Michigan Pharmacist Journal Jan./Feb./March 2023

MICHIGAN T H E O F F I C I A L J O U R N A L O F T H E M I C H I G A N P H A R M A C I S T S A S S O C I AT I O N

2 0 2 3 ANNUA L

CONVENTION & EXPOSITION Friday, Feb. 24 — Sunday, Feb. 26

AR M

ACISTS

AS

S O

AN

PH MICH IG

ON ATI CI

2023

30 YEARS OF MPF

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

The Michigan Pharmacy Foundation celebrates its 30th anniversary and charts its course for 2023. (p. 7)

MichiganPharmacists.org

STRATEGIC PLAN

The Consultant and Specialty Pharmacists of Michigan outlines its priorities for 2023. (p. 17)

EXPANDING FIELD

Examining how pharmacists can be better utilized to help treat diseases in addition to COVID-19. (p. 16)

IN THIS ISSUE ADVOCACY UPDATES

2023 ACE

MEMBERSHIP UPDATE

AR M

ACISTS

AS

S O

AN

PH MICH IG

ON ATI CI

2023

8 3 President’s Platform

New Michigan Pharmacists Association President Hope Broxterman outlines her 2023 goals for the MPA.

24 Student Focus

How deprescribing can help battle issues with polypharmacy.

14

26

4 CEO Corner

20 From CSPM’s President

31 Legal Insights

32 CAPA Spotlight

ACE makes plans to hit the road in 2025, 2026; plus, MPA launches new website that is more userfriendly.

Breaking down the Corporate Transparency Act of 2020 and what it means for medical professionals.

Matthew McTaggart, CSPM president, provides an update on treating cancer patients who have COVID-19.

A look at what the Capital Area Pharmacists Association has been up to.

CEO: Mark Glasper; EDITOR: Ryan Weiss; PUBLISHER: Bryan A. Freeman Michigan Pharmacist (ISSN 1081-6089) is the official journal of the Michigan Pharmacists Association, published four times a year at 408 Kalamazoo Plaza, Lansing, MI 48933. Publication Number: USPS-345-600.

Phone: (517) 484-1466, Fax: (517) 484-4893 Website: www.MichiganPharmacists.org, E-mail: MPA@MichiganPharmacists.org, Advertising Information: Visit www.MichiganPharmacists.org/news-publications/advertising-opportunities or contact Bryan Freeman, MPA marketing and communications director,

2

MichiganPharmacists.org

at (517) 377-0257 or BryanFreeman@MichiganPharmacists.org All opinions expressed in Michigan Pharmacist are not necessarily official positions or policies of the Association. Publication of an advertisement does not represent an endorsement. Michigan Pharmacist is subject to the standards established by the Association. Michigan Pharmacist is distributed as a regular membership service, paid for through allocation of membership dues. © Michigan Pharmacists Association, 2023

— PRESIDENT’S PLATFORM —

BY HOPE BROXTERMAN,

Pharm.D.; president, Michigan Pharmacists Association

"I am excited for 2023 as the Michigan pharmacy community builds on the momentum we have gained over the last year."

Happy New Year! It is this time of year when many of us reflect on the events of the previous year and look forward to what the new year will bring. Many years ago, Julius Caesar introduced the Julian calendar and instituted Jan. 1 as the first day of the year. He did this in part to honor Janus, the Roman god of beginnings, who had two faces which allowed him to look back into the past and forward into the future.1 While we do not have two faces, we do have the opportunity to reflect on what pharmacy has accomplished in the last year and envision what we hope to accomplish and build upon in the coming year.

The COVID-19 pandemic made the last two-and-ahalf years difficult, to say the least. Yet, we know every challenge provides an opportunity for growth and recognition. Recently, the American Pharmacists Association (APhA) provided data recognizing that community-based pharmacists and their teams administered more than 282 million COVID-19 vaccinations since the beginning of the pandemic.

That is a lot of jabs! It was also discovered that pharmacists provided care for more than 5.4 million hospitalized patients with COVID-19, administered more than 42 million COVID tests and provided more than 100,000 monoclonal antibody treatments. These data crystallized pharmacists’ and their teams’ efforts that helped avert more than 1 million deaths in the United States, more than 8 million hospitalizations and $450 billion in health care costs.2 When the call came, our profession stepped up to promote and improve public health. Thank you all!

Another realization that occurred over the last year or so was our underutilization of technology. Not only did the pandemic provide opportunities for people to work remotely and stay connected through virtual meetings, it opened the door to telemedicine.3 Telemedicine provides care to patients who are not able to attend in-person appointments due to distance (rural areas), lack of transportation or are homebound due to illness.

Telemedicine and its underlying technology increases access to healthcare and, importantly, decreases health disparities. While primary care physicians and

specialists can provide telemedicine, pharmacists and their teams are accessible virtually to improve medication adherence and increase patient education.

This is a win for all!

Not only were we able to provide excellent patient care, another opportunity for pharmacy occurred in Lansing. The Michigan Legislature and Gov. Gretchen Whitmer gave pharmacy a big win when the governor signed House Bills 4348, 4351 and 4352 in February 2022. These bills provide for the licensure of pharmacy benefit managers (PBMs) in Michigan, which will assist in lowering the cost of prescription drugs, prohibit PBMs from increasing costs when reimbursing pharmacies for prescription drugs and allowing for more transparency.

Other pharmacy-forward legislation that was signed or introduced within the last year include capping the price of insulin, a standing order to allow community organizations to distribute opioid antagonists, prescribing hormonal contraceptives without supervision from a prescriber and allowing pharmacists to be reimbursed for services provided to medically underserved areas.4, 5 Thank you to our members, MPA staff, the Pharmacy Advocacy Response Team (PART) and lobbyists for making this possible!

Looking back on the last year or so has shed some light that pharmacy has made incredible strides in closing the gap in healthcare. While the pandemic showed how pharmacy can provide testing, vaccinations and treatment, let us look forward with optimism that we can continue to advocate for pharmacy to be a care destination. We cherish our dispensing roles as core to our practices. Looking ahead, we have continued opportunities to advocate to expand our roles by providing increased patient access to our community services such as point-of-care services, medication administration (injectables and vaccinations), prescribing and patient education. I am excited for 2023 as the Michigan pharmacy community builds on the momentum we have gained over the last year. We are on a roll, so let us make this a HAPPY New Year!

References available upon request 2023 Jan./Feb./Mar. | Vol. 61, Issue 1

3

— CEO CORNER —

IT’S 2023 – SO MANY NEW OPPORTUNITIES We ring in the new year with the prospects of making 2023 truly great. However, it’s worth a brief look back at what made 2022 outstanding for Michigan Pharmacists Association (MPA) and you.

BY MARK GLASPER, chief executive officer, Michigan Pharmacists Association

MPA started fast with Gov. Gretchen Whitmer signing HB 4348, Michigan’s first pharmacy benefit manager (PBM) reform legislation. Then we held our first hybrid Annual Convention & Exposition (ACE) to the delight of members and exhibitors longing to return to inperson meetings. Members attending the American Pharmacists Association (APhA) Annual Meeting were treated to the return of the Michigan Reception, the first in three years since the APhA event had been on hiatus due to COVID. We were present at all of our Michigan Colleges of Pharmacy White Coat Ceremonies and Commencement events, welcoming our student pharmacists to the profession. Pharmacy technicians received good news this fall when the National Community Pharmacy Association (NCPA) announced it was joining the Pharmacy Technicians Certification Board’s Board of Governors, of which I am a member. This move will enhance opportunities for pharmacy technicians at community pharmacies across the nation and especially here in Michigan.

Our annual membership survey also gave us outstanding feedback that will fuel our Strategic Plan and propel us into this new year.

ACE Now & in the Future You have much to look forward to at this year’s inperson ACE Feb. 24-26 at the Marriott Renaissance Center in downtown Detroit. We have excellent programming in store for you, including a keynote fireside chat featuring National Association of Boards of Pharmacy Executive Director Al Carter and MPA Past President Charlie Mollien, who is the immediate past chair of the Michigan Board of Pharmacy for two terms. A legislative panel comprised of representatives from APhA, NCPA, American Society of Health-System Pharmacists and National Association of Chain Drug Stores will provide an up-to-date look at pharmacy legislation across the country.

We also plan to take ACE on the road in 2025 and beyond to new cities and venues in Michigan. We’ll still be at the Renaissance Center in 2024, but look for us to take ACE to Traverse City in 2025, Grand Rapids in 2026 and then back to the Detroit area in 2027 before repeating the rotation in subsequent years. This change of scenery also will be accompanied by a change in timing, with April looking like the best month for better driving weather. Stay tuned!

4

MichiganPharmacists.org

New Website for Growing Membership Hopefully, you’ve had an opportunity to check out our new and improved website since it was launched in December. We strived to offer you a better user experience with easier navigation and a fresh new look.

A great new experience you’ll have is when you log in and renew your membership, order a product or sign up for continuing education. Your personal information will automatically populate the order form, leaving you only to enter your payment information. We also will offer soon monthly payments for membership and making donations to the Michigan Pharmacy Foundation and our Michigan PAC. Many of our website improvements were the result of feedback we received from our annual member survey. We took that feedback and have continued to make improvements across MPA. You and others have undoubtedly noticed because MPA membership continues to rise. Membership is now up to more than 2,000 after having been under 2,000 for several years.

We will continue to take your feedback to improve your membership investment!

Welcome New Executive Board Members MPA welcomes our new slate of Officers and Executive Board members from our recent election: Chair Mike Crowe President Hope Broxterman President-Elect Sarah Hill Treasurer Marc Guzzardo Executive Board Members Sarah Lerchenfeldt, Ryan Bickel and new At-Large Representative Maria Young.

I want to thank Past Chair Heather Rickle, Mike Crowe and Heather Broxterman for spearheading a revamping of our bylaws and committee structure over the past year. We now have a streamlined committee structure that will serve MPA well. New for this year was a virtual MPA Committee Day on Jan. 19. It was a great way to kick off the new year by jumpstarting the work of all of our committees.

I look forward to working with our committees and all of our new and existing Executive Board members in 2023!

— EVENTS CALENDAR —

EVENTS CALENDAR

MPA events, as well as health observances, are included below. For the most up-to-date information, please visit our online calendar at www.MichiganPharmacists.org/events.

JANUARY 2023

1-31 1-31 5 19 23 26 31

Sunday, Jan. 1 – Tuesday, Jan. 31

National Birth Defects Prevention Month Nationwide

FEBRUARY 2023

1-28 2

Sunday, Jan. 1 – Tuesday, Jan. 31

National Slavery and Human Trafficking Prevention Month Nationwide

3

Thursday, Jan. 5

MSHP Committee Day Virtual Only

10

Thursday, Jan. 19

MPA Committee Day Virtual Only

23

Monday, Jan. 23

MPA Executive Board Meeting Virtual Only

23

Thursday, Jan. 26

CSPM Board of Directors Meeting Virtual Only

Tuesday, Jan. 31

MSCP Board of Directors and Committee Meetings Virtual Only

24-26

TUESDAY, APRIL 18, 1-2:30 p.m.

Wednesday, Feb. 1 – Tuesday, Feb. 28

American Heart Month Nationwide

Thursday, Feb. 2

MPF Board of Trustees Meeting Hybrid

Friday, Feb. 3

National Wear Red Day for the American Heart Association Nationwide

Friday, Feb. 10

MSPT Board of Directors Meeting Virtual Only

Thursday, Feb. 23

MPA Executive Board Meeting In-Person

Thursday, Feb. 23

MSHP Board of Directors Meeting In-Person

Friday, Feb. 24 Sunday, Feb. 26

MPA Annual Convention & Exposition Detroit Renaissance Center

— CE EVENTS —

Pharmacy Technician Immunization Training As a nationally recognized leader in the development of technician training resources, the Michigan Pharmacists Association (MPA) has developed Pharmacy Technician Immunization Administration training recognized as fulfilling the education requirement for the Pharmacy Technician Certification Board (PTCB) Immunization Administration Certificate Program. The homestudy portion of the course must be complete prior to joining the live review webinar. https://www.michiganpharmacists.org/education-events/pharmacytechnician-programs/pharmacy-technician-advanced-training/pharmacytechnician-advanced-training-immunization-administration/

MARCH 2023

1-31 13 24-27 28

Wednesday, March 1 – Friday, March 31 National Kidney Month Nationwide

Monday, March 13

MPA Executive Board Meeting Virtual Only

Friday, March 24 Monday, March 27

APhA Annual Meeting & Exposition Phoenix, AZ

Tuesday, March 28

American Diabetes Association Alert Day Nationwide

Please note: Some board and committee meetings may be subject to a change in format to virtual or in person at the discretion of the members. Please check the online calendar or contact MPA@MichiganPharmacists.org for more information.

MONDAY, APRIL 10 THURSDAY, JUNE 15 Implicit Bias Training More information on these events will be provided at a later date.

QUESTIONS

If you have any questions about any of these MPA education events, please email MPA@MichiganPharmacists.org.

