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#WeAreTennesseePharmacy SUMMER 2020

TENNESSEE PHARMACISTS ASSOCIATION

CALENDAR OF EVENTS

2021-2022 BOARD OF DIRECTORS

Visit TPA’s online calendar: tnpharm.org/calendar _____________________________________

Kim Jones, PharmD, BCPS, FASHP.........President

2022 _____________________________________

Jay Phipps, PharmD, FACVP...................President-Elect Leslie Shepard Wolfe, PharmD..............Past President

JANUARY 11-12 Tennessee Board of Pharmacy Meeting

Jason Hutchens, PharmD, BCPS, ..........Past President

FEBRUARY 26-3/1 TPA WINTER MEETINGS, NASHVILLE, TN

BCACP

Hilton Downtown Nashville

Jason Greene, PharmD...........................Past President Raewyn Snodderly, PharmD..................Past President

Jason Kizer, PharmD...............................Immediate Past President

MARCH 8-9

Tennessee Board of Pharmacy Meeting

18-21 APhA Annual Meeting and Exposition, San Antonio, TX

James “Jimmy” Torr, PharmD, MS.........Treasurer

29–4/1 AMCP Annual Meeting, Chicago, IL

Casey White, PharmD, MBA, BCPS, BCNSP, BCCCP, FASHP....Speaker of the House of Delegates

MAY 10-11 Tennessee Board of Pharmacy Meeting

Chris Finch, PharmD, FCCM, FCCP........President, Society of Health-System Pharmacists

JUNE 11-15 ASHP Summer Meeting, Phoenix, AZ

Brent Dunlap, PharmD...........................Chair, Society of Independent Pharmacists

16-19 135th TPA SUMMER MEETING, CHATTANOOGA, TN

Mike Wasson, RPh...................................Chair, Society of Chain Pharmacists

Lacey Sexton, PharmD...........................Chair, Society of Long-Term Care Pharmacists

Justin Kirby, PharmD, BCACP,

Hope Ballard Presley, CPhT...................Chair, Society of Pharmacy Technicians

SEPTEMBER 13-14 Tennessee Board of Pharmacy Meeting

Haley Watson (UTHSC)...........................President, Society of Student Pharmacists

Anthony Pudlo, PharmD, MBA*............Executive Director *Non-Voting Board Member Tania Garst...............................................President

TPA ALLIANCE

Vickie Snyder...........................................President-Elect Becky Shepherd......................................Treasurer Bernice Lightfoot.....................................Secretary

JULY 12-13 Tennessee Board of Pharmacy Meeting

23-27 AACP Annual Meeting, Grapevine, TX

NBC-HWC.........................Chair, Society of Pharmacists

OCTOBER 15-18

ACCP Global Conference on Clinical Pharmacy, San Francisco

NOVEMBER 3-6

ASCP Annual Meeting and Exhibition, San Antonio, TX

8-9

Tennessee Board of Pharmacy Meeting

DECEMBER 4-8

ASHP Midyear Clinical Meeting and Exhibition, Las Vegas, NV

_____________________________________

STAFF

2023 _____________________________________

MARCH 21-24 AMCP Annual Meeting, San Antonio, TX

24-27 APhA Annual Meeting and Exposition, Phoenix, AZ

JUNE 22-25 136th TPA SUMMER MEETING, NEW ORLEANS, LA

Lisa Hull, BS, CPhT

Anthony Pudlo, PharmD, MBA

JULY 22-26 AACP Annual Meeting, Aurora, CO

Membership Engagement Coordinator

Executive Director

lisa@tnpharm.org • Ext. 1000

anthony@tnpharm.org • Ext. 1000

OCTOBER 14-17 NCPA Annual Convention, Orlando, FL

Lindsey Inman, BS

Julie Schuffman, BA

Director of Programs and Events

Director of Communications

lindsey@tnpharm.org • Ext. 1500

julie@tnpharm.org • Ext. 1600

Shawna Lightfoot, MBA

Lucy A. Shell, PharmD

Controller

Director of Pharmacy Practice Initiatives

slightfoot@tnpharm.org • Ext. 1700

lucy@tnpharm.org • Ext. 1400

26-29 ASCP Annual Meeting and Exhibition, Kissimmee, FL NOVEMBER 11-14 ACCP Annual Meeting, Dallas, TX _____________________________________

Phone: 615-256-3023 Email: TPA@tnpharm.org Fax: 615-255-3528

Facebook: tnpharmacists Twitter: tnpharmacists Instagram: tnpharmacists

TPA Website: www.tnpharm.org Contact Us Online: tnpharm.org/contact-us The Tennessee Pharmacists Association is affiliated with: Academy of Managed Care Pharmacy American Pharmacists Association American Society of Consultant Pharmacists American Society of Health-System Pharmacists National Community Pharmacists Association National Alliance of State Pharmacy Associations

| TENNESSEE PHARMACIST | WINTER 2021-2022

JULY 20-24 AACP Annual Meeting, Boston, MA

NOVEMBER 7-10

ASCP Annual Meeting and Exhibition, Aurora, CO

TENNESSEE PHARMACIST

TENNESSEE PHARMACISTS ASSOCIATION 1732 Lebanon Pike Circle Nashville, TN 37210

2024 _____________________________________

A PUBLICATION OF THE TENNESSEE PHARMACISTS ASSOCIATION

Julie Schuffman....... Managing Editor Anthony Pudlo....... Editor Baeteena Black....... Editor Emerita

Tennessee Pharmacist (ISSN 1047-0166) is published by the Tennessee Pharmacists Association, 1732 Lebanon Pike Circle, Nashville, TN 37210. [Email: tpa@ tnpharm.org, Website: www.tnpharm.org] The Tennessee Pharmacist is distributed as a regular membership service, paid for through allocation of membership dues. To make address (or other) changes online, log in at tnpharm.org/my-account or call 615-256-3023. Publisher assumes no responsibility for unsolicited material. Submissions are encouraged; publisher reserves the right to publish, in whole or in part, all submissions received. Bylined articles express the opinion of the author and do not necessarily reflect the views or policies of the Tennessee Pharmacists Association. Publication of an advertisement does not represent an endorsement. The Tennessee Pharmacist is subject to the standards established by the Association. Nothing in this publication may be reproduced in any manner, either in whole or part, without specific written permission of the publisher.

SUBMIT ARTICLES, PHOTOS, ADS, AND INQUIRIES to Julie Schuffman, Managing Editor: Call 615-256-3023, email julie@tnpharm.org, fax to 615-255-3528, or mail to TPA, 1732 Lebanon Pike Circle, Nashville, TN 37210.

Tennessee P harmacist A Publication of the Tennessee Pharmacists Association WINTER 2021-2022 • VOLUME 59, NUMBER 1 _______

NEWS AND INFORMATION

Building Tennessee’s Pharmacy Future

Message from the TPA President:

Leaders Sculpt Three-Year Plan for the Future of TPA!

COVID-19 Updates and Resources

Seeking Nominations for TPA, TSHP, and TSSP Awards

Executive Director Update: Strength in Numbers

The Impact of P.C. 569: Filing a Claim Against a PBM

U.S. Court of Appeals Decision Boosts Tennessee’s

ON THE COVER:

_________________

2020 PBM Law

Tennessee P harmacist In his first few WINTER 2021-2022

months as TPA Executive Director, Anthony Pudlo has traveled to meet #WeAreTennesseePharmacy many members in practice settings across the state, a tradition he hopes to continue in the months and years ahead. SUMMER 2020

TPA Practice-Based Resources

Thank You to PharmPAC Donors and TPREF Donors

2022 Public Affairs Preview

12-14

2022 TPA Winter Meetings | February 26 - March 1

TPA | TSHP | TSLTCP | TSSP | Community Pharmacy

Need Help Credentialing Through CAQH?

Diabetes Self-Management Education and Support (DSMES) Toolkit

TPA’s Online TPV Training Recognized by PTCB

Tennessee Board of Pharmacy Contact Information

Are You Receiving Email from TPA?

Rx and the Law: Social Media Prescriptions

Advancing Pharmacy Practice Through the Next Decade: PAI 2030

TPA Membership Goodies: TPA NEWStream

Game Zone: Vaccine Word Search—”Not Throwin’ Away My Shot”

Call for TPA Resolutions

Tennessee Handbook on Pharmacy and Drug Law, 2022 Edition

Upcoming TPA Meetings and Events

Committee Spotlight: ad hoc Collaborative Pharmacy Practice Committee

v-safe After-Vaccination Health Checker

2021 Residency Showcase: Recap

Lifeline for Impaired Pharmacy Professionals: Tennessee Pharmacy Recovery Network

Home-Study CE Opportunities from TPA

2021-2022 TPA Board of Directors

_______

ADVERTISERS

15 Pharmacy Plus 20 PQC 22 PTCB

#WeAreTennesseePharmacy v2 2021-22 Winter Journal COVER.indd 1

12/3/2021 3:43:25 AM

_____________________________________________________________________________ 25 Retail Designs, Inc. 27 Pharmacists Mutual Cover Southern Pharmacy Cooperative WINTER 2021-2022 | TENNESSEE PHARMACIST | 3

Building Tennessee’s Pharmacy Future Just Crossed the Halfway Mark! In 2018, the Tennessee Pharmacists Research & Education Foundation (TPREF), a 501(c)3 subsidiary of TPA, purchased the new home for Tennessee pharmacy. With the purchase, a fundraising campaign was launched to assist the foundation in ensuring that the building will continue to serve the needs of the pharmacy profession in the state. Thanks to the generous donors listed below, we are now more than halfway to our fund-raising goal! Support our efforts with a tax-deductible contribution to the Building Tennessee’s Pharmacy Future capital campaign! The following Legacy Contributors have invested in Building Tennessee’s Pharmacy Future, as of November 30, 2021.

