah, mother of Gus
ThriveRx provides high-touch care for individuals with complex gastrointestinal disorders who require enteral or parenteral nutrition. We believe everyone deserves the opportunity to thrive and live an empowered life. TO LEARN MORE ABOUT HOW WE CAN HELP YOU THRIVE ON NUTRITION SUPPORT, VISIT THRIVERX.DIPLOMAT.IS.
Child of the Year Spotlight • Allison Winter
“I love Oley; it has been a great way to meet and hear about everyone.”
ThriveRx would like to congratulate the 2017 Oley Foundation Child of the Year award winner Allison Winter.
ThriveRx had a chance to get to know Allison at the Oley Foundation Consumer/ Clinician Conference this summer.
ThriveRx has been the proud sponsor of the Oley Foundation Child of the Year award since 2008. This annual award recognizes a child, 18 years of age or younger, who has been on home parenteral and/or enteral nutrition (HPEN) for one year or longer. Award winners are recognized for their positive attitude in dealing with illness and HPEN, as well as their ability to encourage and inspire others.
“When I was 4 years old, two tumors twisted my intestine and I lost all but 25 centimeters of my small bowel,” Allison said. “That is when I first went on HPEN.
The Oley Foundation stated: “Each medical crisis shows Allison’s strength in character and heart. She strives to be her own advocate, even writing her GI doctor a letter when she felt she wasn’t being taken seriously.”
I enjoy giving back to the Ronald McDonald House by baking cookies and donating travel-size toiletries. I also help my family care for special needs foster children. In my free time, I crochet, read science fiction, and host an Instagram account with makeup tutorials. This fall, I will be starting high school and would ultimately like to work with special needs kids or as a child life specialist. I love Oley; it has been a great way to meet and hear about everyone.”
Staff Spotlight Sarah Casey is a nationally certified pharmacy technician with extensive compounding experience. She is a member of the Diplomat Specialty Infusion Group Massachusetts pharmacy team and has worked with ThriveRx since 2013. Sarah lives in New Hampshire. Her passions include riding her motorcycle (a GSX-R600) and going to every concert she can. A few of her favorites have been Coldplay, Brand New, and Adele. She plays several sports, including volleyball, deck hockey, and flag football. Sarah loves Boston sports teams but has a soft spot for Tony Romo! Jillian Pauling and Gita Hosseini commented: “From the cleanroom, to the warehouse, to pumps, to customer service, Sarah not only can do it all, she excels in all areas of pharmacy. She keeps impressing us with her smartness, creativity, and talents. We couldn’t ask for a more dedicated and well-rounded lead technician.”
LEAD PHARMACY TECHNICIAN & EQUIPMENT MANAGER
Sarah Casey, CPhT
CONTACT US Call 888.6.THRIVE Fax 888.401.8557
thriverx.diplomat.is info@thriverx.net
OPEN ENROLLMENT HIGHLIGHTS Open enrollment is the period each year when you can enroll in a health insurance plan or change your coverage. Generally, you cannot make changes outside open enrollment unless you’re eligible for a special enrollment period. You can qualify for special enrollment if you experience a life event such as birth, adoption, marriage, or loss of coverage. ENROLLMENT DATES • Medicare open enrollment for 2018 coverage runs Oct. 15–Dec. 7. • HealthCare.gov exchange open enrollment for 2018 coverage runs Nov. 1–Dec. 15. • Some states extend their enrollment periods. Check with your state to confirm its cutoff date. • Medicaid and the Children’s Health Insurance Program offer year-round enrollment. • Employer plans renew at different times throughout the year. Check with your company’s human resources department about dates and coverage. KEY QUESTIONS
CHANGING COVERAGE
Make your insurance work for you and your family by asking these questions: • Are your physicians and other health care providers covered by your plan?
Verifying insurance coverage: When employers change group coverage guidelines, your benefits could be affected. It’s important to work with your human resources group to understand insurance changes. Send copies of your new insurance cards to your provider to reverify benefits.
• Is your home nutrition support provider contracted with this plan, or will you have to switch? • Does your insurance cover nutrition support therapy or have restrictions based on diagnosis? • What are your premiums, deductibles, copays, and out-of-pocket responsibilities? • What are your in-network and out-of-network benefits? Do they cross-apply? • Do you have adequate Medicare coverage? Do you have a supplemental or advantage plan? Do you have Medicare Part D (drug) coverage? • Do you have the best plan for your needs? Health maintenance organizations (HMOs) and preferred provider organizations (PPOs) might seem the same, but they have different requirements. • Does your plan have a health savings account (HSA) or flexible spending account (FSA) that lets you deduct pre-tax dollars from your paycheck to save for medical expenses?
Gaps in coverage: Some insurance plans require the infusion provider to obtain prior authorization to provide TPN, enteral nutrition, and other IV medications. If an authorization is needed, notify your provider as soon as possible. This will prevent interruption in services or private-pay obligation. Coordination of benefits: Changing your health care coverage or designated primary plan might require that you “coordinate benefits.” This task is completed by calling provider services of all affected plans. Notify your providers: Send copies of your new insurance cards to all your providers to reverify your benefits. Failure to do so could causes unexpected out-of-pocket expenses or lapses in care if provider is not in network with your new plan.
If you are uninsured and seeking coverage: Visit healthcare.gov/get-coverage Call 800.318.2596 TTY 855.889.4325
7167 E. Kemper Road Cincinnati, OH 45249
[address area]
T H R I V E R X C O N S U M E R E D U C AT I O N ThriveRx is proud to offer ongoing educational opportunities for all consumers. Our webinars, tips, and kits are designed to assist consumers with the tools needed to help them thrive while on nutrition support. CONSUMER WEBINAR Understanding the Role of Medications in the Short Bowel Syndrome (SBS) Treatment Plan Consumers and their caregivers will learn about standard medications and growth factors in the management of SBS. Speaker: Maria Karimbakas, RD, CNSC; ThriveRx Clinical Nutritionist Date: 1 p.m. ET Thursday, Oct. 19, 2017
To register for this webinar, visit thriverx.diplomat.is. THRIVERX'S ADVOCATES IN ACTION Advocating for consumers is at the core of who we are—promoting both individual consumer support and policy development to better the lives of HPEN consumers. In collaboration with ASPEN, ThriveRx advocates Ann Weaver and Victoria Delano partnered with clinicians, nonprofit representatives, and family members to develop a school guide for children dependent on HPEN. This guide, paired with the ThriveRx Education Toolkit, provide support for families and schools. This guide can be found at journals.sagepub.com/doi/pdf/10.1177/0884533617718471, and the Education Toolkit is available at thriverx.diplomat.is.
The information herein is for educational purposes only and may not be construed as medical advice. Diplomat Pharmacy Inc. takes no responsibility for the accuracy or validity of the information herein, nor the claims or statements of any manufacturer. Copyright Š 2017 by Diplomat Pharmacy Inc. Diplomat, Diplomat Specialty Infusion Group, and ThriveRx are either trademarks or registered trademarks of Diplomat Pharmacy Inc. All rights reserved. THRV-117453-1017