Michigan Pharmacists Association (MPA) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education.

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

5

— BIOS AND MEMORIES — BERYL E. RIGEL Beryl E. Rigel, 84, of Three Rivers, died peacefully at home Monday, Nov. 21, 2022. He was born Jan. 14, 1938 in Dundee, Mich., the son of Merl E. and Aura (Lerch) Rigel. He graduated from Dundee High School, lettering in football and the high school band. He was also active in scouting, achieving the rank of Eagle Scout – the highest rank in the Boy Scouts. He was a proud graduate of the University of Michigan College of Pharmacy as president of the pharmacy class of 1960 and achieved an emeritus degree in pharmacy in June 2010. He worked as a pharmacist with the Quarry, Inc. in Ann Arbor. He moved to Three Rivers with his wife, Frances, and daughter, Kathryn, where he purchased and operated Sun Cut-Rate Drugs, later renamed Rigel Pharmacy, Inc., until 1992. He then worked as a pharmacist with Rite-Aid, Fred’s Pharmacy and Medical Center Pharmacy after selling his business.

He was a devout Catholic and an active member of Immaculate Conception Catholic Church. Beryl was a third degree, life member and past Grand Knight of the Knights of Columbus (KofC) council No. 4141. He was a lector and usher for many years and volunteered in many capacities — his favorites being donut crew and making

pancakes at the KofC pancake fundraisers. He served as a member of the Three Rivers City Commission for seven years and was instrumental in moving the Three Rivers Public Library to the location on Michigan Avenue. He was also a member of the Jaycees, BPOE No. 1248, Three Rivers Area Chamber of Commerce, Three Rivers Health Advisory Board, the American Pharmacists Association and a 50-year member of the Michigan Pharmacists Association. He also served as a director of The First National Bank for more than 30 years, acting as chairman of the board for 10 years.

In 1960 he married Frances Vergho at St. John the Baptist Catholic Church in Monroe. He enjoyed being with his family, especially his six grandchildren. He was a true “Go Blue” Wolverine sports fan. He enjoyed golfing, playing bridge and fishing on Corey Lake. He tended to bluebirds, helping to repopulate and protect the species.

He is survived by his loving wife of 62 years, Frances; daughters, Kathryn (Steven Davis) Rigel of Three Rivers, Christine (Phillip) Riedy of Livonia, Susan (Theodore) Tucker of Brighton and Jennifer Dickerson of Lake Orion; grandchildren Kevin (Samantha) Riedy, Brian Riedy, Julie Riedy, Andrew Tucker, John Henry Dickerson IV and Elizabeth Dickerson; and three nieces and their families.

NEW STAFF RYAN WEISS, Communications Manager Ryan joined the Michigan Pharmacists Association (MPA) in December after a little more than a decade in the newspaper industry. After graduating from Central Michigan University with a bachelor’s degree in journalism, his first job out of college was as a sports writer for The Argus-Press, a small-town daily newspaper in Owosso, Mich. After three years, he was promoted to sports editor, a capacity he served in for the next seven years. He eventually became the paper’s managing editor in January 2022 before deciding to leave the newspaper industry later that year.

When he’s not working, Weiss enjoys playing video games, biking, fishing and watching sports. Originally from the Saginaw area, he now lives in south Lansing with his wife Anamaria, who he married Aug. 6, 2022, and their 1-year-old pup Delilah, an Australian shepherd mix.

6

MichiganPharmacists.org

MARIA GONZALEZ, Student Pharmacist Maria Gonzalez is in her final year as a student pharmacist at Ferris State University. She is currently completing her master’s degree in public health. Gonzalez is completing a six-week rotation with the Michigan Pharmacists Association, which begins Feb. 13. Gonzalez is passionate about advocacy for pharmacy and engaging students. She believes that as future practitioners, student involvement is vital to the progression of the profession. She is actively involved with national organizations like the American Pharmacists Association Academy of Student Pharmacists, serving on the international standing committee for the past two years. She was involved in both national and international student organizations. Gonzalez believes that as future pharmacists, it is vital to understand the interconnectedness of social and economic factors concerning health and well-being. She works as a pharmacy intern at Walgreens, which has instilled in her the value of direct patient care. Upon graduation, she hopes to pursue a PGY-1 Residency Program. She hopes to eventually practice in an ambulatory or outpatient setting, serving an underserved or rural patient population.

Visit MPA’s social media channels for the most up-to-date information on events, resources and issues affecting pharmacy practice in Michigan.

Facebook.com/MichiganPharmacists

Twitter.com/MIPharmacists

Instagram.com/mipharm

Linkedin.com/company/ michigan-pharmacists-association

— FROM THE FOUNDATION —

DELIVERING ON DREAMS Help Shape the Future of MPF, the Pharmacy Profession

A

s the Michigan Pharmacy Foundation (MPF) begins 2023, it is time to celebrate the Foundation’s 30th anniversary, evaluate where we are now and look forward to the Foundation’s future. Throughout the upcoming year, there will be opportunities to celebrate MPF’s rich history and its many contributions over the past 30 years to enhance Michigan’s pharmacy profession.

BY RICK DRABEK, executive director, Michigan Pharmacy Foundation

“I would like to thank all of you for your ongoing financial support as the Foundation would not be able to deliver on its mission or dreams for the future without you!”

The Foundation’s Board of Trustees has spent considerable time this past year contemplating what it really means to serve the pharmacy profession and deliver on that mission. The MPF Board undertook a strategic planning process to guide the Foundation’s direction for the next three to five years. As part of this process, MPF’s mission statement was updated and now is “To Foster the Future of Pharmacy.”

The Foundation plans to continue delivering on its mission by awarding annual scholarships to pharmacy students, creating networking and mentoring opportunities for pharmacy students through MPF’s Adopt-A-Student program, funding grants to support projects that promote health and wellness delivered through the pharmacy profession and offering Health Professional Leadership Academy (HPLA) training opportunities for healthcare professionals.

Here is where we need your input. We would like to hear your thoughts, ideas and dreams for how you think the Foundation can best deliver on our mission moving forward. What are you passionate about in the pharmacy profession that you would like to see the Foundation invest in to make a meaningful impact?

For the Foundation to know what direction to focus on in the future, we need to hear from you on specific ways you feel the Foundation can help foster the future of pharmacy in Michigan. Please take some time to dream: what is your vision for the Foundation that you would invest in to advance the proud profession of pharmacy?

Dream about the difference you would like to see in your profession. Dream about the ways the pharmacy profession can help others achieve a better level of health and wellness. Share your dream with others in the profession about the impact the Foundation can achieve if we all work together.

There are several ways for you to share your ideas regarding the Foundation’s future direction. Please feel free to reach out to me directly at (517) 377-0227 or email me at RDrabek@MichiganPharmacists.org.

You can also reach out to one of our MPF Trustees and discuss with them what you feel the Foundation can do to support fostering the pharmacy profession.

Stop by the Foundation’s booth at the upcoming Michigan Pharmacists Association (MPA) Annual Convention & Exposition (ACE) at the Detroit Marriott at the Renaissance Center, Feb. 24-26, 2023. Consider gathering a small group who have various dreams for the Foundation and what impact you could have on the pharmacy profession. We could then meet in person or via Zoom to discuss these ideas further.

Our plan is to collect all of this feedback by March 31, 2023, and synthesize the information to guide the future impact of MPF. I would like to thank all of you for your ongoing financial support as the Foundation would not be able to deliver on its mission or dreams for the future without you!

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

7

— ADVOCACY UPDATE —

The Year of Pharmacy: PART II D

uring the 2021 legislative PAC panel at the MPA Annual Convention and Exposition, state Rep. Mary Whiteford (R-Casco) declared 2021 “the year of pharmacy.” Through MPA’s tireless advocacy efforts, we were able to lengthen that year into an entire legislative session. As a result, 2021-22 was an extremely positive time for pharmacy. We worked with state legislators, members of Michigan’s congressional delegation, various state departments and the governor’s office on everything we accomplished.

BY BRIAN SAPITA,

former government affairs director, Michigan Pharmacists Association

"The legislative term kicked off with a bang, reintroducing a tweaked version of MPA’s pharmacy benefit manager (PBM) reform legislation that we had been pushing during the 2019-20 term."

8

MichiganPharmacists.org

The legislative term kicked off with a bang, reintroducing a tweaked version of MPA’s pharmacy benefit manager (PBM) reform legislation that we had been pushing during the 2019-20 term. Michigan was one of the last states to have regulations placed on PBMs. MPA’s legislation was touted by many, including Speaker of the House Jason Wentworth, R-Farwell, as one of the nation’s most comprehensive pieces of PBM legislation.

Through MPA’s advocacy network, we were able to educate the legislature and governor’s office and get the bill signed into law.

Electronic prescribing is now in effect; hopefully, it has been a smooth transition for everyone. When the e-prescribing bill was introduced, the original piece of legislation held pharmacists liable for any prescription that was not properly e-prescribed. MPA worked with the legislature to remove the language and ensure pharmacists would be held harmless. To allow for patient continuity of care, MPA recommended waiver language the prescribers could obtain under certain circumstances.

Dwindling reimbursements from Medicaid and commercial insurers were an issue for many of our independent pharmacies; MPA was able to bring those concerns to the legislature and for the past three years, we have been able to advocate for the inclusion of the National Average Drug Acquisition Cost (NADAC), plus a professional dispensing fee for our independent members. In the state’s last fiscal year, this amounted to $1.5 billion going to our community pharmacies.

Provider status is always the goal of MPA and to ensure pharmacists can practice at the top of their license.

We had our first pharmacist-prescribing legislation introduced with our oral contraceptive prescribing legislation. Additionally, we had legislation introduced allowing pharmacists to administer immunizations independent of a collaborative practice agreement with a physician. Even though both bills “died” in the legislature, they were firsts for the state and were a step towards provider status in Michigan. MPA will continue these efforts in 2023.

These huge wins could not have been accomplished without the tireless efforts of the MPA and its advocates.

On average, most legislation introduced has a 10 percent chance of being signed into law. However, MPA put in the work through early mornings, late nights and countless miles driven across the state to build relationships with legislators and department heads, yielding a 42 percent success rate with legislation that we worked on. The work is not done yet; the 101st legislature ended Dec. 31, and the 102nd legislature began Jan. 1. We have been working with the new legislators on important pharmacy issues such as white bagging, provider status, oral contraceptive prescribing, independent vaccine authority, and of course, more PBM reform which should improve reimbursements to our members.

This is the last time I write for the Michigan Pharmacist, and by the time you read this, I should have already moved on to my new government affairs position. I have enjoyed working with many of you over my years at MPA. I have put my heart into advocating on your behalf and am extremely proud of everything I have done for the pharmacy profession. I was in the scouts growing up and one of their mottos is “leave things better than you found it.” I can truthfully say I believe I have left MPA in a better state than I found it. I believe I have been able to lay the foundation for whoever comes after me to hit the ground running and score many wins for pharmacy.

To all the members I have gotten to know, thank you for welcoming me. To my fellow MPA staff, thank you for being a second family.

— ADVOCACY UPDATE —

MPA ROLLS OUT

K

LEGISLATOR SCORECARD

nowing how your legislators are voting on important pharmacy issues should be a priority for every member. The Michigan Pharmacists Association (MPA) is trying to make it easy for everyone to keep up to date on their legislators' votes. A resolution approved by the MPA House of Delegates asked MPA to create a legislator scorecard so that our members can keep track of how their lawmakers vote on important pharmacy issues. Below is a new scorecard that lists legislation that has at least moved from one chamber to the other, MPA’s official stance on the legislation, and how each legislator voted. This scorecard will be placed on the MPA website so that members can keep track of their legislator’s votes in real time. This listing was how the previous legislature voted on MPA legislation. HBs 5580, 5637 and 5655 did not make it out of the legislature before the session ended.

2022 MICHIGAN SENATE BILL MPA POSITION LEGISLATOR

Alexander, Betty Jean Ananich, Jim Barrett, Tom Bayer, Rosemary Bizon, John Dr. Brinks, Winnie Bullock, Marshall Bumstead, Jon Chang, Stephanie Daley, Kevin Geiss, Erika Hertel Jr., Curtis Hollier, Adam Horn, Ken Wozniak, Douglas C. Huizenga, Mark E. Irwin, Jeff Johnson, Ruth LaSata, Kim Lauwers, Dan MacDonald, Michael McBroom, Ed McCann, Sean McMorrow, Mallory Moss, Jeremy Nesbitt, Aric Outman, Rick Polehanki, Dayna Runestad, Jim Santana, Sylvia Schmidt, Wayne A Mike Shirkey Stamas, Jim Theis, Lana VanderWall, Curt Victory, Roger Wojno, Paul Zorn, Dale

SB 155 SUPPORT PARTY Dem Dem Rep Dem Rep Dem Dem Rep Dem Rep Dem Dem Dem Rep Rep Rep Dem Rep Rep Rep Rep Rep Dem Dem Dem Rep Rep Dem Rep Dem Rep Rep Rep Rep Rep Rep Dem Rep

Insulin Refill

Yes Yes Yes Yes Yes Yes Yes Yes Yes Sponsor Yes Yes Excused Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Excused Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

SB 166 SUPPORT

SB 247 SUPPORT

Refill Expansion Insurance Reform

Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Excused Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Sponsor Yes Yes Yes

Green indicates the legislator voted with the MPA's position

Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Excused Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Sponsor Yes Yes Yes

HB 4348 SUPPORT

HB 4659 SUPPORT

PBM Reform

E-prescribing

Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Blue indicates external link

Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Excused Yes Yes Yes Yes Yes Yes Yes

HB 5072 SUPPORT

HB 5637

Distributor License COVID Treatments

Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Excused Excused Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

This bill was introduced in the house and not voted on.