Visit www.tnpharmacyforward.org to contribute today.

THANK YOU! Pharmacy Legends ($10,000 or Greater) Baeteena Black Alan Corley and Family Micah Cost Donald Jones First Pharmacy Services Pharmacy Plus Programs Rick Sain Martha and David Shepard

Pharmacy Visionaries ($5,000 – $9,999) Don Branam Terry Brimer Roger Davis Doug Duncan

Paula Hinson Ray Marcrom Leslie Shepard Wolfe

51%

$253K

of campaign goal achieved

in contributions pledged

Pharmacy Innovators ($2,500 – $4,999) Denise Barker Jim McBride

Lucy A. Shell Buddy Stephens

Pharmacy Champions ($1,000 – $2,499) Emily Brinser Phonzie Brown Debbie Byrd Dianne Duncan Glen Farr

FountainRx Jason Greene Justin Kirby Kay Ryan Joe Saffles

Larry Shepherd Eddie Sturgeon Mark Sullivan Whit Taylor Randle Williams

______________________________ Pharmacy Friends ($100 – $999) ______________________________ Olugbenga Abijo

Jennifer Aiken

Julianna Bolton Brad Boucher Cindy Brasher Beth Breeden Richard Breeden Andrea Bryant Larry Calhoun Tom Campbell Rick Chinouth

Peter Chyka Terry Cost Kelly Covert Brian Cross Diane Crutchfield Tamara Davis Sarah Eudaley Jeanne Ezell Carla Fahhoum Andrew Finney Stephan Foster

Teresa Fulcher Ned Giles Jeremiah Glass Stacey Grant Bill Greene David Gregory Justin Griner

Monica Guttman Tracy Hagemann Patricia Harris Nancy Hart

Gena Hawk Rebecca Hopper Sarah Isaacs Kim Jones

Todd Karpinski Brittany Kelley Jason Kizer Linda Knecht Jeff Lewis Shawna Lightfoot Rob Lucas

Sheila Mitchell Susan Shepard Sharon Moore Kent Stoneking Tara Moore Natalie Tate John Muchka Jennifer Tatum-Cranford Kam Nola Judy Trac Gene Parsons Brenda Warren Paul Peterson James Wheeler Anthony Pudlo Casey White Emily Quintanilla Steve Zaver Laura Raney Julie Schuffman

__________________________________________________________________________________________________ 4

| TENNESSEE PHARMACIST | WINTER 2021-2022

Leaders Sculpt Three-Year Plan for the Future of TPA The year is passing quickly! Since of expectation in our six colleges of June, your 2020-2021 TPA Board of Dipharmacy—an expectation that gradrectors has been hard at work seekuates will join and serve TPA upon ing to create and execute a three-year graduation. We desire to improve the vision for the future of TPA. I am so leadership on-boarding and transition proud of our TPA leaders and their experience and are excited about excommitment to this important underpanding our communication processtaking. In September, we held an ones to not only be more innovative, but site Strategic Planning Workshop fato also be timelier for all members. cilitated by Vista Cova, LLC, and I’m Finally, we expect the organizaexcited to share the four priority areas tion to continue to serve as a hub for that emerged from our collective work! generating and disseminating the information necessary to create and First, let us focus on ADVOCACY. maintain innovative pharmacy pracWe have seen great success of late in tice models. With a focus on PRACthis arena, and we desire to continue TICE, EDUCATION, and CLINICAL advancing and promoting the profession of pharmacy in Tennessee through SUPPORT, we hope to create a space where members can both serve and legislative efforts. While engagement inform one another, as we collectiveat the state level is always important, ly provide evidence-based, future-diwe have also committed to improving rected care to the citizens of Tennesthe work of TPA’s House of Delegates. see. We envision a space, both online If we are stronger within, we will be and physical, where pharmacist and able to amplify our external efforts. technician members can collaborate Secondly, we commit to a focus on in a spirit of advancement, mentorORGANIZATIONAL STRUCTURE. In an ship, and engagement. We anticipate effort to improve organizational effecthat changes to our website, and even tiveness and efficiency, the TPA Board in our meeting proof Directors is taking We must remain gramming, will be great an intentional look at organization demounified in our efforts, to first steps to establish a culture of shared pracgraphics, structure, ensure that our state tice development and engagement, leadassociation remains enhancement. ership development Each of these four pipelines, committee on the forefront of priority areas will be structure, communiadvancing and grounded in a spirit of cation processes, and protecting the health diversity, equity, and inquality assessment clusion. It is the desire procedures to meaof Tennesseans. of the Board to ensure sure effectiveness. I that this concept permeates each aswill be convening a task force to examine and address this theme purposefully pect of the organization’s work in the years to come. Therefore, it does not over the next two to three years. exist as a stand-alone theme, but rath Thirdly, we focus on YOU through er as a central pillar housed in each of an intentional look at MEMBERSHIP DEVELOPMENT and SUPPORT. Mem- the four priority areas. bers remain the primary catalyst for “From those to whom much is givthe organization’s mission, vision, and en, much is expected” is a statement goals. Without you, change would not you’ve likely heard. I think we can all happen. This theme aims to cultivate agree that TPA has provided much in a more engaged membership, at all our respective pharmacy careers. Howlevels of the organization. It is my per- ever, our work is not done. We must resonal desire to create an atmosphere main unified in our efforts, to ensure

“

M E S S AG E F R O M T H E T PA

PRESIDENT

Kim Jones, PharmD, BCPS, FASHP that our state association remains on the forefront of advancing and protecting the health of Tennesseans. I hope this glimpse into our organization’s forthcoming strategic plan excites you! The Board of Directors hopes that we can share a finalized version of the Strategic Plan during the 2022 Winter Meeting in Nashville, February 26 – March 1, at the Hilton Downtown. If you haven’t registered to attend yet, please do so now! Some of the changes alluded to in this message will be happening there, with a new venue and changes to programming. Come experience what TPA has to offer, in person! To learn more, visit tnpharm.org/winter22. As I’ve said before, all it takes is ONE—one professional meeting to spark a desire to improve your practice, or one conversation with a peer to prompt you to volunteer for a leadership position. Let us build upon the individual and collective successes we have had to date, supporting ONE another, as ONE profession, ONE TPA.

See You in Nashville! Nashville !

WINTER 2021-2022 | TENNESSEE PHARMACIST | 5

COVID-19 Updates and Resources

TPA COVID-19 Practice-Based Resource Page tnpharm.org/covid-19

TPA staff continues to monitor the COVID-19 pandemic and keep members informed about current trends and opportunities. Pharmacy teams are stepping up to the plate with the rollout of COVID-19 booster vaccines, COVID-19 vaccines for children aged 5-11, monoclonal antibody treatment, and continued testing for COVID-19, all while ensuring that patients continue to receive other important pharmacy services. At the time of writing, Tennessee vaccine providers are undergoing audits of vaccination policies and practice, to ensure compliance with CDC provider agreements, and new COVID-19 treatment options are expected to be distributed by community pharmacies. COVID-19 information published in this Journal could quickly become outdated, so we are providing resources (at right) that will contain important, up-to-date information. Members are also encouraged to review our weekly NEWStream publications, where TPA highlights important information and key changes to programs.

TDH COVID-19 Resource Page for Health Care Providers

bit.ly/3zUbb2B

v-safe Information: Provide to Patients to Track Side Effects bit.ly/3xoE22p TDH Routine and Emergency Vaccine Management Plan

bit.ly/337bP3j

Report Vaccine Adverse Reactions to VAERS vaers.hhs.gov/faq.html

COVID-19 Emotional Support Line for Healthcare Workers

bit.ly/3rRG4SE

N ow S eeking N ominations for TPA, TSHP & TSSP AWARDS 2 0 2 2 AWARDS

S ubmit by M arch 1

C elebrating E xcellence in P atient C are and the P rofession of P harmacy N o m i n at e

C o l l e ag u e

M a r c h 1, 2022

Help an extraordinary pharmacist, pharmacy technician, pharmacy professional, student pharmacist, innovative practice, or supporting organization get the recognition they deserve, by submitting a nomination for one or more awards! To learn more about each award and submit your nomination(s), visit: tnpharm.org/awards the A wards C eremony in C hattanooga DURING THE 2022 TPA SUMMER MEETING, JUNE 16-19, 2022

A ttend

| TENNESSEE PHARMACIST | WINTER 2021-2022

Executive Director Update Strength in Numbers Anthony Pudlo, PharmD, MBA The transition of executive leadership is an opportunity to reflect on the events of the past few years, in preparation for the opportunities and challenges of the next. The Tennessee Pharmacists Association has had remarkable success in recent years: Legislative victories. The launch of new Foundation programs, like Clinical Pathways. Expansion of continuing education opportunities. Progress towards provider status implementation. Over that time, we were not without our challenges, yet our success is rooted in one of TPA’s strengths—our numbers. What continues to make TPA strong is the number of pharmacists and pharmacy technicians from different practice sites, career stages, and backgrounds, coming together to form the vision for pharmacy practice in the state of Tennessee. As I talk with colleagues in other states, it’s rare to find the depth of bench strength that we have to lead our profession in Tennessee. As I have traveled across the state in my first several months as Executive Director, I have come to see that Tennesseans have a strong voice—one for justice, accountability, and patient advocacy. That speaks volumes to the level of leadership that TPA is fortunate to have had, as well as to the strong contingency of leaders

who want to continue being a part of the progressive practice of pharmacy in Tennessee. As we continue to fight against the COVID-19 pandemic, and as we enter the 2022 legislative session, we have a mountain ahead of us in overcoming the efforts of PBMs that refuse to comply with Public Chapter 569, as well as working to codify provisions of the PREP Act into state law. I have faith in the strength of our grassroots network, in order to get the attention of our state legislators. This is no small feat, and we need to recognize the impact that our voices can have—individually and collectively—in influencing policy and legislation. Your passion and effort as members must be matched in stewardship by the Association, so that our mission can continue. As your new Executive Director, I am proud to lead TPA through its new strategic plan and address the needs of the membership. My focus during these initial few months was to meet many of you in your practice setting. This focus will continue, as I meet with more members across the state in the months and years ahead. We will continue to need the strength of our numbers, as the Association takes a hard look at our structure and engagement opportunities, renews our focus on our

lobbying efforts at the state capitol, and collaborates with the Board of Pharmacy to modernize the regulations that govern our profession. Looking forward into the coming year, I believe our continued success as an association and profession will depend on an important number—the number ONE: All of us, with our diversity of experience, skill, and passion, working together as ONE profession, as we embrace the changes that come from the global pandemic to advance practice. All of us, advocating as ONE for fair compensation and a level playing field. All of us, speaking in ONE voice to explain the valuable role of the pharmacist on the healthcare team, to our provider colleagues, patients, policy makers, and communities. Thank you for your faith in me to lead TPA into a successful future. The year 2022 will bring the next wave of opportunities and challenges for our profession, and I am confident that a large number of Tennessee’s pharmacists, pharmacy technicians, and student pharmacists will be standing by, ready to advocate for and advance our profession. “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed it’s the only thing that ever has.” —Margaret Mead

WINTER 2021-2022 | TENNESSEE PHARMACIST | 7

THE IMPACT OF PUBLIC CHAPTER 569: FILING A COMPLAINT AGAINST A PBM

If the granted claim is still below cost

Filing a MAC Appeal

Submitting a PBM Complaint with the TDCI

TN Law: TCA 56-7-3108 : • The pharmacist or pharmacy must file the appeal within 7 business days of the submission of the initial claim for reimbursement. • The PBM or covered entity must make a final determination of the appeal within 7 business days of the receipt of the appeal.

If you have exhausted the appeals/rate review requests process provided by the PBM and have not received an adequate response or the claim is still below cost, then submit a complaint to the Tennessee Department of Commerce and Insurance (TDCI). The PBM will then have 30 days to respond to the complaint. (TCA 56-1-106) To help with this process, TPA has created an Excel template to help track the appeals your PSAO has filed with the PBMs. Once you have followed up with your PSAO and the PBM has not responded adequately, you may use the completed Excel template to submit all of your claims for that one PBM to the TDCI. Along with the completed Excel template, please fill out the Complaint Form.

If the pharmacy’s appeal is denied: • The PBM must give a reason for denial and provide the NDC of an equivalent drug that is generally available for purchase in the state at a price equal to or less than the MAC for that drug. If the pharmacy's appeal is valid (granted): • The PBM/covered entity shall adjust the MAC of the drug/ product/device for the appealing pharmacy and the adjustment shall be effective from the date the appeal was filed. Reimbursement shall be provided, and the appealing pharmacy may need to reverse and rebill the claim in question. Note: either the pharmacy or their PSAO should submit the appeal, not both. PBM MAC Appeal Forms: OptumRx: tnpharm.org/optumrx-mac-appeal CVS Caremark: tnpharm.org/caremark-mac-appeal Express Scripts: tnpharm.org/express-scripts-mac-appeal Cigna: tnpharm.org/cigna-mac-appeal © 2021 Tennessee Pharmacists Association • Last Updated 12/1/2021

| TENNESSEE PHARMACIST | WINTER 2021-2022

Step 1: Use the Excel template (tnpharm.org/pharmacistcomplaint-excel) to keep track of the claims you and your PSAO are submitting to the PBM. Fill in all required information. Step 2: Complete the Complaint Form: tnpharm.org/tdci-complaint Step 3: If mailing supporting documents, please include a copy of the Complaint Form and mail to: Consumer Insurance Services 500 James Robertson Parkway, 6th Floor Nashville, TN 37243-0574 or FAX supporting documents, along with a copy of the Complaint Form, to (615) 532-7389.

U.S. Court of Appeals Decision Boosts Tennessee’s 2020 PBM Law Since the successful passage of Public Chapter 569 (tnpharm.org/ pbm-pc569 ) and its effective date of July 1, 2021, TPA has heard from many pharmacists and pharmacy technicians about the implementation process, especially regarding the filing of PBM complaints with the Tennessee Department of Commerce and Insurance (TDCI). TPA has collaborated with TDCI to troubleshoot the complaint process and has been working to develop materials and provide information to guide pharmacies as they submit formal PBM complaints, such as the development of the flowchart found on the opposite page. As part of our education efforts on P.C. 569, TPA hosted several webinars during the fall of 2021, with representatives of various stakeholders, including TDCI, pharmacy services administrative organizations (PSAOs), and specialty pharmacies, to discuss the status of implementing the bill. TPA has found that the biggest gap in implementation has been enforcement, and we have been working closely with Senator Shane Reeves and the TDCI to determine the tools needed to fully implement the law as intended. The PBMs are stating three major reasons for not complying with the law: 1) they are ERISA plans, 2) contracts were in place before the effective date of the bill, and 3) the plan is located outside the state of Tennessee. On November 17, a decision by the Eighth Circuit of the U.S. Court of Appeals supported North Dakota’s right to regulate PBMs, in the first case at the federal appellate level to consider the scope of the U.S. Supreme Court’s Rutledge v. PCMA decision in 2020. This latest decision will further assist in TPA’s efforts to ensure PBMs are held

accountable to Tennessee law, especially when it comes to laws affecting ERISA plans. For more information, visit tnpharm.org/pbm-decision. TPA has compiled information on our members-only “PBM Laws” practice-based resource page (tnpharm.org/pbm-lawsresource) to help members navigate P.C. 569, as well as previous PBM laws enacted in Tennessee. As we continue to work through implementation of the law, new resources will be added. Holding PBMs accountable continues to be a priority for TPA and its members. Watch for communications in the new year, as the legislative session begins. Key Reminders: • A MAC appeal is required first for claims below cost. • A MAC appeal must be filed within 7 days of initial claim. • PBMs have 30 days to respond to a complaint filed with TDCI. • TDCI cannot regulate Medicare, so please do not file these claims with them.

TPA Practice-Based Resources: tnpharm.org/practice-resources The TPA Practice-Based Resource pages below are program-specific resources designed to help members expand their pharmacy practice and provide a broader range of services to patients. Note that most TPA Practice-Based Resource pages are available to members only, so you will be asked to log in to your TPA account, if you aren’t logged in already.

WINTER 2021-2022 | TENNESSEE PHARMACIST | 9

Thank You to PharmPAC Donors and TPREF Donors! SEPTEMBER 1, 2020, THROUGH AUGUST 31, 2021 TPA recognizes and thanks the contributors to the Tennessee Pharmacists Political Action Committee (PharmPAC), chaired by Leslie Shepard Wolfe with vice-chair Lacey Sexton, as well as the Tennessee Pharmacists Research and Education Foundation (TPREF), during the cycle ending August 31, 2021.