HB 5655

LEGISLATOR SCORE

Contraceptives This bill was not voted on by the senate.

100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

9

— ADVOCACY UPDATE —

2022 MICHIGAN HOUSE OF REPRESENTATIVES BILL MPA POSITION LEGISLATOR

PARTY

HB 4348 SUPPORT

HB 4659 SUPPORT

HB 5072 SUPPORT

HB 5637 OPPOSE

HB 5880 OPPOSE

SB 155 SUPPORT

SB 166 SUPPORT

SB 247 SUPPORT

PBM Reform

E-prescribing

Distributor License

COVID Treatments

Informed Consent

Insulin Refill

Refill Expansion

Insurance Reform

LEGISLATOR SCORE

Aiyash, Abraham (District-4)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

Albert, Thomas (District-86)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Alexander, Julie (District-64)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

100%

Allor, Sue (District-106)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Anthony, Sarah (District-68)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Beeler, Andrew (District-83)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Bellino, Joe (District-17)

Rep

Yes

Sponsor

Yes

Yes

Yes

Yes

Yes

Yes

75%

Berman, Ryan (District-39)

Rep

Yes

Yes

Sponsor

Yes

Yes

Yes

Yes

Yes

75%

Beson, Timothy (District-96)

Rep

Yes

Yes

Yes

Yes

Excused

Yes

Yes

Yes

88%

Bezotte, Robert (District-47)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Bolden, Kyra (District-35)

Dem

Yes

Yes

Yes

Yes

Excused

Yes

Yes

Yes

88%

Bollin, Ann (District-42)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Borton, Ken (District-105)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75% 100%

Brabec, Felicia (District-55)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

Brann, Tommy (District-77)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Breen, Kelly (District-38)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100% 100%

Brixie, Julie (District-69)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

Calley, Julie (District-87)

Rep

Sponsor

Yes

Yes

Yes

Sponsor

Yes

Yes

Yes

88%

Cambensy, Sara (District-109)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100% 100%

Camilleri, Darrin (District-23)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

Carra, Steve (District-59)

Rep

No

Yes

Yes

Yes

Yes

Yes

Yes

No

50%

Carter, Brenda (District-29)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Carter, Tyrone (District-6)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Cavanagh, Mary (District-10)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Cherry, John (District-49)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Clemente, Cara (District-14)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Clements, TC (District-56)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Coleman, Kevin (District-16)

Dem

Yes

Yes

Yes

Yes

No

Yes

Yes

Yes

88%

Damoose, John (District-107)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Eisen, Gary (District-81)

Rep

Yes

Yes

Yes

No

Yes

Yes

Yes

Yes

88% 100%

Ellison, Jim (District-26)

Rep

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

Farrington, Diana (District-30)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Filler, Graham (District-93)

Rep

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

63% 75%

Fink, Andrew (District-58)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Frederick, Ben (District-85)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Garza, Alex (District-12)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Glenn, Annette (District-98)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Green, Phil (District-84)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Griffin, Beth (District-66)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Haadsma, Jim (District-62)

Dem

Yes

Yes

Yes

No

Yes

Yes

Yes

Yes

88%

Hall, Matt (District-63)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Hauck, Roger (District-99)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Hertel, Kevin (District-18)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Hoitenga, Michele (District-102)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100% 100%

Hood, Rachel (District-76)

Dem

Hope, Kara (District-67)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

Hornberger, Pamela (District-32)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Howell, Gary (District-82)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Johnson, Cynthia (District-5)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Johnson, Steven (District-72)

Rep

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

63%

Jones, Jewell (District-11)

Dem

Yes

Yes

Excused

No

No

Yes

Yes

Yes

100%

Kahle, Bronna (District-57)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Koleszar, Matt (District-20)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Green indicates the legislator voted with the MPA's position

10

MichiganPharmacists.org

Blue indicates external link

— ADVOCACY UPDATE —

2022 MICHIGAN HOUSE OF REPRESENTATIVES BILL MPA POSITION LEGISLATOR

PARTY

HB 4348 SUPPORT

HB 4659 SUPPORT

HB 5072 SUPPORT

HB 5637 OPPOSE

HB 5880 OPPOSE

SB 155 SUPPORT

SB 166 SUPPORT

SB 247 SUPPORT

PBM Reform

E-prescribing

Distributor License

COVID Treatments

Informed Consent

Insulin Refill

Refill Expansion

Insurance Reform

LEGISLATOR SCORE

Kuppa, Padma (District-41)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

LaFave, Beau (District-108)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

LaGrand, David (District-75)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

100%

Lasinski, Donna (District-52)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Liberati, Tullio (District-13)

Dem

Yes

Yes

Yes

No

Excused

Excused

Yes

Yes

100%

Lightner, Sarah (District-65)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Lilly, Jim (District-89)

Rep

No

Yes

Yes

Yes

Excused

Yes

Yes

Yes

75%

Maddock, Matt (District-44)

Rep

No

Yes

Excused

Excused

Yes

Yes

Yes

Yes

75%

Manoogian, Mari (District-40)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Marino, Steve (District-24)

Rep

No

Yes

Excused

Yes

Yes

Yes

Yes

Yes

63%

Markkanen, Gregory (District-110)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Martin, David (District-48)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75% 100%

Meerman, Luke (District-88)

Rep

Morse, Christine (District-61)

Dem

Yes

Yes

Excused

Excused

Excused

Yes

Yes

Yes

Mueller, Mike (District-51)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Neeley, Cynthia (District-34)

Dem

Yes

Yes

Excused

No

No

Yes

Yes

Yes

100%

O'Malley, Jack (District-101)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

O'Neal, Amos (District-95)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Outman, Pat (District-70)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Paquette, Brad (District-78)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Peterson, Ronnie (District-54)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Pohutsky, Laurie (District-19)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Posthumus, Bryan (District-73)

Rep

Yes

Yes

Yes

Yes

Excused

Yes

Yes

Yes

88%

Puri, Ranjeev (District-21)

Dem

Yes

Yes

Yes

No

Excused

Yes

Excused

Yes

100% 100%

Rabhi, Yousef (District-53)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

Reilly, John (District-46)

Rep

No

Yes

Yes

Yes

Excused

Yes

Yes

No

63%

Rendon, Daire (District-103)

Rep

Yes

Yes

Yes

Yes

Excused

Yes

Yes

Yes

88%

Rogers, Julie (District-60)

Dem

Yes

Yes

Yes

No

No

Yes

Excused

Yes

100%

Roth, John (District-104)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Sabo, Terry (District-92)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Scott, Helena (District-7)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Shannon, Nate (District-25)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Slagh, Bradley (District-90)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Sneller, Tim (District-50)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Sowerby, William (District-31)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Steckloff, Samantha (District-37)

Dem

Yes

Yes

Yes

No

Excused

Yes

Excused

Yes

100%

Steenland, Richard (District-22)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Stone, Lori (District-28)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Tate, Joe (District-2)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100% 100%

Thanedar, Shri (District-3)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

Tisdel, Mark (District-45)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

VanSingel, Scott (District-100)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

VanWoerkom, Greg (District-91)

Rep

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Wakeman, Rodney (District-94)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75% 100%

Weiss, Regina (District-27)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

Wendzel, Pauline (District-79)

Rep

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

63%

Wentworth, Jason (District-97)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Whiteford, Mary (District-80)

Rep

Yes

Yes

Yes

Sponsor

Yes

Yes

Yes

Yes

88%

Whitsett, Karen (District-9)

Dem

Yes

Yes

Yes

Yes

Excused

Yes

Yes

Excused

88%

Witwer, Angela (District-71)

Dem

Yes

Yes

Yes

No

Yes

Yes

Yes

Yes

88%

Yancey, Tenisha (District-1)

Dem

Yes

Yes

Yes

No

Excused

Yes

Yes

Yes

100%

Yaroch, Jeff (District-33)

Rep

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

75%

Young, Stephanie (District-8)

Dem

Yes

Yes

Yes

No

No

Yes

Yes

Yes

100%

Green indicates the legislator voted with the MPA's position

Blue indicates external link

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

11

— ADVOCACY UPDATE —

2023 MICHIGAN SENATE NAME

Erika Greiss Sylvia Santana Stephanie Chang Darrin Camilleri Dayna Polehanki Mary Cavanagh Jeremy Moss Mallory McMorrow Michael Webber Paul Wojno Veronica Klinefelt Kevin Hertel Rosemary Bayer Sue Shink Jeff Irwin Joe Bellino Jonathan Lindsey Thomas Albert Sean McCann

PARTY D D D D D D D D R D D D D D D R R R D

DISTRICT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

HOME CITY/AREA Taylor Detroit Detroit Brownstown Livonia Redford Southfield Royal Oak Rochester Hills Warren Eastpointe St. Clair Shores Beverly Hills Ann Arbor Ann Arbor Monroe Bronson Lowell Kalamazoo

SPECIAL ROLE

Majority Whip

NAME

PARTY

Aric Nesbitt Sarah Anthony Lana Theis Jim Runestad Ruth Johnson Dan Lauwers Kevin Daley John Cherry Sam Singh Winnie Brinks Mark Huizenga Roger Victory Jon Bumstead Rick Outman Roger Hauck Kristen McDonald Rivet Michele Hoitenga John Damoose Ed McBroom

R D R R R R R D D D R R R R R D R R R

DISTRICT 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38

HOME CITY/AREA Porter Twp Lansing Brighton Twp White Lake Twp Holly Capac Lum Flint East Lansing Grand Rapids Walker Hudsonville Newaygo Six Lakes Mt. Pleasant Bay City Manton Harbor Springs Vulcan

SPECIAL ROLE Minority Leader

Minority Floor Leader Majority Floor Leader Majority Leader Minority Whip

2023 MICHIGAN HOUSE OF REPRESENTATIVES NAME

Tyrone Carter Tullio Liberati Alabas Farhat Karen Whitsett Natalie Price Regina Weiss Helena Scott Mike McFall Abraham Aiyash Joe Tate Veronica Paiz Kimberly Edwards Lori Stone Donovan McKinney Erin Byrnes Stephanie Young Laurie Pohustsky Jason Hoskins Samantha Steckloff Noah Arbit Kelly Breen Matt Koleszar Jason Morgan Ranjeev Puri Kevin Coleman Dylan Wegela Jaime Churches Jamie Thompson James DeSana William Bruck Reggie Miller Jimmie Wilson Jr. Felicia Brabec Dale Zorn Andrew Fink Steve Carra Brad Paquette Joey Andrews Pauline Wendzel Christine Morse Julie Rogers Matt Hall Rachelle Smit Jim Haadsma Sarah Lightner Kathy Schmaltz Carrie Rheingans Jennifer Conlin Ann Bollin Bob Bezotte Matt Maddock Mike Harris Brenda Carter Donni Steele Mark Tisdel

12

PARTY D D D D D D D D D D D D D D D D D D D D D D D D D D D R R R D D D R R R R D R D D R R D R R D D R R R R D R R

DISTRICT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55

MichiganPharmacists.org

HOME CITY/AREA Detroit Allen Park Dearborn Detroit Berkley Oak Park Detroit Hazel Park Hamtramck Detroit Harper Woods Eastpointe Warren Detroit Dearborn Detroit Livonia Southfield Farmington Hills West Bloomfield Novi Carleton Ann Arbor Canton Westland Garden City Grosse Ile Flat Rock Carleton Erie Belleville Ypsilanti Pittsfield Twp Onsted Adams Twp St. Joseph Niles St. Joseph Bainbridge Twp Texas Twp Kalamazoo Richland Twp Martin Battle Creek Springport Jackson Ann Arbor Ann Arbor Brighton Twp Livingston County Milford Clarkston Pontiac Orion Rochester Hills

SPECIAL ROLE

Majority Floor Leader Speaker of the House

Speaker pro tem

Minority Leader

NAME

Sharon MacDonell Thomas Kuhn Nate Shannon Doug Wozniak Joseph Aragona Denise Mentzer Alicia St. Germaine Jay DeBoyer Andrew Beeler Jaime Greene Josh Schriver Phil Green David Martin Jasper Martus Cynthia Neeley Brian BeGole Mike Mueller Julie Brixie Kara Hope Penelope Tsernoglu Angela Whitwer Emily Dievendorf Gina Johnsen Angela Rigas Phil Skaggs Rachel Hood Kristian Grant John Fitzgerald Carol Glanville Bradley Slagh Nancy De Boer Will Snyder Greg VanWoerkom Luke Meerman Bryan Posthumus Pat Outman Jerry Neyer Graham Filler Amos O'Neal Bill G. Schuette Timothy Beson Matthew Bierlein Gregory Alexander Mike Hoadley Tom Kunse Joseph Fox Curt VanderWall Betsy Coffia John Roth Ken Borton Cam Cavitt Neil Friske Dave Prestin Jenn Hill Gregory Markkanen

PARTY D R D R R D R R R R R R R D D R R D D D D D R R D D D D D R R D R R R R R R D R R R R R R R R D R R R R R D R

DISTRICT 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110

HOME CITY/AREA Troy Troy Sterling Heights Shelby Twp Clinton Twp Mt. Clemens Harrison Twp St. Clair Port Huron Richmond Oxford Millington Davison Flushing Flint Antrim Twp Linden Meridian Twp Holt East Lansing Delta Twp Lansing Odessa Twp Alto Grand Rapids Grand Rapids Grand Rapids Wyoming Walker Zeeland Holland Muskegon Norton Shores Coopersville Cannon Twp Six Lakes Shepherd DeWitt Saginaw Midland Bangor Twp Vassar Croswell Au Gres Clare Fremont Ludington Traverse City Traverse City Gaylord Mullett Twp Charlevoix Cedar River Marquette Hancock

SPECIAL ROLE

Minority Floor Leader

— FROM THE FOUNDATION —

2023 MPF BOARD OF TRUSTEES

The Michigan Pharmacy Foundation (MPF) is proud to introduce its new officers and members of the 2023 MPF Board of Trustees. Members are elected by the board annually on a rotating basis to three-year terms. Newly-elected trustees for 2023 are Ghada Abdallah, Rani Saadallah and Scott Huizenga. Christopher Maksym, Margaret (Peggy) Malovrh and Susan Erickson all were elected to return to their roles as chair, vice-chair and treasurer, respectively. Incumbent returning trustees are Amy Adams, Denise Markstrom, James Vander Linde, John Brubaker, Rox Gatia and Terry Gottschall.

Michigan Pharmacists Association (MPA) CEO Mark Glasper serves as secretary, while MPA President Hope Broxterman also sits on the board.

CHRISTOPHER MAKSYM

MARGARET (PEGGY) MALOVRH

SUSAN ERICKSON

Dexter

Okemos

Burton

MPF CHAIR

MPF VICE CHAIR

HOPE BROXTERMAN

MARK GLASPER

Traverse City

Williamston

MPA PRESIDENT

MPF TREASURER

AMY ADAMS

SECRETARY/CEO

West Branch

DENISE MARKSTROM

GHADA ABDALLAH

JAMES VANDER LINDE

JOHN BRUBAKER

RANI SAADALLAH

ROX GATIA

SCOTT HUIZENGA

TERRY GOTTSCHALL

Sterling Heights

Farmington

Grosse Pointe

Bloomfield Hills

East Lansing

Ann Arbor

Sterling Heights

Wixom

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

13

— MEMBERSHIP —

FROM THE DESK OF

I

MEMBERSHIP

want to start off my 2023 From the Desk of Membership thanking you for your continued support, as we would not have had success in 2022 without you, our members. As of this writing, our membership growth is slightly more than 20% compared to 2021. This means we now have over 2,000 paying members, a number we haven’t seen since 2019. This was accomplished with a lot of hard work from the Michigan Pharmacists Association (MPA) staff and Executive Board, along with our committees.

BY SCOTT WALSH,

director of membership, Michigan Pharmacists Association

As we start 2023, I feel very confident the MPA will be able to maintain this momentum, with help from the MPA Membership Committee, MSHP/MPA Membership Committee and the New Practitioner Committee. As the Director of Membership, I have the pleasure of serving as a staff liaison to each. My experiences through 13 years of association membership management have taught me many valuable insights, but the most important insights come from our members, who are the profession. The membership and new practitioner committees work jointly with me to recruit and maintain MPA members; they also provide priceless means of engagement for current and potential members.

Not only do I have the MPA staff, Executive Board and three amazing committees to help this momentum continue, I also get the benefit of the local associations to assist through their outreach in the community and to their own members. If you are reading this article right now and are unsure if you are part of a local association, finish reading and email or call me to find out, as local associations are complimentary with your membership.

In closing, as a member-driven organization, we encourage you to refer any non-members to us. If you have yet to renew your membership, please renew online or contact me if you have any questions. We are only as strong as our membership is and we want to thank you for an amazing 2022.

— MEMBER BENEFIT —

TRIPPLANET WELCOMES MPA MEMBERS

A

s a member of the Michigan Pharmacists Association (MPA), you’re entitled to many benefits. One you may not be as familiar with is access to TripPlanet. Whether you are looking out your office window at snow drifts, or dropping your kids off at school because the buses are delayed due to icy conditions, now is your time to take part in TripPlanet and escape the winter.

TripPlanet welcomes MPA members by giving you access to deeply discounted airfare and hotel rates through a private, invite-only platform.

Once you are signed up, you can expect to receive 60% off on accommodations and deep, member-only discounts on airfare. The best way to see these amazing discounts is to try for yourself by visiting https://trplnt.co/mpa.

The search for a getaway doesn’t just stop by getting out of Michigan for a little rest and relaxation. Take advantage of another fantastic MPA benefit and attend the 2023 Annual Convention & Exposition (ACE) Feb. 24-26, 2023, while saving 50 percent compared to non-members of the MPA. We look forward to seeing you there.

14

MichiganPharmacists.org

Home Mortgage Loans Made for Pharmacists and Medical Professionals.

PHYSICIAN MORTGAGE PROGRAM: • • • • •

•

Available for PharmD, MD, DO, DDS, DMD or DVM1 100% financing up to $1 million2 89% financing up to $2 million No private mortgage insurance (PMI) Medical Residents with proof of fully executed employment contract eligible for loan amounts up to $500,0003 Student Loans may be excluded from debt-to-income calculations if in deferment or forbearance for at least 12 months following closing

TONY CABRERA NMLS# 533270 Mortgage Sales Manager 734-417-6008 | tcabrera@firstmerchants.com

firstmerchants.com/tonycabrera Available to medical doctors who have a minimum of a Doctor of Pharmacy (PharmD), Medical Doctor (MD), Doctor of Osteopathy (DO), Doctor of Dental Surgery (DDS), Doctor of Dental Medicine (DMD), or Doctor of Veterinarian Medicine (DVM) degree and an employment contract or verification of terms of employment acceptance. Medical Doctors with the degrees listed above but specializing in a particular field including but not limited to Dentists, Podiatrists and Ophthalmologists are also permitted. 2100% financing does not exclude closing costs and/or prepaids that may be required. 3Borrower must have a minimum credit score of 680 to be eligible. Must be purchase of a primary residence in Michigan, Ohio, Indiana, Illinois or Kentucky. All loans are subject to credit approval. Program is available only to qualified borrowers. Please contact First Merchants Bank to learn more about the program and the eligibility requirements. Program is subject to change without notice. Underwriting terms and conditions apply. Some restrictions may apply.

1

PTCB Launches New Certificate for Pharmacy Technicians As part of its mission to ensure pharmacy technicians meet the evolving challenges in medication safety, the Pharmacy Technician Certification Board (PTCB) has launched a new Supply Chain and Inventory Management Certificate. This advanced credential assesses pharmacy technicians’ knowledge of laws and regulations, administrative processes, inventory management, documentation requirements and key players in the supply chain.

Pharmacy technicians play an increasingly vital part in patient care teams, and fluency in supply chain and inventory management can help keep the focus on safety at every step, from the manufacturing lab to the medicine cabinet. By earning this certificate, technicians can demonstrate their understanding of supply chain and inventory management regulations, processes, and responsibilities and better adapt to changing guidelines.

View all pharmacy technician credentials at ptcb.org/credentials 2023 Jan./Feb./Mar. | Vol. 61, Issue 1

15

— PROFESSIONAL AFFAIRS —

Pharmacist-Led Test-to-Treat Models Becoming Customary:

How the Pandemic Exposed the Essentiality of Prescriptive Authority

A

BY ERIC R. FOSTER,

B.S., Pharm.D., MBA

s the dust settles from the pandemic, governing groups are left to determine the appropriate course of action regarding healthcare functionality. While the federal COVID-19 Public Health Emergency Declaration has been extended for a few months, other emergency declarations which aided pharmaceutical care and management have expired.

These emergency declarations, often in the form of emergency use authorizations, granted pharmacists avenues to serve patients throughout the pandemic by leading COVID-19 testing and vaccination efforts.1 Coupled with the fact that about 90 percent of the U.S. population lives within 5 miles of a pharmacy, it is easy to understand why pharmacists were vital to COVID-19 strategies.2

Studies have shown that an increase of 40 percent in testing and treatment for communicable diseases, like influenza, could result from the utilization of pharmacists' accessibility and availability outside of regular clinical hours.7 Furthermore, 40 percent of the patient population have no primary care provider and thus may not seek medical attention, resulting in a greater risk of exposure to the public.7 These facts have been proven many times in multiple states and countries for the last decade, with no known incidences of alleged harm at the hands of pharmacists.5 These successes are attributed to pharmacists' knowledge and proficiency as medication experts and health professionals responsible for ensuring safe medication use, including identifying and mitigating drug interactions associated with prescribed therapies.8

Due to their accessibility, pharmacists were utilized to address public health concerns when granted prescriptive authority and prescribing protocols. In some states, prescriptive authority allows pharmacists to issue prescriptions for immunizations, naloxone, oral contraception, tobacco cessation aids, HIV PreExposure Prophylaxis (PrEP)/Post-Exposure Prophylaxis (PEP) and antivirals, either through expanded scope of practice or under the delegation of a collaborative practice agreement.3 The argument can be made, however, that pharmacists are still underutilized because there are more crippling ailments that can be addressed— ailments that can be quickly identified using U.S. Food and Drug Administration-approved diagnostic equipment. This is where a pharmacist's potential truly lies. Test-to-treat is the amalgamation of point-of-care testing and prescriptive authority.

With appropriate training, pharmacists can administer laboratory-grade diagnostic CLIA-waived testing to treat patients for certain infections such as influenza, RSV, group A strep and COVID-19, just to name a few. Confirmatory high-grade diagnostics, access to patient medical information, and pharmacist clinical knowledge can be utilized to prescribe and dispense an appropriate prescription to the patient on-site with haste and ease of access. The early identification and treatment of influenza, RSV, group A strep and COVID-19, when provided by a pharmacist, resulted in reduced sick days, high patient satisfaction rates, and improved antimicrobial stewardship.4,5,6

Test-to-treat programs have gained positive responses from local communities, state officials and cooperation from physicians. As indicated during the COVID-19 pandemic, where patients were referred for testing at pharmacy locations and, most recently, the prescribing of COVID-19 antiviral therapy.1 The argument is these test-to-treat programs can be extrapolated to so many other disease states and display similar levels of success. Walgreens has plans to launch influenza testto-treat programs this winter to expand patient access to diagnostic testing and oseltamivir, an antiviral drug used to treat influenza A and B. The prediction is many other retail locations will follow suit, piggybacking off the success of the many other pharmacists prescribing protocols that came before.

To allow pharmacists to practice at the top of their license, it is necessary to translate the momentum from these test-to-treat programs into statute and expand the pharmacist's scope of practice. One example would be monitoring type 2 diabetes patients' blood glucose and A1C when they pick up refills to determine if another oral therapy or injectable needs to be added to their regimen.

Under a prescribing protocol, a pharmacist would then be able to prescribe an additional agent. Centers for Medicare and Medicaid Services has already begun to reimburse pharmacists for the management of diabetic patients, which demonstrates that the profession is not far from these practices.1 Prescriptive authority that allows pharmacists to provide these services takes the profession from test-to-treat towards test-to-manage.

References available upon request

16

MichiganPharmacists.org

— CSPM FOCUS —

Get to Know Consultant and Specialty Pharmacists of Michigan and our 2023 Strategic Priorities

T

BY JAMIE THARP, Pharm.D., BCSCP AND LINDSEY GHIRINGHELLI, Pharm.D., BCGP, FMPA

he Consultant and Specialty Pharmacists of Michigan (CSPM) is the Michigan Pharmacist Association’s (MPA) practice section for a diverse group of pharmacy practice areas, including consultant pharmacists, specialty, long-term care, home care, radiopharmaceutical (Nuclear Medicine, or “Nuc Med”), managed care and academia. This may seem like a group of disparate practice areas, but we share some commonalities. Each of these practice areas is rarely explored in pharmacy curricula.

Traditionally, many of these practice areas use on-the-job training to develop specialized pharmacist skills in the absence of prevalent graduate or postgraduate residency training programs. These practice areas tend to be heavily regulated and require practitioners to keep abreast of ever-changing payer and regulatory standards in addition to maintaining clinical skills. As of April 2022, CSPM had 131 members from these various practice sites.