2021 PharmPAC Donors tnpharm.org/pharmpac PharmPAC Gold Level Donors ($1,000-$9,999) Independent Pharmacy PAC of Tennessee National Association of Chain Drug Stores Okies Pharmacy (Will Bunch) PharmPAC Silver Level Donors ($500-$999) Denise Barker Barry Walton Lacey Sexton Leslie Shepherd Wolfe

2021 Tennessee Pharmacists Research & Education Foundation (TPREF) Donors

PharmPAC Bronze Level Donors ($250-$499) Kimberly Bibb Blount Discount Pharmacy Phonzie Brown Jackie Bundy Jim Bundy Corley’s Pharmacy (Alan Corley) Brian Cross Dover Family Pharmacy (Marty Blane) Douglas Duncan Graves Family Pharmacy (Emily Graves) Sherry Hill Rebecca Hopper Donald Jones

tnpharm.org/tpref Please see page 4 for the list of donors to the TPREF “Building Tennessee’s Pharmacy Future” capital campaign. Yearly TPREF Cycle: September 1 through August 31 Donations received as of August 31, 2021 Baeteena Black Alan Corley Bill Greene Nancy Hart Zac Renfro Kim Roberts Tim Tucker Brian Winbigler

Jason Kizer Phil Lafoy Sharon Moore Aubrey Nunley James Petty Jerry Phipps Plateau Drugs (Brent Dunlap) Eddie Rowe Rick Sain Nina Smothers Natalie Tate Eleanor Twigg Mac Wilhoit Randle Williams Brian Winbigler

PharmPAC Members (Up to $249) Amber Cagle Leonard Compton Macy England Jeanne Ezell Brandon Farmer Joyce Folce Jeremiah Glass

Stacey Grant Hassler Drugs (Gena Hassler) Rob Lucas Kam Nola Thomas Rawl Mollie Scarbrough

David Shepard Martha Shepard Kenneth Smith Kent Walker Steve Zaver

If you haven’t contributed to PharmPAC and/or TPREF in the 2022 cycle—that is, since August 31, 2021—we hope you’ll make the decision to do so! The names of all PharmPAC and TPREF donors making contributions after August 31, 2021, will be listed in the Summer 2022 issue of the Tennessee Pharmacist.

THANK YOU! 10

| TENNESSEE PHARMACIST | WINTER 2021-2022

2022 Public Affairs Preview TPA’s Legislative and Regulatory Committee and Board of Directors have established the legislative priorities listed below for 2022. In setting priorities, issues are considered by the Legislative and Regulatory Policy Committee as a result of feedback from members and the House of Delegates, guidance from TPA’s legislative counsel, and opportunities to advance practice.  These priorities reflect critical practice or public health issues, feedback from members, practice advancement opportunities in Tennessee, and opportunities to collaborate with other health care organizations.

State Legislative Priorities Effective Regulation of PBMs In 2021, the state of Tennessee passed and adopted Public Chapter 569 to further regulate pharmacy benefit managers (PBMs). While the law has been enacted, PBMs are not abiding by the law. With the U.S. Supreme Court decision in Rutledge v. PCMA, the state of Tennessee, through the Tennessee Department of Commerce and Insurance, has clear authority to regulate PBMs. TPA will work to ensure that this authority is maintained and PBMs are accountable to the standards laid out in law.

Other Issues to Monitor Board of Pharmacy Executive Director Transition In the fall of 2021, the Tennessee Board of Pharmacy sought applications for the position of Executive Director. The Board has stated that they will conduct interviews of candidates throughout the winter. TPA expects the new Executive Director to be announced and begin in early 2022. This leadership transition at the Board of Pharmacy will be critical in helping to shape the practice of pharmacy in the state.

Codifying Provisions of the PREP Act

Expanded Contract Lobbyist Services

The fight against COVID-19 has required that the federal government take action to allow pharmacists and other health care professionals to provide essential services, in order for patients to get the care they need. Through flexibility on certain requirements and expanding scope of practice, the federal government has made it easier for pharmacists and pharmacy technicians to provide care to patients during the COVID-19 public health emergency.  Many of these flexibilities and authorities are not considered permanent and would end when the public health emergency ends. Therefore, further action is needed at the state level to maintain the level of care currently provided by the pharmacy community.

With approval from the Board of Directors, TPA released a request for proposal to expand contract lobbyist services for the Association. By the end of 2021, TPA will announce the selection of the individual(s)/firm that will fulfill the needs of TPA’s advocacy efforts into the future.

While these themes will drive our advocacy efforts forward, TPA will seek guidance to confirm which areas within these themes should be key targets for the profession.

WINTER 2021-2022 | TENNESSEE PHARMACIST | 11

2022 TPA WINTER MEETINGS NEW LOCATION! HILTON DOWNTOWN NASHVILLE • FEBRUARY 26 TO MARCH 1

tnpharm.org/winter22 Recharge, Reconnect, and Refocus Together in Person For the first time in two years, Tennessee pharmacists,

student pharmacists, and pharmacy professionals from all practice areas will gather in Nashville! Join us, and create connections with fellow pharmacy professionals and legislators, stand up for the rights of pharmacists and patients, improve lives through idea-sharing and innovation, catch up with friends you haven’t seen in a long while, and earn ACPE-accredited continuing education.

February 26–March 1

February 26 (Saturday) • Tennessee Society of Student Pharmacists (TSSP) Winter Meeting February 27 (Sunday) • Tennessee Society of Health-System Pharmacists (TSHP) Winter Meeting • Community Pharmacy Workshop • Society Meetings **New day this year** February 28–March 1 (Monday & Tuesday) • Tennessee Pharmacists Association (TPA) Winter Meeting: o Legislative Reception o Pharmacy Day on the Hill (Wear Your White Coat!)

Location and Reservations NEW VENUE! Hilton Downtown Nashville 121 4th Avenue South, Nashville, TN 37201 The 2022 Winter Meetings will be at the Hilton Downtown Nashville—a new, more spacious, all-suites hotel just off Broadway. Special room rates starting at $259 (single/ double) will be available until January 21 or until the group block is sold out, whichever comes first. To reserve your room at the discounted rate, visit bit.ly/ winter22hotel and select “Attendee” as your guest type. Valet parking is available for $45 per night plus tax (subject to change), and self-parking is also available.

| TENNESSEE PHARMACIST | WINTER 2021-2022

The TPA Winter Meetings will include one-day meetings for Health-System Pharmacists and Student Pharmacists, a one-day Community Pharmacy Workshop, the latest news about regulatory changes and pending legislation that could change the way we practice pharmacy, and opportunities to meet with legislators during our Legislative Reception and Pharmacy Day on the Hill. For details and updates, visit tnpharm.org/winter22, and watch your email!

Registration

To register online, visit tnpharm.org/winter22 and click “Registration.” Be sure to log in to receive your member discounts! A registration form is also printed on page 14 in this Journal. Register by January 21 with promo code SeeYou22 for $50 registration discounts!

Continuing Education

For information about continuing education, visit tnpharm.org/winter22. The Tennessee Pharmacists Consortium for Education (TPCE) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Additional information will be provided to meeting registrants. Currently, the Winter Meetings are planned with the following live ACPE continuing education credits: • TSHP Winter Meeting: 6 hours • Community Pharmacy Workshop: 5 hours • TPA Winter Meeting: 5.5 hours

Special Accommodations

If you have dietary restrictions or require special accommodations in order to attend this meeting, please contact Lindsey Inman at lindsey@tnpharm.org or 615-256-3023 by January 27.

2022 WINTER MEETINGS OF THE TENNESSEE PHARMACISTS ASSOCIATION

TENTATIVE AGENDA FEBRUARY 26 - MARCH 1, 2022

Saturday, February 26 TENNESSEE SOCIETY OF STUDENT PHARMACISTS (TSSP) WINTER MEETING

WORLD PHARMACY 8:30 am – 9:30 am 9:00 am – 9:30 am 9:30 am – 10:00 am 10:00 am – 11:30 am 11:30 am – 12:00 pm

• Registration • Coffee & Networking • Welcome by TSSP President • Educational Sessions • TSSP Business Meeting/President-Elect Nominations 12:00 pm – 1:00 pm • Lunch 1:45 pm – 4:00 pm • Educational Sessions 4:00 pm – 4:45 pm • TSSP Business Meeting/Transition of Leadership/Society Meeting 5:00 pm – 7:00 pm • Social Event/Reception

Sunday, February 27 TENNESSEE SOCIETY OF HEALTH-SYSTEM PHARMACISTS (TSHP) WINTER MEETING 7:30 am – 8:30 am 8:00 am – 8:15 am 8:15 am – 10:15 am 10:15 am – 11:15 am 11:20 am – 12:20 pm 12:30 pm – 1:30 pm 1:30 pm – 3:00 pm 3:00 pm – 4:00 pm 4:00 pm – 5:30 pm

• Registration • Welcome by TSHP President • Educational Sessions (2.0 Hours CE) • Networking/Poster Presentations • Educational Sessions (1.0 Hour CE) • Lunch • Educational Sessions (1.5 Hours CE) • TSHP Business Meeting/Society Meeting • Educational Sessions (1.5 Hours CE)

COMMUNITY PHARMACY WORKSHOP 7:30 am – 8:15 am 8:00 am – 8:15 am

• Registration • Welcome by Tennessee Society of Independent Pharmacists (TSIP) Chair 8:15 am – 10:15 am • Educational Sessions (2.0 Hours CE) 10:15 am – 11:15 am • Networking/Poster Presentations 11:20 am – 12:20 pm • Educational Session (1.0 Hour CE) 12:30 pm – 1:30 pm • Lunch 1:30 pm – 2:30 pm • Educational Session (1.0 Hour CE) 2:30 pm – 4:00 pm • TSIP Business Meeting/Society Meeting 4:00 pm – 5:00 pm • Educational Sessions (1.0 Hour CE) 5:00 pm – 6:00 pm • Community Pharmacy Enhanced Services Network (CPESN) Meeting