The CSPM Board of Directors spent the fall of 2022 revising the practice section’s strategic priorities. The Board aims to align the group’s goals with MPA's by creating SMART (Specific, Measurable, Attainable, Reasonable and Time-bound) goals that can provide value to members and grow the practice section.

Below we explain the diverse practice areas that comprise CSPM and how we envision new strategic priorities to focus the CSPM Board activities on enhancing member services and benefits.

Practice Section Highlights: Specialty Pharmacy

Specialty medications are high-cost prescription medications used to treat complex, chronic conditions such as multiple sclerosis, rheumatoid arthritis, infertility, dermatological conditions, organ transplants and many cancers. Specialty medications often require special handling, dosing or administration, as well as enhanced and intensive clinical oversight. Patients utilizing these medications often need continuous monitoring and education along with

specialized financial support services due to the high cost of many medications.

Specialty pharmacists and pharmacy technicians provide these services along with ongoing medication management to ensure optimal patient outcomes and medication safety. Specialty pharmacies are typically closed-door operations, communicating with patients by phone and shipping medications from a centralized location. Specialty pharmacies are highly scrutinized by payers and regulators and are typically accredited by the Utilization Review Accreditation Commission incorporated (URAC) or the Accreditation Commission for Healthcare (ACHC). They may also have various payer and health care organization accreditations/ certifications. Specialty pharmacists may demonstrate their expertise in the field by qualifying as a Certified Specialty Pharmacist (CSP) through the National Association of Specialty Pharmacy (NASP). Many specialty pharmacists also hold certification as HIV Pharmacists (AAHIVP) from the American Academy of HIV Medicine, board certification as Oncology Pharmacists (BCOP), Pharmacotherapy Specialists (BCPS), or Solid Organ Transplant Pharmacists (BCTXP) from the Board of Pharmacy Specialties and/or masters-level degrees in business or healthcare-related fields.

Long-Term Care

Patients in long-term care facilities receive pharmacy services from the dispensing pharmacy and the facility’s consultant pharmacist. Pharmacists and pharmacy technicians at the dispensing pharmacy, usually off-site, receive and dispense medication orders from the nursing facility.

The orders are checked for safety and accuracy, then medications and supplies are prepared and delivered to the facility.

Additional services include sterile and nonsterile compounding, specialized medication packaging, vaccine clinics, pharmacist-led IV antibiotics dosing, anticoagulation and other medications. Each facility will also have an emergency backup medication kit maintained by the dispensing pharmacy.

Skilled nursing facilities are required by the Centers for Medicare and Medicaid (CMS) to retain the services of a consultant pharmacist (CP) to oversee all aspects of medication use within the facility, including clinical evaluation, appropriate administration and storage and regulatory compliance.

The CP performs a medication regimen review for each resident at least monthly to identify any clinical concerns and provide written recommendations to prescribers and nursing staff. Examples include drug interactions, renal dosing and transitions of care discrepancies. A full-time consultant can oversee 10 or more facilities each month and complete as many as 1,200 chart reviews.

Many practitioners are board-certified in geriatric pharmacy. The CP is a member of the facility’s quality assurance committee to educate on medication use and help coordinate quality patient care as a part of the healthcare team.

Nuclear Pharmacy

Nuclear pharmacists and pharmacy technicians are specially trained to work with radioactive drugs. They create drugs using nuclear compounds that are safe to administer to patients and often ship them to hospitals or clinics. Radiopharmaceuticals are frequently used for diagnostic testing and cancer treatment and can be swallowed, inhaled or injected. Nuclear pharmacies typically start very early in the morning and may need to be on-call for emergencies. Staff has extensive training in handling radioactive substances and uses specialized protective equipment to protect from radiation exposure.

Many pharmacists are also board-certified in nuclear pharmacy and work closely with radiologists and oncologists to ensure safe medication use.

Home Care

Home care pharmacies bring medical services to patients with difficulty getting to a medical provider. They also help with patient discharge from healthcare facilities and receive care at home or another setting, such as assisted living facilities and group homes. Pharmacists and pharmacy technicians are an integral 2023 Jan./Feb./Mar. | Vol. 61, Issue 1

17

— CSPM FOCUS — part of this team to help bring pharmacy services to the patient and provide smoother and safer transitions of care between care settings. Home care pharmacy offers ongoing education and assessment of chronic conditions and medications to reduce adverse drug reactions, prevent hospitalizations and improve health outcomes.

Figure 1. 2022 MPA Member Survey- CSPM Member Local Association Membership

Managed Care

Pharmacy professionals within managed care settings help patients navigate their drug benefits. Tasks include drug utilization reviews, involvement in pharmacy and therapeutics committees, developing quality assurance programs, overseeing programs that reduce fraud, waste and abuse, and Figure 2. 2022 MPA Member Survey- CSPM Member Top Pharmacy Advocacy Priorities assistance with prior authorizations. Managed Figure 2. 2022 MPA Member Survey- Top CSPM Member Advocacy Top Pharmacy Advocacy Priorities care pharmacists and pharmacy technicians Figure 2. 2022 MPA Member SurveyCSPM Member Pharmacy Priorities work to improve medication access, ensure patient safety, manage costs and help patients make the best use of their medication insurance coverage. In addition to managed care pharmacy residency training, many pharmacists in managed care roles often have masters-level degrees in business or healthcare-related fields (MBA, MPH, MHA, etc.), and many possess certifications in medication management from groups like the American Pharmacists Association or the Academy of Managed Care Pharmacy.

Academia

Pharmacists and pharmacy technicians in academia shape the future of the pharmacy profession. In addition to teaching and See Figure 3 for an overview of MPA’s 2022in August to review the CSPM member assisting with continuous development Strategic Priorities: 2024 Strategic Plan, ideas generated by the responses toCSPM the 2022 MPA member survey. and improvement of the curriculum, CSPM workgroup to support the MPA goals/ The survey responses were evaluated and pharmacy professionals in academia The CSPM Boardrevisions of Governors aims to align CSPM strategicand priorities the MPA Strategic Plan and objectives, initialwith actions planned by the utilized to draft proposed to the serve as faculty advisors to students and CSPM board.

CSPM strategic priorities. Key CSPM survey student organizations, serve on institutional member survey feedback. See Figure 3 for an overview of MPA’s 2022-2024 Strategic Plan, ideas response results are highlighted in Figures 1 Key aims of the Board were to advise MPA committees, leadership councils and task andPriorities: 2. CSPM members hail from across the CSPM Strategic on CSPM priorities, member benefits and forces, complete research, publish and present state, with over 50 percent affiliating with services; and to increase membership levels their work at conferences, and write grants Oakland, Genesee and Wayne County Local and practice section diversity. We believe and publications. Many faculty members The CSPM Board of Governors aims align CSPM strategic priorities with the MPA Strategic Plan and Associations (Figure 1). to Top-ranked MPA there is a significant opportunity to increase spend more than half of their time working benefits were receiving legislative updates, eligible-member awareness of the practice as pharmacists and pharmacy technicians member survey feedback.

See Figure 3 for anopportunities, overview of MPA’s 2022-2024 Strategic Plan, ideas advocacy, continuing education sites served by CSPM and demonstrate the to provide hands-on clinical education and connecting with other members and access value of CSPM and MPA membership to those mentorship to students at a wide variety to MPA staff for professional practice individuals. CSPM’s Board of Directors wants of pharmacy practice sites. They prepare or law-related questions. The top three to ensure MPA prioritizes CSPM value-added students for a career in pharmacy and set CSPM member-stated advocacy priorities benefits and advocacy initiatives as we seek an example of lifelong learning, teaching and included pharmacy benefit manager (PBM) to increase membership levels. While the service to the profession. transparency, fair pharmacy reimbursement CSPM board has representation from most and CMS provider status (Figure 2). practice areas, engaging non-board members CSPM Member Survey Results is essential to increase diverse perspectives The CSPM Board of Directors is actively CSPM Strategic Priorities and advocacy. revising the practice section’s strategic The CSPM Board of Directors aims to align To establish and pursue CSPM strategic priorities to align with MPA’s 2022-2024 CSPM strategic priorities with the MPA priorities, the Board will develop project Strategic Plan. A CSPM workgroup convened Strategic Plan and member survey feedback. charters for each of the strategic priorities

18

MichiganPharmacists.org

De

De

— CSPM FOCUS — Figure 3. Overview of MPA Strategic Plan, CSPM Support Ideas and Initial CSPM Board Actions

To establish and pursue CSPM strategic priorities, the Board will develop project charters for each of the strategic priorities (Figure 4). We plan to use the charters to establish project scope, resource needs, task assignments and deliverables. These focused planning steps will hopefully increase the likelihood of our success in achieving our goals.

(Figure 4). The board plans use the charters to establish project scope, resource needs, task assignments and deliverables. These focused planning steps will hopefully increase the likelihood of CSPM's success in achieving its goals.

Figure 4. Strategic Priority Project Charter Priority ExampleProject Charter Example Figure 4. Strategic

Conclusion CSPM is a practice section with a lot of diversity and often-overlooked practice sites. The CSPM board aims to increase the awareness of potential members about the scope and strategic priorities of the practice section. CSPM also hopes that practitioners who are members of other practice sections, like health-system or community pharmacy, with intersectional interests will consider selecting CSPM as a secondary practice section. Through the achievement of our revised strategic priorities, the board hopes to partner with MPA to grow membership and find novel ways to engage and serve members.

Conclusion: CSPM is a practice section with a lot of diversity and often-overlooked practice sites. The CSPM board

19

2023 | Vol. 61, Issue 1 of the aims to increase the awareness of potential members about theJan./Feb./Mar. scope and strategic priorities

— CSPM PRESIDENT —

COVID-19 & CANCER CARE FALL 2022 UPDATES

EDITOR’S NOTE: This information was accurate as of fall 2022; however, information changes and may not be up-to-date as of this publication date.

R

BY MATTHEW G. MCTAGGART, Pharm.D.,

RPh, CSPM president

ecent studies have reported an increased risk of SARS-CoV-2 infection and a more severe COVID-19 disease course in patients with cancer.1 Many patients with cancer are also older with more comorbidities and often have compromised immune function because of disease, anti-cancer treatment, or both. It is estimated there are more than 16 million cancer survivors in the United States alone as of 2019.

That figure is projected to increase in the coming years as novel treatment options increase cancer survival. As one of the most accessible healthcare professionals and the medication expert on the oncology team, pharmacists can play an essential role in COVID-19 prevention and treatment for patients with cancer.2,3

COVID-19 Prevention - Vaccinations Recommendations from oncology and healthcare organizations currently call for administering the primary series followed by a bivalent booster for moderately or severely immunocompromised patients.4-7 Those 12 years and older should receive either a three-dose mRNA-based primary series (Moderna or Pfizer-BioNTech) or a two-dose protein-based (Novavax) primary series, followed at least two months later by a bivalent booster that is updated to cover the Omicron COVID-19 variant. Adults 18 years and older who previously received a Janssen primary series dose

20

MichiganPharmacists.org

should receive an additional mRNA-based primary dose, followed by a bivalent booster at least two months later.

It should be noted that the Janssen COVID-19 vaccine is now recommended only in certain limited situations where the patient cannot take an mRNA-based or protein-based vaccine, or when the recommended vaccines are not readily available. Patients should be made aware of the risk of thrombosis with thrombocytopenia syndrome (TTS), a rare but lifethreatening bleeding disorder, that has been reported following vaccination with the Janssen COVID-19 vaccine. Details on the COVID-19 vaccination schedule can be found in the CDC infographic located in Figure 1. For the most up-to-date info on vaccinating immunocompromised individuals, visit https://www. cdc.gov/vaccines/covid-19/clinical-considerations/ interim-considerations-us.html#immunocompromised.

While current CDC recommendations have shifted to a single bivalent booster, previously boosted patients who already completed a primary series and received two monovalent boosters are eligible for an additional bivalent booster, equivalent to a “sixth dose” of the vaccine.7 The National Comprehensive Cancer Network (NCCN) has also developed

— CSPM PRESIDENT — recommendations for unique vaccine timing considerations.5 Patients undergoing Hematopoietic Cell Transplantation (HCT)/ Cellular Therapy should start the series at least three months post-HCT/cellular therapy.

Additionally, patients receiving regimens to treat graft-versus-host-disease may have a blunted immune response and delay of vaccination may be considered in these patients. For patients with hematologic malignancies receiving intensive cytotoxic chemotherapy, NCCN recommends delaying vaccination until absolute neutrophil count (ANC) recovery. However, vaccination should start as soon as possible for those whose ANC is not expected to recover. For patients with solid tumor malignancies undergoing major surgery, NCCN suggests separating the surgery date from vaccination by at least a few days. More complex surgeries may necessitate a wider window; for example, two weeks.

Figure 1: COVID-19 Vaccination Schedule for Moderately to Severely Immunocompromised People4

COVID-19 Prevention Pre-exposure prophylaxis Tixagevimab co-packaged with cilgavimab (EvusheldTM) is a combination of two longacting monoclonal antibodies targeting the SARS-CoV-2 spike protein. Early results from neutralizing assays suggest EvusheldTM provides at least partial efficacy against Omicron variants, including BA.2, and may provide additional protection for patients at high-risk for severe COVID-19 infection.

On Jan. 26, 2023, the FDA announced that the EUA for Evusheld has been revised and based on this revision, Evusheld is not currently authorized for use in the U.S. This is because it is unlikely to be active against more than 90 percent of the SARSCoV-2 variants currently circulating in the U.S. based on the latest CDC data. However, people who have used Evusheld still have options to increase their protection against the most serious consequences of COVID-19, including hospitalization and death. HHS and AstraZeneca have paused distribution of Evusheld until further notice by the Agency.

COVID-19 Treatment Treatment of COVID-19 in the outpatient setting has shifted mainly to two recently authorized oral antiviral medications, nirmatrelvir and ritonavir (PaxlovidTM) and molnupiravir (Lagevrio®). Remdesivir (Veklury®) remains a good option to reduce COVID-19-associated hospitalization, but

The National Comprehensive Cancer Network (NCCN) has also developed recommendations for unique 5 Patients undergoing Hematopoietic Cell Transplantation (HCT)/Cellular vaccine timing considerations. requires three sequential intravenous interaction management.

Therapy should start series at making least three therapy. Additionally, patients (IV) infusions overthe three days, it months post-HCT/cellular Although COVID-19 will likely continue to receiving regimens to treatfor graft-versus-host-disease may have a blunted immune response and delay of logistically challenging many patients. present substantial challenges for patients vaccination may be antibody considered in these patients. with hematologic malignancies receiving The monoclonal bebtelovimab is For patients with cancer, pharmacists can help provide intensive cytotoxic chemotherapy, NCCN recommends delaying vaccination until absolute neutrophil no longer FDA authorized as of December clinical support to the oncology team by count (ANC) vaccination as soon as possible for those whose ANC is not 2022 due recovery. to lack of However, efficacy against the should startpromoting of current COVID-19 prevention and expected to recover. BQ.1 For patients with Omicron solid tumor malignancies undergoing major surgery, NCCN widely circulating and BQ.1.1 treatment strategies.

8 suggests separating date from vaccination by at least a few days. More complex surgeries subvariants.

Onethe keysurgery area pharmacists References available upon request may necessitate a wider window; for example, two weeks. can assist patients with is the numerous

drug-drug interactions associatedprophylaxis with COVID-19 Prevention - Pre-exposure

some COVID-19 therapies. The University of Liverpool has developed a comprehensive and free interaction-checking tool for PaxlovidTM and other COVID-19 medications available at https://www.covid19druginteractions.org/ checker.9 Clinicians can filter interactions by therapeutic group, including a large list of cancer medications.

The tool provides clinical recommendations on 2023 Jan./Feb./Mar. | Vol. 61, Issue 1

21

— MPA EXECUTIVE BOARD —

MPA EXECUTIVE BOARD Elections for the 2023 Michigan Pharmacists Association Executive Board were held last October, and the president-elect and board members took office Jan. 1, 2023. Installation ceremonies will be held in person at the MPA Annual Convention & Exposition (ACE) in Detroit, Friday, Feb. 24, to Sunday, Feb. 26.

MIKE W. CROWE

HOPE M. BROXTERMAN

Grand Blanc

Traverse City

PRESIDENT

CHAIR

MARC GUZZARDO

MARK GLASPER

Howell

Williamston

PRESIDENT-ELECT

SECRETARY/CEO

ROBIN CURTIS

TREASURER

SPEAKER OF THE HOUSE OF DELEGATES

VICE SPEAKER OF THE HOUSE OF DELEGATES

JAMIE THARP

JOHN S. CLARK

MICHELLE KELLY

Rochester

Ann Arbor

RYAN J. GREENLEY Chassell

22

KATIE AXFORD

SARAH HILL

MichiganPharmacists.org

Rockford

Saline

RYAN D. MOORE Zeeland

Ada

Rockford

SARAH LERCHENFELDT Rochester Hills

MARIA YOUNG Canton

ANGELA FASZCZEWSKI Lexington

RYAN BICKEL Kalamazoo

MARY WESTOVER Grand Rapids

— MEMBER SPOTLIGHT —

NEW PRACTITIONER MEMBER SPOTLIGHT QUESTIONNAIRE Name and credentials: Corey Rowe, Pharm.D. Title/Employer: Executive Fellow, Michigan Pharmacists Association (MPA) Member Since: 2018 Why did you join MPA? I joined MPA as a first-year student pharmacist. As a student, pursuing networking opportunities is a key step towards landing a career and I saw the value in the local connections MPA provides its members.

Why did you become a pharmacist?

To me, being a pharmacist means having the opportunity to engage in research and new discoveries while bettering the lives of patients. Pharmacists are the most

accessible healthcare providers and as such, our profession has close ties to public health policy and advocacy efforts where many of my interests meet. Pharmacy is a unique practice setting which empowers me to advance positive change within my local community.

What are you hoping to accomplish in the short-term and long-term?

In the short-term as the MPA fellow, I hope to continue advancing pharmacy practice through educating our state lawmakers and managing professional training programs.

Long-term, my career interests are pharmacy informatics, research and a continued role in state-level advocacy.

Where do you see pharmacy in the future?

I see more opportunities to provide direct, individualized care. We do much more than just treat conditions and diagnosis codes; we treat patients as people, and we are well suited to meet them where they are. Our patients stand to benefit from the expansion of pharmacy services such as point-of-care testing, mobile immunization clinics and other accessible efforts.

What do you like to do in your free time?

Software development and transportation advocacy! I’m actively involved in several targeted efforts to expand public transit throughout Michigan. I get around by bus and by bike rather than driving whenever possible and enjoy starting conversations about the ongoing “mode shift” we’re seeing in our cities.

JOIN THE KROGER HEALTH TEAM Scan the QR code or visit TheKrogerCo.com/careers to apply now.

Once you’ve submitted your application, email your resume to MIPharmacyDept@Kroger.com and mention your referral from the MPA.

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

23

— STUDENT FOCUS —

THE COMMUNITY PHARMACIST'S ROLE IN DEPRESCRIBING

BY EMMA DITTMAR,

Pharm.D., Candidate 2023, University of Michigan College of Pharmacy

"While some patients may positively react to the idea of stopping a medication, others may express concerns or resistance."

24

MichiganPharmacists.org

P

olypharmacy is a growing problem across the country, but it creates an opportunity for community pharmacists to play a more prominent role in patient-centered care.

Polypharmacy is commonly defined as taking five or more medications at a time or using multiple drugs to treat diseases and other health conditions.1,2 Polypharmacy in and of itself does not necessarily pose a problem, as some health conditions require multiple medications; however, using inappropriate medications can create new issues.2 It is estimated around onethird of the U.S. population aged 60 years and older is taking at least five medications, including at least one on the American Geriatric Society’s Beers list of high-risk medications.2,3 Multiple medications may create cost and adherence issues for patients and increase the risk of drugdrug interactions and side effects.2,3 Issues with polypharmacy are also associated with higher hospitalizations and mortality rates.1

Pharmacists can help mitigate these issues by taking an active role in deprescribing. Deprescribing is "the process of withdrawal of an inappropriate medication, supervised by a healthcare professional, with the goal of managing polypharmacy and improving outcomes."4 Removing inappropriate medications from a patient's regimen helps to decrease the burden of polypharmacy and can help patients from falling into a prescribing cascade in which a new medication is added to a regimen to treat the side effect of an existing medication. Community pharmacists are in a unique position to facilitate deprescribing as they are often cited as the most accessible health care professional (HCP) and trusted regarding medication safety.5 However, there are some barriers present that limit pharmacists’ success in deprescribing, such as patient concerns and access to prescribers or health records.

Patients who are potentially eligible for deprescribing can be identified using resources such as deprescribing.com.

This website has guidelines for proton pump inhibitors, antihyperglycemics, antipsychotics, benzodiazepines, cholinesterase inhibitors and memantine. The Beers Criteria and the Screening Tool of Older Persons’ Prescriptions (STOPP) criteria can also be used to

identify potentially inappropriate medications for older adults.1 In addition to reviewing individual classes of medications, it is essential to consider the patient's entire medication regimen given the overall risks of polypharmacy.

While some patients may positively react to the idea of stopping a medication, others may express concerns or resistance. Patients may not realize that there can be consequences with medications they are prescribed, so educating them on any risks and potential alternatives is helpful in the deprescribing process.6 Studies have shown that when patients are provided information on the risks of unnecessary long-term proton pump inhibitors before their appointments, they are more likely to start conversations about deprescribing with their HCP.7 Overall, having these conversations with patients is important because shared decision making, in which the patient and HCP are working together to make decisions, lead to a better quality of care for patients.3 Prescribers can also be a good resource in deprescribing, but this can create an additional barrier for community pharmacists. Without having access to electronic health records (EHR), community pharmacists

— STUDENT FOCUS —

"Deprescribing is one strategy to overcome the growing problem of polypharmacy." may lack critical information when considering if a medication is appropriate to deprescribe. Unfortunately, prescribers may not always respond to pharmacies requesting information to evaluate the patient's medication regimen or to a deprescribing recommendation.6 To overcome this barrier, community pharmacists might seek access to the EHR for the practice or health system where their patients commonly receive care. Alternatively, community pharmacists may help to equip patients to initiate a deprescribing conversation when visiting their HCP. Gathering as much information directly from the patient about their medications can be beneficial. Specifically, it can be helpful to collect information on the indication for each medication and whether it is effective or causing side effects. Knowing this information can strengthen a recommendation to give to the HCP, or if the patient does not know the indication, that may spark a conversation when they next talk with their HCP. It is not always necessary for the community pharmacist to talk directly with patients to promote the deprescribing of inappropriate

medications. Some methods that have shown to be effective and overall cost-saving include providing education on medications and using predefined protocols for medication usage.4 Multiple deprescribing organizations have created materials for patient and provider education on potentially inappropriate medications and guidelines on how to deprescribe. Some of these materials have been studied in the D-PRESCRIBE randomized controlled trial and shown to be effective in practice.4 These materials were most effective when they were given to patients to review before meeting with their prescribers, so it could be beneficial to provide them in the community pharmacy setting, such as in the prescription medication bag at the point of dispensing.4 Regardless of how conversations are started, the most important thing to remember is that patients must be included in the decision.

In many community pharmacies today, adding another clinical task while trying to meet corporate metrics and focusing on safely dispensing current prescriptions may seem impractical. One potential strategy is

to engage student pharmacists and medical history pharmacy technicians as they can review patient medication lists to identify potential medications to deprescribe, initiate the conversation with the patient about the potential benefits of deprescribing and follow up with the prescriber if needed. If students are available to help with this task, this could help pharmacies and reinforce the idea of medication safety in the student's education.

While it may sound daunting to have a deprescribing conversation with a patient, they can be as short as five minutes and may not take away as much time from other tasks as many would initially think.6 Deprescribing is one strategy to overcome the growing problem of polypharmacy, especially among older adults with multiple chronic conditions. There are numerous barriers to effective deprescribing in the community setting, but there may be opportunities for community pharmacists and student pharmacists to identify potentially inappropriate or unsafe medications and intervene.

PRES ENTS

HEALTH EQUITY IN THE

PHARMACY

Learning Objectives: At the end of this activity, participants should be able to: 1. D escribe health equity, health disparity, social determinants of health, and implicit bias 2. D iscuss the impact of health disparities on patients 3. Examine the role of healthcare providers in promoting health equity 4. Investigate actions for pharmacy professionals to take that reduce healthcare inequities

— FREE CONTINUED EDUCATION — Free from: 2/1/23-4/30/23 • Register Here: https://www.lecturepanda.com/a/HealthEquityinthePharmacy 2023 Jan./Feb./Mar. | Vol. 61, Issue 1

25

2 02 3 ANNUAL

CONVENTION & EXPOSITION FRIDAY, FEB. 24 – SUNDAY, FEB. 26

The Michigan Pharmacists Association (MPA) is delighted to deliver your Annual Convention & Exposition (ACE) from Friday, Feb. 24 to Sunday, Feb. 26, 2023, at the Detroit Marriott at the Renaissance Center in Detroit.

We’ve heard from our members, board, partners and staff on their excitement and preference for in-person events! After those communications and additional trend research, MPA has decided to align with other pharmacy organizations, including the American Pharmacists Association (APhA) and the National Community Pharmacists Association (NCPA), to no longer offer a virtual experience in conjunction with the Annual Conference.

BY LISA N. POWERS,

After the rollercoasters of the past few years, we’re thrilled for members to see colleagues and friends yet again. We’re hoping many more members can join us in 2023, as research has shown the importance of face-to-face interaction for growth. This growth happens not only professionally, but also personally as we look to strengthen the network of pharmacy professionals and allies. In addition to professional and personal growth, the keynotes and sessions offered this year will grow your knowledge in key areas including birth control prescribing, implicit bias training, workplace environment components, pain and so much more. If you were to attend every keynote and ACISTS AR M AS H P a session at each breakout offering, you could acquire up to 15 hours of live S CE credit at this year’s Annual Conference.