SOCIETY MEETINGS 4:30 pm – 6:00 pm

NASHVILLE ALL TIMES CENTRAL

Monday, February 28 TENNESSEE PHARMACISTS ASSOCIATION (TPA) WINTER MEETING — DAY 1 7:00 am 8:15 am – 8:30 am 8:30 am – 9:30 am 9:30 am – 10:00 am 10:00 am – 12:05 pm 12:05 pm – 1:45 pm 1:45 pm – 2:45 pm 2:45 pm – 3:15 pm 3:15 pm – 4:45 pm 6:00 pm – 8:00 pm

• Registration Opens • Welcome from TPA President • Educational Sessions (1.0 Hour CE) • Networking Break • Educational Sessions (2.0 Hours CE) • Lunch & Exhibit Hall • Educational Sessions (1.0 Hour CE) • Networking Break • Educational Sessions (1.5 Hours CE) • Legislative Reception

Tuesday, March 1 TENNESSEE PHARMACISTS ASSOCIATION (TPA) WINTER MEETING — DAY 2 7:00 am – 9:00 am 7:30 am – 8:30 am 8:45 am – 9:00 am 9:00 am – 10:30 am 10:30 am – 11:00 am 11:00 am

• Registration • PharmPAC Breakfast (Ticket Required) • Welcome from TPA President • House of Delegates • Final Legislative Debriefing HOTEL • Board Bus to Capitol CHECKOUT: (Wear Your White Coat!) 12:00 PM 11:30 am • Group Photo on Capitol Steps 12:00 pm – 2:30 pm • Meetings with Legislators

INFORMATION FOR SPONSORS & EXHIBITORS For the first time in two years, TPA can offer our industry supporters the chance to connect in person with key pharmacy decision-makers from all practice areas in Tennessee. Through exhibits, sponsorships, product theaters, and custom packages created just for you, the 2022 TPA Winter Meetings are the perfect opportunity for you to showcase your pharmacy goods and services. To learn more, contact Lindsey Inman at 615256-3023 or lindsey@tnpharm.org, or visit tnpharm.org/22-wm-supporters.

• TCPS, TSCP, TSLTCP, TSP, TSPT

WINTER 2021-2022 | TENNESSEE PHARMACIST | 13

Promo Code

tnpharm.org/winter22 Complete this form to register by fax or mail, OR register online at beeid.org/88536b24872e • Fax : 615-255-3528 • Mail: TPA, 1732 Lebanon Pike Circle, Nashville, TN 37210 • Winter Meeting Info: tnpharm.org/winter22 • Questions? Call 615-256-3023 or email lindsey@tnpharm.org

_________________________________________________ _____________ �� . ________________________________ �� . (�� )

____________________________ �� (��/��), ��

___________________________________________________ �� ___________________________________________________ ��

� ��

______________________________________________________ ________ ��/�� (��, �� ) �� # _____________________________________________________________ �� (�� ) ____________________ ____________________ ____________________ �� ______________________________ ________________________________ �� ’� �� HOTEL — NEW VENUE: Hilton Downtown Nashville, 121 4th Avenue South, Nashville, TN 37201. Room rate: $259 Single/Double. Room Block Deadline: January 21 OR when the room block is full, whichever comes rst. To reserve your room, visit bit.ly/NewHotel2022. CONTINUING EDUCATION — The Tennessee Pharmacists Consortium for Education (TPCE) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. SPECIAL ACCOMMODATIONS — If you have dietary restrictions or require special accommodations in order to attend this meeting, please contact Lindsey Inman at lindsey@tnpharm.org or 615-256-3023 by January 27. PHOTO RELEASE — By submitting your registration, you grant permission for your name, photographs, and/or video taken at the meeting to be used on the TPA website, social media, and/or in subsequent TPA publications. CANCELLATION POLICY — Registration fees will be refunded only if a written request is received in the TPA oﬃce by January 27, 2022. In that case, a refund will be provided in the amount of the total registration minus a $75 administrative fee.

PAYMENT Visa

Mastercard

AmEx

Check enclosed (payable to TPA)

Pay with the credit card I have previously stored with TPA. Signature required below. Pay with the credit card below, and securely store it for future TPA transactions. Signature required below. ____________________________________________________________ �� ____________________________________________________________ �� SECURITY CODE (REQUIRED): 3 DIGITS AFTER CARD _____/_____ ______________ NUMBER ON BACK OF VISA AND MASTERCARD; 4 DIGITS �� ABOVE CARD NUMBER ON FRONT OF AMERICAN EXPRESS. ____________________________________________________________ �� ____________________________________________________________ �� ____________________________________________________________ �� (��) tnpharm.org//wm22_reg • Rev. 12.6.21

SඍඍY඗ඝ22

for a $50 discount on registration for each meeting you attend!

| TENNESSEE PHARMACIST | WINTER 2021-2022

TSSP Wඑඖගඍක Mඍඍගඑඖඏ Saturday, February 26 (All Day)

Pක඗ඕ඗ C඗ඌඍ

SඍඍY඗ඝ22

- FORM RECEIVED BY 1/21 -

RECEIVED AFTER 1/21

$80

$130

_______

$100

$150

_______

• TPA/TSSP Member • TPA/TSSP Nonmember ..... Includes 12-Month Membership

TSHP Wඑඖගඍක Mඍඍගඑඖඏ

Pක඗ඕ඗ C඗ඌඍ SඍඍY඗ඝ22 Sunday, February 27 (All Day) - FORM RECEIVED BY 1/21 P��: • TPA Member $170 • TPA Nonmember - Registration Only $340 • TPA Nonmember ............... Includes 12-Month Membership $465 T��: • TPA/TSPT Member $105 • TPA/TSPT Nonmember ..... Includes 12-Month Membership $155 R��/F��: $105 S�� P��: $105

RECEIVED AFTER 1/21

$220 $390

_______ _______

$515

_______

$155

_______

$205 $155 $155

_______ _______ _______

C඗ඕඕඝඖඑගඡ Pඐඉකඕඉඋඡ W඗කඓඛඐ඗඘ (CPW) Sunday, February 27 (All Day) P��: • TPA Member • TPA Nonmember ��: ��/��: �� P��:

Pක඗ඕ඗ C඗ඌඍ

RECEIVED AFTER - FORM RECEIVED BY 1/21 1/21

SඍඍY඗ඝ22 $170 $340 $105 $105 $105

$220 $390 $155 $155 $155

_______ _______ _______ _______ _______

TPA Wඑඖගඍක Mඍඍගඑඖඏ

Lඍඏඑඛඔඉගඑඞඍ ຺ Rඍඏඝඔඉග඗කඡ P඗ඔඑඋඡ F඗කඝඕ

Monday, February 28 (All Day), and Tuesday, March 1 (Half Day) Pක඗ඕ඗ C඗ඌඍ RECEIVED

SඍඍY඗ඝ22

- FORM RECEIVED BY 1/21 P��: • TPA Member $295 • TPA Nonmember – Registration Only $445 • TPA Nonmember ............... Includes 12-Month Membership $590 T��: • TPA/TSPT Member $105 • TPA/TSPT Nonmember ..... Includes 12-Month Membership $155 R��/F��: $105 S�� P��: $105

AFTER 1/21

$345 $495

_______ _______

$640

_______

$155

_______

$205 $155 $155

_______ _______ _______

Lඍඏඑඛඔඉගඑඞඍ Rඍඋඍ඘ගඑ඗ඖ Monday Evening, February 28

�� ___ ___

Do you expect to participate in the Legislative Reception? (Included with TPA Winter Meeting registration)

Pඐඉකඕඉඋඡ Dඉඡ ඗ඖ ගඐඍ Hඑඔඔ - ਭਮ ਢਮਲਲ਼ ਲ਼ਮ ਠਲ਼ਲ਼ਤਭਣ Tuesday, March 1 Do you expect to participate in Pharmacy Day on the Hill?

�� ___ ___

$65 $65 $65 $95 $100

_______ _______ _______ _______ _______

Specify student or school (Optional): ______________________________ TSSP Winter Meeting: Full registration ($80) or other amount TSHP Winter Meeting: Full registration ($105) or other amount CPW: Full registration ($105) or other amount TPA Winter Meeting: Full registration ($105) or other amount

_______ _______ _______ _______

Tඑඋඓඍගඛ

TSHP Luncheon (Sun.) –Ticket not required for TSHP Meeting registrants CPW Luncheon (Sun.) –Ticket not required for CPW registrants TPA Luncheon (Mon.) –Ticket not required for Monday registrants Legislative Reception (Mon.) –Ticket not required for Monday registrants PharmPAC Breakfast (Tue.) –Ticket required for all Breakfast attendees

Sගඝඌඍඖග Pඐඉකඕඉඋඑඛග Sඋඐ඗ඔඉකඛඐඑ඘

TOTAL ENCLOSED

$___________

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The Tennessee Pharmacists Association advances, protects, and promotes high-quality, pharmacist-provided patient care in Tennessee.

Need Help Credentialing Through CAQH? Have you been credentialed through CAQH? Becoming credentialed is one of the first steps in being recognized as a provider through managed care organizations and being paid for clinical services. It can be intimidating at first glance, but in working with the Tennessee Pharmacists Association, CPESN TN and CPESN NET developed a guide to help pharmacists complete the process. The CAQH ProView Account Guide CAQH for Community Council for Affordable Quality Healthcare Pharmacists will CPESN TN take you through the information you need Community Pharmacy to gather before you begin, as well as provide Enhanced Services Netguidance on each section of your CAQH acwork of Tennessee count. Visit tnpharm.org/caqh-guide to get CPESN NET Community Pharmacy started. Still have questions? Reach out to TPA at tpa@tnpharm.org.

Enhanced Services Network of Northeast Tennessee

providing services to help independent pharmacies grow revenue and improve patient care:

Audit Assistance Brand and Generic Pharmaceutical Contracts Compounding Supplies and Support Comprehensive Pharmacy Management Systems Consulting Services Inventory Management Managed Care Services Online FWA Compliance Courses Online Ordering Solutions Pharmacy Containers and Labels Pharmaceutical Returns and Destruction Promotional Banners, Displays, and Signs Reimbursement Consulting Services Specialized Care Center Programs

independent pharmacies' resource for solutions, support and services

To learn more, please email us at:

info@pharmacyplusprograms.com ...Or visit us online at:

www.pharmacyplusprograms.com Sponsor of the Independent Link, TPA’s fax and online publication providing information for independent pharmacies.

WINTER 2021-2022 | TENNESSEE PHARMACIST | 15

Diabetes Self-Management Education and Support (DSMES) Toolkit

TPA’s Online TPV Training Recognized by PTCB

Diabetes Self-Management Education and Support, or DSMES, is a reimbursable service that can be provided by pharmacists. DSMES can be a great tool for patients with diabetes, leading to improved A1c levels, higher rates of medication adherence, and healthier lifestyle behaviors.

TPA’s online training program on Technician Product Verification (TPV) gives pharmacy technicians the education and tools necessary to perform TPV, where practice site and rules allow. This program consists of five modules, including a final product simulation that prepares technicians for common errors they might see in practice. The TPV module created by TPA has been recognized by the Pharmacy Technician Certification Board (PTCB) as a program that allows technicians to sit for the PTCB Assessment-Based Certificate Program in Technician Product Verification, which could in turn lead to an Advanced Certified Pharmacy Technician credential (CPhT-Adv).

To learn more about DSMES, visit www.cdc.gov/diabetes/dsmes-toolkit/index.html. Please contact Lucy Shell (lucy@tnpharm.org), if you are interested in providing DSMES services at your pharmacy. If you have patients who may benefit from DSMES, locate a diabetes education program in your area by visiting diabeteseducator.org/find.

Training Course TPA Members Non-Members

$79 $99

For information and registration, visit beeid.org/adab3fc29042

TENNESSEE BOARD OF PHARMACY DEPARTMENT OF HEALTH

665 Mainstream Drive Nashville, TN 37243 Phone: 615-741-2718 • Fax: 615-741-2722 pharmacy.health@tn.gov Website: bit.ly/2BVYKFF INTERIM EXECUTIVE DIRECTOR Terry Grinder, DPh PRESIDENT Katy Wright, PharmD VICE PRESIDENT Adam Rodgers, DPh

Are You Receiving Email from TPA? 16

BOARD MEMBERS Shanea McKinney, PharmD Richard Breeden, PharmD Melissa McCall, PharmD Jake Bynum, Public Member Rissa Pryse, DPh

new in the

tpa journal www.tnpharm.org

Scan QR codes with your smartphone to quickly access web links in this publication.

As much as we might’ve felt like “opting out” over the last several months, it’s been a great time for members to “opt in” to receive TPA communications. If you have opted out of TPA’s email list, we urge you to reconsider! If you haven’t received any email from TPA in a while, we encourage you to let us know, and we’ll be glad to re-subscribe you or troubleshoot any missed communications. We strive to provide relevant and valuable resources to our members, and we appreciate your support of TPA! Please contact us at 615-256-3023 or tpa@tnpharm.org.

| TENNESSEE PHARMACIST | WINTER 2021-2022

Rx AND THE LAW

This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

Social Media Prescriptions Don R. McGuire, Jr., R.Ph., J.D. The growth and use of social media has definitely changed the society in which we live. Chain letters and phone trees are no longer the most efficient ways to communicate with a large number of people. The use of social media and the COVID-19 pandemic have intersected in a way no one imagined. I call this phenomenon the Social Media prescription. In 2020, it was the clamor for hydroxychloroquine. In 2021, the clamor is for ivermectin. Pharmacists were, and are, faced with demands to fill these prescriptions without much or any knowledge of the recommended dosage or its safety and effectiveness. While these are two recent examples, this phenomenon is not likely to go away. Social media has the capacity to create fads and demands overnight. While we knew to keep laundry detergent pods away from our toddlers, we didn’t think we would have to do so with our teenagers. I have been asked numerous times in the last year whether a pharmacist has potential liability when filling a prescription for hydroxychloroquine or ivermectin for COVID-19. The answer is yes. Using the basic premise First, Do No Harm as the guideline, the pharmacist can analyze the Social Media prescription in a two-step fashion. First, will the patient benefit from the drug? In these two examples, and most likely in future scenarios, the pharmacist is not sure. When the clamor started, there were no controlled studies to indicate any effectiveness. Would the mechanism of action for an antiparasitic drug be effective against a virus? It seems unlikely, but we do not know. If the effectiveness of the prescription is unknown, the second question is whether the patient would be injured by taking the drug. There are some risks associated with every drug and every treatment. If a recommended dose is unknown, how does a pharmacist assess the appropriateness of the prescription? Ivermectin can cause serious side effects in an overdose situation. Prescriptions that could harm the patient should not be dispensed, especially when there is no corresponding benefit to taking it. If the pharmacist believes there is a high probability that the patient will be harmed, no one can order them to dispense the prescription. Another question frequently asked this past year is whether their insurance policy would cover the pharmacist

for dispensing the Social Media prescription. I can answer in generalities, but each pharmacist will need to read their own policy for definitive answers. Pharmacy Professional Liability policies generally don’t single out specific drugs in the policy language. Pharmacy practice is too fluid and complex for that to work. Insurance companies depend on the professional judgment of the dispensing pharmacist to assess the risk/benefits of any unapproved use before dispensing. Policies typically have an exclusion that addresses injury that is expected by the insured. If the dose is large enough or the lack of data is stark enough, it could be alleged that the patient’s injury was expected and the claim excluded. Another common exclusion addresses injuries arising out of the pharmacist’s reckless disregard for the safety or lives of others. That can be difficult to prove, but what is different here is that most unapproved uses are not addressed on the Food and Drug Administration’s (FDA) website. The FDA’s statement that ivermectin has not been shown to be safe or effective for the treatment or prevention of COVID-19 in people or animals could be used by a plaintiff’s attorney to assert that the pharmacist acted in a reckless manner. The final question I get asked is if the pharmacist can have the patient sign a release form absolving the pharmacist of any liability for dispensing the Social Media prescription. While it is possible to draft such a release, —Continued

© Don R. McGuire Jr., R.Ph., J.D., is General Counsel, Senior Vice President, Risk Management & Compliance at Pharmacists Mutual Insurance Company. This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with policies and procedures of their employers and insurance companies, and act accordingly.

WINTER 2021-2022 | TENNESSEE PHARMACIST | 17

Advancing Pharmacy Practice Through the Next Decade: PAI 2030 ASHP’s Practice Advancement Initiative 2030 (PAI 2030) provides pharmacy teams with guidance for advancing healthcare, patient outcomes, and pharmacy practice through 59 recommendations. The PAI 2030 Self-Assessment Tool is designed to help you determine how well your practice setting aligns with the PAI 2030 recommendations. The tool identifies areas where the PAI 2030 recommendations could have the biggest impact on your practice setting. The survey format is applicable to both institutional and ambulatory care pharmacy practice settings. Participants can complete the assessment, which takes about 45 minutes, from the perspective of a single practitioner or as an organization. The results will identify several areas for improvement. From there, a list of priorities for implementing change can be developed.

TPA MEMBERSHIP

GOODIES STAFF PICK

With the endless amount of Lisa Hull, BS, CPhT TPA Membership information at your fingertips, it Engagement can be daunting to track down Coordinator the important news that affects your patients and your pharmacy. Let TPA do the work for you! The NEWStream is a weekly email publication for TPA members only, with links to a wide variety of news items to keep you informed about the latest developments affecting pharmacy practice. Frequent topics are shown below. If you are a TPA member and are not receiving the NEWStream, please email tpa@tnpharm.org.

For more information and to access the Self-Assessment Tool, visit ashp.org/pai.