ON ATI CI

MICH IG

O

AN

CAE, CTA, director of education & events, Michigan Pharmacists Association

2023

For those who cannot attend ACE in-person this year, MPA plans to release recorded components at a premium to non-members and discounted to members on a session-by-session basis.

It is important to note that MPA is keeping the safety of our members, staff and partners top of mind. MPA will be following Centers for Disease Control and Prevention (CDC), state and the Detroit Health Department guidelines for COVID-19 precautions. COVID-19 policies and guidelines will be strongly enforced for the safety of our staff and attendees.

"After the rollercoasters of the past few years, we’re thrilled for members to see colleagues and friends yet again."

— ON THE COVER —

KEYNOTE HIGHLIGHTS FRIDAY OPENING SESSION After a full morning of educational programming that will begin at 8 a.m.

Friday, Feb. 24, MPA is honored that our opening keynote address will be given by the Executive Director of the National Al Carter Association of Boards of Pharmacy, Al Carter, and the immediate past chair of the Board of Pharmacy, Charlie Mollien.

This engaging and interactive “fireside chat” will address various topics, including “just Charlie Mollien culture,” the impact of regulatory bodies, accrediting organizations and payers have on pharmacy and much more. Get all your queries and questions answered by the top leaders in your field during this session, such as: “Why are pharmacists scared to notify the Board of Pharmacy of differing issues” and “how can pharmacists work with their state and national association to get reimbursed for services?” Be sure to come prepared with your questions and engage these experts on areas of their expertise.

Don’t miss this opening keynote beginning at 1:30 p.m., after the welcome address from MPA CEO Mark Glasper.

SATURDAY KEYNOTE SESSIONS Saturday, Feb. 25 is another full day of programing, beginning with education sessions taking place after breakfast (7 a.m.) at 8:30 a.m. The keynote address will be a heavy-hitting legislative panel comprised of national pharmacy leaders and advocates from all sections of pharmacy. Panelists will be discussing major topics facing the industry in 2023 and beyond. A few of the topics that will be covered during this exciting keynote include provider status, pharmacy reimbursement and pharmacy benefit manager (PBM) reform.

Distinguished Panelists • Ilisa Bernstein, Pharm.D., J.D., FAPhA, interim CEO for the American Pharmacists Association • Anne Cassity, J.D., vice president, federal and state government affairs for the National Community Pharmacists Association • Tom Kraus, J.D., MHS, vice president of government relations for the American Society of Health-System Pharmacists • Bill Tighe, vice president, federal government affairs for the National Association of Chain Drug Stores Taking place at 2 p.m., back by popular demand, is the National Association of State Pharmacy Associations (NASPA)-

NMA Self-Care Challenge. The Self-Care Challenge provides students an opportunity to showcase their extensive over-the-counter (OTC) knowledge against their rival pharmacy students in a lighthearted competition while granting continuing education credits for attendees. This year’s competition will feature three students from each college of pharmacy in Michigan: Ferris State University, Wayne State University and the University of Michigan. These three-student teams will compete in a three-round, “Jeopardy!”-style competition for a chance to be crowned the victors! Each round will have a lead from the team who oversees buzzing in and answering the questions for that round, while still being able to communicate with teammates. For the first two rounds, the first team to buzz in after a question is read will get a chance to answer the question. If they get it right, they get points. If they get it wrong, the question is open for the remaining two teams to buzz in and try to answer correctly. The third and final round allows teams to bet all or a portion of their total points on the final question — either gaining or losing the amount of points they “gamble.” The team with the most points at the end of the game wins!

Careful attention has been given to create pharmacy continuing education programs that not only help pharmacists and pharmacy technicians fulfill licensure and certification requirements, but to also help you grow in your healthcare setting as a community, consultant, specialty or health-system pharmacist or pharmacy technician.

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

27

— ON THE COVER — NEW IN 2022, BACK IN 2023

Fellow of MPA

Excellence in Innovation Award

MPA has partnered with pharmaceutical sponsors to offer you product knowledge programming during lunch Friday. From 11:30 a.m. to 12:25 p.m., attendees will be able to choose a product theater session to join while you eat lunch, which will be provided. Product theater sessions offer an opportunity for our industry partners to provide educational programs about new pharmaceutical products and services, as well as the latest in data and research findings.

The ‘Fellow of MPA’ designation recognizes the honoree’s achievements and dedication to the practice of pharmacy and the community.

This distinction signifies the recipient's actions well beyond regular pharmacy practice. The fellowship is divided into three areas: professional actions in practice, public service and Association participation — all of which help define a well-rounded pharmacist.

Recipients receive an exclusive lapel pin, a certificate and recognition in the Michigan Pharmacist.

The Excellence in Innovation Award is presented annually to an individual or team who has demonstrated an innovative pharmacy practice program, resulting in improved patient care or safety, advancement of the profession, enhanced pharmacy systems or other professional development.

The following awards will be recognized, among others:

Years of Membership Award The Years of Membership Awards are given to honor and thank pharmacy professionals for their many years of membership and dedicated service to MPA.

Pharmacy Hall of Honor

Fred W. Arnold Public Relations Award (MPF) This award is presented to an MPA member or team of MPA members who have shown outstanding achievement and dedication to the pharmacy profession through community education and awareness.

Distinguished New Pharmacist Practitioner Award The Distinguished New Pharmacist Practitioner Award is presented annually to an MPA member pharmacist who has been licensed to practice for less than 10 years and participates in local, state and national pharmacy associations, professional programs and/or community service.

Bowl of Hygeia Award The Bowl of Hygeia derives its name from the Greek goddess, Hygeia, who was the guardian over the healing potion contained in the bowl. The Bowl of Hygeia Award is given to a pharmacist who has made outstanding professional contributions and has participated in community or governmental activities that reflect well on the pharmacy profession.

MPA Pharmacist of the Year Award The MPA Pharmacist of the Year Award is given to a pharmacist who demonstrates professional excellence and exemplary service to the profession in advancing public health at either the state or local level and displays all the traits and characteristics of someone with a true commitment to advancing the pharmacy profession and public health.

A PH

RMACISTS A SS ON ATI CI

Each year, qualifying members who have accumulated 500 points for their volunteer activities are inducted into the Hall of Honor.

In addition to the individual’s name being displayed in the Pharmacy Hall of Honor at the MPA office, the recipient receives an exclusive lapel pin to signify their accomplishment.

The Michigan Pharmacy Foundation (MPF) is proud to recognize exceptional student pharmacists during the Annual Convention & Exposition. The Larry Wagenknecht Leadership Scholarship awards $3,000 to a student who especially exhibits exceptional leadership capabilities. Each year, a $2,500 scholarship is awarded to one student pharmacist at each of Michigan’s three colleges of pharmacy. Since establishing the program in 2002, the Foundation has awarded more than $110,000 in scholarships to deserving future practitioners.

O

The Pharmacy Hall of Honor was established

by MPA in 1986 to recognize members who have provided volunteer leadership in service to the Association by participating on committees and in designated Association programs.

Student Scholarship Program

AN

MPA honors many distinguished individuals who serve and advance the profession of pharmacy and the health of our patients at our Annual Banquet & Awards Ceremony. This year, the banquet is back and better than ever.

The ceremony will take place Saturday evening during the awards banquet dinner. MPA will recognize several worthy awardees, including our 25-, 40- and 50-year members with the Years of Membership Awards; our volunteer leaders through induction into our Pharmacy Hall of Honor; as well as our elected boards, leaders and fellows for their service. MPA also honors scholarship recipients, the MPA Pharmacist of the Year and other honorable awardees for their noteworthy achievements.

The Executive Board Medal Award is given annually to an individual who has demonstrated an extraordinary personal commitment to MPA. The award was developed to recognize individuals who have been instrumental to the Executive Board and the Association in advancing pharmacy’s agenda.

MICH IG

AWARDS RECOGNITION

Executive Board Medal Award

2023

28

MichiganPharmacists.org

— ON THE COVER — HOUSE OF DELEGATES The MPA House of Delegates is the policyforming body of the Association. The MPA House of Delegates is comprised of pharmacy professionals from across the state and includes delegates from the Executive Board, the Michigan Society of Pharmacy Technicians, local associations, regional societies and the Michigan colleges of pharmacy. It is the responsibility of the House of Delegates to interpret the objectives of the Association as stated in the Bylaws and to serve as the policy-forming body of the

Association. The House of Delegates will act on all policy reports and adopt resolutions of policy directed to the Executive Board. The House of Delegates will also act on proposals for amendment of the Bylaws. The House of Delegates may adopt rules of procedures for the governing and administration of the House of Delegates.

The 2023 House of Delegates will convene in-person at the Marriott on Sunday, Feb. 26, 2023, to discuss proposed policy changes, proposed resolutions and review the MPA Bylaws. After discussion and a vote on any

proposed changes, those resolutions are directed to the MPA Executive Board for review and recommendation.

REGISTRATION Go to MPA’s website at https://www.

MichiganPharmacists.org/education-events/ annual-conference-exhibition for more convention information and to register if you have yet to do so.

We can’t wait to see you again soon!

We wouldn’t be able to host you without the support of our sponsors! At the time of publication, the companies below had committed to sponsoring the 2023 Annual Convention & Exposition. We thank them for their continued partnership and support.

GOLD

SILVER

BRONZE

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

29

— ON THE COVER —

PROGRAM SCHEDULE

FRIDAY, FEB. 24 8 - 9:30 a.m.

Cases in Anticoagulation Management

8 - 9:30 a.m.

MSHP: Financial Planning

8 - 9:30 a.m. CPSM: Non-Traditional Pharmacy Roles & How We Address Unique Patient Care Challenges 8 - 9:30 a.m. MSPT: A Tale of Two Michigans: The Opioid Crisis 9:45 - 11:15 a.m. Trending: Continuous Glucose Monitoring in Diabetes Management 9:45 - 11:15 a.m. Managing Opioids Throughout the Lifespan: Opioid Awareness Training for Pharmacist Licensure 9:45 - 11:15 a.m. Birth Control Panel Implementation of Pharmacist-Prescribed Contraception Service into a Busy Pharmacy 9:45 - 11:15 a.m. Immunization Update 2023 1:30 - 3 p.m. KEYNOTE: Fireside Chat on Hot Topics with Pharmacy Leaders 3:15 - 4:45 p.m. Expedited Partner Therapy (EPT): What Pharmacists Need to Know 3:15 - 4:45 p.m. Evidence-Based law: The Continuum of Pharmacists Prescriptive Authority & Pharmacy Technician Support Roles 3:15 - 4:45 p.m. MSCP: MPA Pharmacy Workplace Environment Task Force – The Journey 3:15 - 4:45 p.m. Asthma-COPD Overlap- New Frontiers to Explore

SATURDAY, FEB. 25 8:30 - 10 a.m. Setting the Stage: Implementing Michigan Medicaid MTM Into Your Practice Setting 8:30 - 10 a.m.

Legal Aspects of Pharmacist-Prescribed Birth Control

8:30 - 10 a.m. Using Opioids Safely in Patients with Renal or Hepatic Dysfunction 8:30 - 10 a.m.

MSHP: Clinical Pearls for Pharmacy, Residency Panel

10:15 - 11:45 a.m. Keynote National Legislative Panel: Pharmacy Advocacy on a National and Local Level 2 - 3:30 p.m.

NASPA OTC Self-Care Competition

3:45 - 5:45 p.m.

Implicit Bias Training 2.0: Education, Practice and Teams

4 - 5:30 p.m.

MSCP: New Drug Update 2023 Retail/Specialty Focus

4 - 5:30 p.m.

Winning Combinations: The Role of Polypharmacy in Psychiatric Conditions

4 - 5:30 p.m.

Using CHARM to Support Outpatient Antimicrobial Stewardship

SUNDAY, FEB. 26

RMACISTS A SS O

MICH IG

ON ATI CI

AN

A PH

8 - 9:30 a.m.

Preconception Care and Contraception Prescribing: A Primer

8 - 9:30 a.m.

Updates GLP-1 and GLP-1/GIP Agonists: Agonistics for Weight Loss

8 - 9:30 a.m. From the ED to the Pharmacy: Innovations in Pharmacists-Led Hypertension Management *Accredited for Pharmacist Only 9:45 - 11:15 a.m. Impact of Payor-Driven Treatment Site of Care Initiatives: Balancing Safety, Quality and Cost

2023

9:45 - 11:15 a.m. Stop Taking Your Medication! Approaches to Support Patient-Centered Deprescribing 9:45 - 12:45 p.m.

30

MichiganPharmacists.org

House of Delegates

— LEGAL INSIGHTS —

The Corporate Transparency Act of 2020 and Mandatory Registration of Your Personal Information with the Federal Government I thought that title would get your attention.