Social Media Prescriptions (continued) it most likely would not hold up in court. The professional responsibilities of the pharmacist under statutes and regulations were created to protect patients. Those responsibilities are placed on the pharmacist because of their education and experience. The pharmacist’s duty is to protect the patient, and sometimes this means protecting them from themselves. If the idea of a release like this was viable, every professional would use one with every transaction or encounter. I tell pharmacists in these situations it is easier to defend a case where the pharmacist refuses to fill a questionable prescription than it is to defend a case where the pharmacist has doubts about what was dispensed. When asked at your deposition “And what did you do when you became aware of this potential danger?” you don’t want your answer to be “Nothing.” Pharmacists can’t guarantee 100% safety, but they should avoid prescriptions with high probabilities of serious harm. Social Media is not going away. Pharmacists will continue to face the dilemma of patients demanding treatments generated from Social Media. It isn’t easy to tell a patient no. But an uncomfortable encounter in the pharmacy will be shorter and less damaging than an uncomfortable encounter in the witness chair.

| TENNESSEE PHARMACIST | WINTER 2021-2022

• • • • • • • • • • • • • • • • • • • • • • • • • •

ACA open enrollment and updates CDC rule changes and recommendations CMS rule changes and recommendations COVID-19 developments DEA practices Drug approvals FDA recalls and warnings Flu vaccine information Fraudulent prescriptions Health-system news and guidance HHS rule changes and recommendations Medicare open enrollment and updates National association initiatives Opioid abuse and legislation PBM issues and legislation Pharmacy practice tools and innovations Pharmacy technician roles and credentialing Prescription drug pricing Research findings State and national legislative advocacy TennCare/Medicaid updates Tennessee Board of Pharmacy news Tennessee Department of Health news TPA news, events, and initiatives USP announcements WHO recommendations

PHARMACY WORD SEARCH Can you find the terms hidden in the Vaccine Word Search puzzle below? Be the first TPA member to submit the correct solution, and win a $50 VISA gift card! Use the clues to figure out the answers, then find and circle them in the grid. Answers may be hidden in any direction—up, down, right, left, or diagonal. When you’ve found and circled all of the answers, send your completed puzzle to TPA by email (tpa@tnpharm.org) or fax (615255-3528). The Vaccine Word Search puzzle was developed by TPA’s pharmacy intern in November 2021, Hope Brandon, 2022 PharmD/ MBA Candidate at the University of Tennessee Health Science Center College of Pharmacy. Thanks for everything, Hope!

Not Throwin’ Away My Shot

Congratulations to SHREYAKUMARI CHAUDHARI, 2023 PharmD Candidate, University of Tennessee Health Science Center College of Pharmacy, and MBA Candidate, University of Memphis! Shreyakumari won a $50 gift card for being the first TPA member to submit the correct solution to the ”Pharmacy History” Crossword in TPA’s Summer 2021 Journal. THANK YOU to everyone who played! SOLUTION: “Pharmacy History” Crossword Tennessee Pharmacist, 2021 Summer Issue

• Vaccination against this disease state is rare outside bioterrorism or contact with infected animals. The disease against which the vaccine works is caused by the bacterium Bacillus anthracis. What is the vaccine’s brand name? • Pay attention to the capitalization and order of letters in set of vaccines. A misplaced T, D, or P will change your answer. Which vaccine is recommended in children? Look for the 4 letter acronym for the vaccine. • _______ vaccine is two in one! You might say a “twin” that covers two types of Hepatitis. Look for the brand name. • This vaccine prevents cancer! It is recommended between the ages of 11 or 12 but can be started as young as 9 and as old as 26. What is the brand name? • Brush up on your subcutaneous vaccination technique for this vaccine. It protects against four different diseases and is given to children less than 12 years old. Look for the brand name! • Wow, these vaccines get confusing! There are two types of vaccines in the category. Do you give 13 first? 23? What time interval - 8 weeks, 1 year, 5 years? Find the brand name of the one used routinely in infants. • This disease state has been eliminated from the U.S., thanks to widespread vaccination! This inactivated vaccine has been given in the U.S. since 2000. What is the disease against which this vaccine protects? • You’re foaming at the mouth for this one. This vaccine series is not routinely given, and the regimen is Day 0, 3, 7, 14 for those not immunized already. What is the disease against which this vaccine protects? • This vaccine is routinely given in people 50 years old and older. The vaccine has to be reconstituted, and dose one and two are separated by 2 to 6 months. Look for the brand name! • This was the first successful vaccine to be developed. It was observed that milkmaids who previously caught cowpox did not catch this disease. Another hint? This disease has been eradicated since 1980, due to vaccination efforts! • This vaccine was recently fully approved by the FDA for use above the age of 16. It was also given an EUA for children ages 5 and up. What does everyone call this vaccine (sorry, BioNTech)? • This vaccine is uncommon but considered for those traveling to rural parts of Asia, to protect against a disease spread through mosquitos. What is the brand name of this vaccine? • People who get this travel vaccine should be given an International Certificate of Vaccination, because it is required when traveling to and from certain countries. It is a single dose that provides lifelong protection and is recommended when traveling to Africa and South America. What is the disease against which this vaccine protects? • This childhood vaccine is included in several combination products and is important for preventing bacterial meningitis in young children. Due to this vaccine, the rates of disease from this pathogen have dropped exponentially. What is the 3-letter acronym used to refer to this pathogen? • No more parties to protect against this pathogen! This vaccine protects against a disease state that manifests primarily as an itchy rash. What is the brand name of this vaccine? (Hint: Not the combo product.)

WINTER 2021-2022 | TENNESSEE PHARMACIST | 19

Call for TPA Resolutions Submission Deadline: JANUARY 31, 2022

YOUR IDEAS iNto ACTION Put

If you feel something needs to be changed, submit a resolution for possible consideration by the TPA House of Delegates on Tuesday, March 1, during the 2022 TPA Winter Meeting in Nashville.

Call for TPA Resolutions

Submission Deadline: January 31, 2017 If you feel something needs to be changed, think about submitting a resolution for consideration by the TPA House of Delegates during the Winter Meeting in February. Resolution submissions are now being accepted online. For more information, visit:

It’s easy to submit resolutions online!

For more information, visit:

tnpharm.org/resolutions

TPA’s Recommended Resource for Tennessee and Federal Laws Affecting Pharmacy

Order your 1,300+ page Tennessee Handbook on Pharmacy and Drug Law (2022 edition) and download it directly to your computer!

—Members pay only $35—

RESOLUTIONS ADOPTED IN 2016: • •

Resolution Honoring Dr. Larry Calhoun Resolution Encouraging Board-Approved CE Credit for Precepting Student Pharmacists

tnpharm.org/resolutions Read them online at:

tnpharm.org/resolutions-adopted-2016.pdf

Visit beeid.org/27c53efca6f0

WE HELP PHARMACIES PUT SAFETY AT THE CENTER OF EVERYTHING THEY DO. Team up with APMS, a federally listed Patient Safety Organization (PSO) www.medicationsafety.org | (866) 365-7472

| TENNESSEE PHARMACIST | WINTER 2021-2022

UPCOMING TPA MEETINGS & EVENTS Check your email inbox and TPA’s website (tnpharm.org) for updated information!

Join Us for the 2022 TPA Winter Meetings!

Recharge, Reconnect, and Refocus Together In Person ...for you, for your practice, and for your patients. Visit tnpharm.org/winter22 or see pages 12-14 to learn more.

tnpharm.org/winter22

TENNESSEE s RESIDENCY s SHOWCASE

SUMMER / FALL 2022

PRESENTED BY THE TENNESSEE SOCIETY OF HEALTH-SYSTEM PHARMACISTS AND TENNESSEE PHARMACISTS ASSOCIATION

Prospective residency candidates (student pharmacists graduating in 2022 or 2023 and pharmacists interested in completing a PGY1 or PGY2 residency) are invited and encouraged to take advantage of this unique opportunity to meet with representatives from residency/fellowship programs in and around Tennessee, to learn about their programs and how they could help you achieve your career goals.

Representatives of residency/fellowship programs in Tennessee and surrounding states are invited to take advantage of the opportunity to meet prospective residents/fellows and familiarize them with your program. This event is a great opportunity to get your program in front of prospective residency candidates from Tennessee and other states.

TPA SUMMER MEETING

SAVE THE DATES!

2022 TPA SUMMER MEETING JUNE 16-19, 2022 THE WESTIN CHATTANOOGA

NOLA

2023 JUNE 22-25, 2023

SHERATON NEW ORLEANS 500 CANAL STREET

Learning looks different these days. As pharmacy professionals, however, we know that learning is a lifelong commitment to our patients. The Tennessee Pharmacists Consortium for Education (TPCE) is here to meet your educational needs during this time. Home study and live options can be found on our website. Have a program in mind for an upcoming TPA event? Email lucy@tnpharm.org with your ideas.

tnpharm.org/tpce WINTER 2021-2022 | TENNESSEE PHARMACIST | 21

Patient safety. Professional practice. Community impact.

PTCB’s Certified Pharmacy Technician (CPhT) Program is fundamental across pharmacy practice and is the foundation for all PTCB specialty and advanced credentials.

Assessment-Based Certificates

State pharmacy associations like ours work with PTCB because PTCB chooses excellence. Advanced Certifications

Build your team with confidence. Employers who rely on PTCB consistently report improved employee performance, greater efficiency, lower turnover, and reduced time and expense to train and advance pharmacy technicians.