BY JULIE JANEWAY,

MSA, JD, senior healthcare counsel, Foley, Baron, Metzger & Juip, PLLC; chair, MPA Reproductive Health Work Group

Congress passed the Corporate Transparency Act (CTA) on Jan. 1, 2021, as part of the National Defense Authorization Act for Fiscal Year 2021 (31 USC §5336). It requires the Department of the Treasury to create a national database to collect “beneficial ownership” information for most business entities.

Although I can only give you a ridiculously short report on this colossal new law, feel free to contact me if you would like further information.

The CTA intends to protect U.S. national security, provide information to law enforcement and promote financial transparency. Through this law, Congress is trying to address the U.S. deficiencies in information reporting regarding those with financial benefit business interests as noted by the (international) Financial Action Task Force (FATF), established in 1989 at the G7 Summit. In 1990, the U.S. adopted the FATF’s measures developed to combat money laundering and its report containing 40 recommendations (including subsequent revisions). Two recommendations address beneficial ownership reporting, stating governments should take measures to prevent the misuse of “legal persons,” such as business entities and trusts, for money laundering or financing terrorism.

If this sounds like a Hollywood movie, I assure you it isn’t. Over the past 10 years, I have given presentations across the country on how healthcare fraud in the United States funds terrorism around the world.

The statute requires companies to collect and report the personal identifying information of a non-exempt company’s current “beneficial owners,” as well as the personal identifying information of the person who was responsible for filing the company’s formation documents (an “applicant”), which includes attorneys (like me) who form companies for clients. This information must be reported to the Financial Crimes Enforcement Network (FinCEN) of the Department of the Treasury. The information will be maintained in a secure database by FinCEN and made available to financial institutions and law enforcement nationally and internationally.

A “reporting company” is a company that is either formed under the laws of a state by filing with a Secretary of State (SOS) or other equivalent state agency, or is a foreign company registered to do business in the United States by having filed a registration notice with an SOS. This would include corporations, LLCs and “other similar entities” (for

example, LPs and LLPs) formed by filing with a state agency. Nonprofit corporations, general partnerships and sole proprietorships are exempt.

“Beneficial owners” are natural persons who directly or indirectly own 25 percent or more of the reporting company’s equity interests, exercise “substantial control” over the reporting company, or receive substantial economic benefits from the company’s assets. It does not include passive or future interest owners (future inheritors). The proposed regulations define “substantial control” as including a company’s senior officers, persons with authority to appoint or remove a company’s senior officers or board members and persons otherwise having the ability to provide direction or influence on the company’s major decisions — however that will be defined (like attorneys?).

FinCEN stated in its September 2022 press release regarding the issuance of the Final Rule that “illicit actors frequently use corporate structures such as shell and front companies to obfuscate their identities and launder their ill-gotten gains through the United States.”

FinCEN further reported that “shell and front companies can shield beneficial owners’ identities and allow criminals to illegally access and transact in the U.S. economy while disadvantaging small U.S. businesses who are playing by the rules.”

When filing annual Beneficial Ownership Interest (BOI) reports with FinCEN, the rule requires a reporting company to identify itself and report four pieces of information about each of its beneficial owners: name, birthdate, address and a unique identifying number and issuing jurisdiction from an acceptable identification document, like a passport or government ID (and the image of such document). The new regulations are effective Jan. 1, 2024. Companies created before the effective date must file initial reports by Jan. 1, 2025 (you get an extra year of not reporting), while companies established after Jan. 1, 2024, will have 30 days to comply. So, if you want to buy, sell, merge, split, or expand a business, it is best to do it before the end of 2023. Start planning now.

This is just the tip of the iceberg about this law, and it is expected to apply to approximately 90 percent of businesses operating in the United States. Failing to file, filing late, or filing false information will result in jail of up to two years and fines of $500 per day, up to $10,000.

I will just leave that information with you for now and wait for your shocked and confused call.

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

31

— LADC FEATURE —

LOCAL ASSOCIATION SPOTLIGHT:

CAPITAL AREA PHARMACISTS ASSOCIATION

BY SUSAN BENIVEGNA, RPh, incoming CAPA president

CAPA’s Poison Prevention Week event took place at Impression 5 Science Museum in downtown Lansing March 20, 2022.

The Burcham Hills Retirement Community in East Lansing was treated to the Pharmacy Week Presentation “Pharmacy Topics in Small Doses” in October 2022.

CAPA volunteers served at Culver’s as part of a fundraiser for the CAPA Scholarship Fund.

Number of years as MPA Member and number of years with local association:

I’ve been with MPA and MSHP for 24 years. I have been with CAPA casually for continuing education, but have been more active with CAPA for additional activities the last few years.

When was your local formed?

CAPA started in 1962 as the Ingham County Pharmaceutical Association.

In 1984, it changed its name to the Capital Area Pharmacists Association and brought in Eaton, Clinton and Shiawassee Counties. In 2000, the Central Michigan Society of Hospital Pharmacists (CMSHP) merged with CAPA.

CAPA held its Member Summer Social at Eagle Monk Brewery with MPA CEO Mark Glasper, front.

CAPA volunteers prepared a meal for people at Advent House Ministries Oct. 29, 2022.

professionals locally, that you may not otherwise have a chance to meet and share ideas with, is key to getting more fulfillment in your daily professional role as a pharmacist or a technician. CAPA members have many mutual and diverse challenges that can be worked on together. I have been given the opportunity to look at the profession in new ways through my association with CAPA.

Do you have a favorite event or memory related to your local?

From co-workers at Sparrow Hospital.

One of my favorite recent memories was volunteers from our Poison Prevention Week Committee sharing their presentation materials and knowledge of this subject with families in the Lansing community at the Impression 5 Science Museum in downtown Lansing. Even the local news station interviewed us!

Where and when does your local hold meetings?

Please list any upcoming events:

How did you learn about your local association?

We meet at the Sparrow Professional Building when able to do so inperson, or virtually via Zoom.

Why do you feel it is valuable to support and join a local association? How has it benefitted you?

I feel that there is great value to joining a local association for several reasons: networking, continuing education, local advocacy; community outreach and volunteerism. Getting to know and work with other

32

MichiganPharmacists.org

Jan. 23, 2023: Pharmacists’ Role in Poison Prevention CE program Feb. 24-26, 2023: MPA Annual Convention and Exposition (ACE) at the Detroit Marriott at the Renaissance Center in Detroit

Who is a good contact at your local for further information and questions?

Dr. Curtis Smith at smithc@ferris.edu

LOCAL MEETINGS AND EVENTS Capital Area Pharmacists Association (CAPA)

Oakland County Pharmacists Association (OCPA)

Jan. 23: Poison prevention operations and medication abuse CE, 6:30 p.m., (in-person)

Jan. 12: Monthly meeting, 7 p.m.

E-board meeting, time TBD.

March 9: Monthly meeting, 7 p.m.

March 14: CE TBD. E-board meeting, time 7 p.m.

Contact: capapharm@gmail.com

Wayne County Pharmacists Association (WCPA) Jan. 6: Awards and Installation Banquet, TBD for location Jan. 17: Monthly meeting, 7:30 p.m., TBD for Zoom or hybrid Feb. 21: Monthly meeting, 7:30 p.m., TBD for Zoom or hybrid March 21: Monthly meeting, 7:30 p.m., TBD for Zoom or hybrid

Kent County Pharmacists Association (KCPA) Jan. 18: KCPA Holiday Party, 6-9 p.m.

Uccellos Ristorante, 2630 E. Beltline Ave., Grand Rapids Contact: kcpapharmacists@gmail.com Feb. 21: Monthly meeting, 7:30 p.m., virtual via Zoom, https://zoom.us/j/92565737649 March 21: In-person meeting, 7:30 p.m., location TBD

Feb. 9: Monthly meeting, 7 p.m.

To join meetings, email hanadithomas@yahoo.com

Genesee County Pharmacists Association (GCPA) Jan. 11: Monthly Meeting, 7 p.m.

March15: Monthly meeting, 7 p.m., Location TBD Contact: thomas.breeden@ascension.org

Western Michigan Pharmacy Association (WMPA) Jan. 10: Annual Holiday Dinner, 7 p.m.

Walker’s Restaurant, 939 Third St., Muskegon RSVP uganski@gmail.com or 231-744-5173

Macomb County Pharmacy Association (MCPA) Jan. 19: Monthly meeting, 7 p.m., virtual via Zoom March 16: Monthly meeting, 7 p.m., virtual via Zoom

April 18: Monthly meeting, 7:30 p.m., virtual via Zoom, https://zoom.us/j/92565737649

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

33

— COVER YOUR ASSETS —

As we head into a new year, we at PSI Insurance Agency hope you and yours had nothing but the happiest of holidays. We’re in business to protect your business and personal assets as well.

Recently, I talked to a couple of our longtime business clients. They both asked me an interesting question: “Do you sell (insert type of policy here)?” It could be their home, auto, or even their life insurance.

BY RON DEVERS,

CIC, CPIA, director of operations, PSI Insurance Agency

34

MichiganPharmacists.org

It occurred to me that many of our members may not know exactly what we do. Many assume that we only deal in business insurance for pharmacies around the state. While it’s true that when we first opened 30 years ago we only serviced pharmacies and pharmacists, we also write insurance for many non-pharmacy related interests. Over the years, we have also maintained our niche of helping the pharmacy industry with its insurance needs.

When I was asked the question above, my first thought was this article. At PSI Insurance Agency, we want to be your insurance source and risk management resource.

We can help to insure your home, auto, umbrella, and items like jewelry, boats, motorcycles, or even life and disability insurance. We are here to help and serve!

This year, my aim is to use “Cover Your Assets” to share insurance information that is relevant to you, from what to do in a claim situation to how to prepare your home for winter. I hope to cover a wide range of topics to help make your life a little more manageable.

Until then, Happy New Year! To the many customers that are reading this, thank you for trusting us with your insurance matters.

TripPlanet welcomes MPA members by giving them access to deeply discounted airfare and hotel rates through a private, invite-only platform

&

2023 Jan./Feb./Mar. | Vol. 61, Issue 1

35

— PAAS NATIONAL —

OIG TELEHEALTH FRAUD CONCERNS

I

n September 2022, the U.S. Department of Health and Human Services Office of Inspector General (OIG) put out a report1 on program integrity risks concerning Medicare telehealth services during the first year of the COVID-19 pandemic. The OIG states that in the first year of the pandemic, more than 28 million Medicare beneficiaries (roughly 2 in 5) used telehealth — amounting to a dramatic 88-fold increase from the previous year. Because of this, the OIG wanted to find out if providers were appropriately billing telehealth services, while looking to identify the best way to further protect the Medicare program and beneficiaries from fraud, waste and abuse (FWA).

BY TRENTON THIEDE,

Pharm.D., MBA, president, PAAS National®, expert third-party audit assistance and FWA/HIPAA compliance

The OIG did some brief data analysis of telehealth claims from March 1, 2020, through Feb. 28, 2021, of 742,000 providers. They found that 1,714 providers posed a high-risk to Medicare due to concerning billing practices, such as charging for services that were not medically necessary or were never provided. Other reasons for scrutiny included being in the same medical practice as another provider who engaged in high-risk billing practices (i.e., guilt by association).

High-risk providers were identified by the OIG when they billed: • Both a telehealth service and a facility fee for most visits • Telehealth services at the highest, most expensive level every time • Telehealth services for a high number of days in a year • Both Medicare fee-for-service and a Medicare Advantage plan for the same service for a high proportion of services • A high average number of hours of telehealth services per visit • Telehealth services for a high number of beneficiaries • For a telehealth service and ordering medical equipment for a high proportion of beneficiaries The OIG’s recommendations to Centers for Medicare and Medicaid Services included strengthening target oversight and monitoring of telehealth services, providing education on appropriate billing for providers, improving transparency, identifying companies who provide telehealth to Medicare beneficiaries, and following up with providers identified in the OIG report as high-risk.

36

MichiganPharmacists.org

PAAS Tips: • Determining the legitimacy of a telehealth visit is difficult, so it is important to evaluate the patient/ prescriber/pharmacy relationships. PAAS Audit Assistance3 members can refer to the November 2021 article, Telemedicine Audits: Are Your Prescriptions Legitimate?2 in the PAAS Member Portal for a list of questions to consider when identifying if these relationships are valid.

• Ensure you have a robust FWA program. Add the PAAS National® FWA program today by contacting us at info@paasnational.com or (608) 873-1342.

PAAS National® is committed to serving community pharmacies and helping keep hard-earned money where it belongs. Contact us today at (608) 873-1342 or info@paasnational.com to see why membership might be right for you.

Copyright © 2022 PAAS National, LLC. Unauthorized use or distribution prohibited. All use subject to terms at https://paasnational.com/terms-of-use/.

References: 1. https://oig.hhs.gov/oei/reports/OEI-02-20-00720.pdf 2. https://portal.paasnational.com/Paas/Newsletter/Go/924 3. https://paasnational.com/audit-assistance/

2022 Oct./Nov./Dec. | Vol. 60, Issue 4

37

38

MichiganPharmacists.org