Choose PTCB. Choose Excellence. View PTCB’s full suite at ptcb.org/credentials

| TENNESSEE PHARMACIST | WINTER 2021-2022

Compounded Sterile Preparation Technician® (CSPT®) Certification

Advanced Certified Pharmacy Technician (CPhT-Adv) Certification

ad hoc Collaborative Pharmacy Practice Committee TPA’s ad hoc Collaborative Pharmacy Practice Committee works to establish Tennessee as a national leader in advancing the profession of pharmacy and collaborating with third-party payors across all patient care settings. To this end, the Committee is interviewing practice sites and pharmacists engaged in best practices across the state, including those featured below. Full interviews with these and other Committee members can be found on the TPA website at tnpharm.org/cpp-committee-spotlights.

TPA COMMITTEE SPOTLIGHTS

Vanderbilt University Medical Center Transplant Pharmacy Services Chris Hayes, PharmD; Rachel Chelewski, PharmD, CSP; Keren Rodriguez, PharmD, CSP; Genny Staff, PharmD The Renal Transplant Clinic at Vanderbilt University Medical Center (VUMC) transplanted 265 renal transplant recipients in 2020 and currently services thousands of patients to manage their long-term post-transplant care. Transplant Pharmacy Services have had a pharmacist embedded in the outpatient renal transplant clinic since 2015, when the need was identified to have a pharmacist assist with medication refill requests and other medication-related services. In 2017, we developed a collaborative pharmacy practice agreement that allows our pharmacists to work closely with the participating providers. In this role, the pharmacists serve as liaisons between the clinic and pharmacy, to improve communication and streamline care. Our current collaborative practice agreement allows us to provide patient care and drug therapy management for patients with chronic kidney disease, end stage renal disease, or those who have undergone a kidney transplant. Physician buy-in was essential for successful implementation

First row L-R: Kirsten Mitchell, Laurie Blackmer, Karen Hamm, Keren Rodriguez*; Second row L-R: Sarah Osman, Chelsea Ray, Carey Vallone, Valencia Lawrence, Stephanie Hines, Kendra Williams, Genny Staff*; Back row L-R: Chris Hayes*, Hansel Newman, Levi Thomas, Andrae Abrams, Michael Wilson. Not pictured: Rachel Chelewski* [*Pharmacists with interprofessional team members]

of our practice model, which led to our initial collaborative practice agreement and at present supports the process of helping us expand our current roles. While a lengthy process to get established, our collaborative practice agreement has been beneficial for the pharmacists, clinic, and patients we serve. We sustain our operations through the generation of prescriptions filled and billed through our own in-house outpatient transplant pharmacy. Since we have established a collaborative practice agreement, we have tripled the number of

patients we are servicing monthly. We are in continuous communication with clinic leadership about the expected growth of the outpatient transplant clinics, to anticipate future needs and maintain our expected level of care for years to come. We continue to look for more ways to increase revenue through reimbursement and actively look for ways to expand our clinical services for our pharmacists, but our primary focus remains on the high level of care our patients and providers have come to expect from our department.

ETSU Family Medicine McKenzie Calhoun Highsmith, PharmD, BC-ADM; Ryan Tewell, PharmD, BCACP; Brandi Dahl, BCPS, BCACP ETSU Family Medicine has three clinics in the Tri-Cities area, in Kingsport, Johnson City, and Bristol, each of which has large interprofessional teams that include nursing staff, attending physicians, physicians in residency, social workers, psychologists, clinical pharmacists (both residents and attending pharmacists), and others. Our clinics not only serve as places for our patients to receive a variety of important health care services, but as great places for students and residents to learn in a collaborative environment. Pharmacists function as an integral part of the team, providing direct patient care, as well as consult services. Patients are scheduled for interprofessional office visits for a variety of reasons, and high functioning transitions of care clinics are set up for all patients who have recently been discharged from various settings. Additionally, pharmacists lead pharmacy clin-

ics, where physicians send patients with complicated medication regimens/polypharmacy, uncontrolled or treatment resistant chronic diseases, drug therapeutic monitoring, quality measure attainment, and sometimes “simply” a medication reconciliation. McKenzie Calhoun Ryan Tewell Brandi Dahl Our pharmacists have Highsmith remained an integral part of our practices, allowing our roles to be assisting our quality team with medicationfluid as healthcare changes. Within our related measures. In Kingsport, we have clinics, we have measured multiple clinical tested out “gaps closure clinics,” where we metrics, revenue, and patient satisfaction, work with patients who are identified to all showing that an interprofessional model, have medication-related or multiple quality including or led by the clinical pharmagaps. Working collaboratively in our clinics cists, have positive patient and financial to take care of patients has proven easy and outcomes. As quality measure attainment successful, as we share a goal of providing was implemented as a source of payment outstanding care to patients and outstandstructure, we have become responsible for ing education to a variety of learners.

WINTER 2021-2022 | TENNESSEE PHARMACIST | 23

10:18 AM

Get vaccinated. Get your smartphone. Get started with v-safe.

What is v-safe? V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. Through v-safe, you can quickly tell CDC if you have any side effects after getting the COVID-19 vaccine. Depending on your answers, someone from CDC may call to check on you. And v-safe will remind you to get your second COVID-19 vaccine dose if you need one. Your participation in CDC’s v-safe makes a difference — it helps keep COVID-19 vaccines safe.

How can I participate? Once you get a COVID-19 vaccine, you can enroll in v-safe using your smartphone. Participation is voluntary and you can opt out at any time. You will receive text messages from v-safe around 2 p.m. local time. To opt out, simply text “STOP” when v-safe sends you a text message. You can also start v-safe again by texting “START.”

Use your smartphone to tell CDC about any side effects after getting the COVID-19 vaccine. You’ll also get reminders if you need a second vaccine dose. 10:18 AM

How long do v-safe check-ins last? During the first week after you get your vaccine, v-safe will send you a text message each day to ask how you are doing. Then you will get check-in messages once a week for up to 5 weeks. The questions v-safe asks should take less than 5 minutes to answer. If you need a second dose of vaccine, v-safe will provide a new 6-week check-in process so you can share your second-dose vaccine experience as well. You’ll also receive check-ins 3, 6, and 12 months after your final dose of vaccine.

Is my health information safe? Yes. Your personal information in v-safe is protected so that it stays confidential and private.*

*To the extent v-safe uses existing information systems managed by CDC, FDA, and other federal agencies, the systems employ strict security measures appropriate for the data’s level of sensitivity. CS324195-A

04/27/2021

| TENNESSEE PHARMACIST | WINTER 2021-2022

2021 Residency Showcase: Recap ANNUAL

TENNESSEE RESIDENCY SHOWCASE A

VIRTUAL EVENT

In 2021, the TSHP Residency Showcase was held virtually once again, on September 20-21. We were extremely excited to provide this opportunity for residency candidates and programs to connect.  We were pleased to host 186 candidates and 50 programs in this year’s Showcase! Candidates were able to attend the program presentations of their choosing and ask questions to gain an understanding of which programs would best suit them. The residency programs did an outstanding job with their presentations, and their time is greatly appreciated.

Lifeline for Impaired Pharmacy Professionals Pharmacists, student pharmacists, and pharmacy technicians are at risk for chemical dependency for many reasons, and impairment creates major problems—not just in their own lives, but in the potential harm to patients who rely on them. Recognizing this, the Tennessee Pharmacists Association has a vigorous program in place to provide assistance to impaired colleagues. An impaired pharmacy professional may be identified by another person or through voluntary self-identification. TPRN works to identify and facilitate acute treatment and to provide long-term support for the recovering pharmacist, student, or technician, with the goal of returning to a productive place within the profession. If you are a pharmacist, student pharmacist, or pharmacy technician who needs assistance, or if you know someone who might need help, please call 615-256-3023 or visit tnpharm.org/tprn to learn more.

We thank each program and candidate for participating in the 2021 TSHP Residency Showcase!

WINTER 2021-2022 | TENNESSEE PHARMACIST | 25

Home-Study CE Opportunities from TPA

Now that you’ve gotten more comfortable with online learning, you’ll want to check out the 40+ home-study continuing education opportunities on the TPA website! We’ve put them all in one place for you. Pick and choose sessions from different programs to create your own personalized curriculum, then complete each course on your own time, at your own pace, in your own place. Our home-study CE is also surprisingly affordable, especially for TPA members.

Are you a certified pharmacy technician looking for medication safety and law CE? We’ve published the online Medication Safety Program for pharmacy technicians (6 hours of ACPE-accredited CE), focused specifically on the pharmacy technician’s role in medication safety. To see the complete catalog of TPA’s home-study sessions and program offerings, scan the QR code or visit tnpharm.org/home-study.

2021-2022 TPA Board of Directors

INSTALLED IN JUNE 2021

Kim Jones, PharmD, BCPS, FASHP

Brent Dunlap, PharmD

Jason Hutchens, PharmD, BCPS, BCACP

President

Chair, TSIP

Past President

Jay Phipps, PharmD, FACVP

Lacey Sexton, PharmD

Jason Greene, PharmD

President-Elect

Chair, TSLTCP

Past President

James “Jimmy” Torr, PharmD, MS

Justin Kirby, PharmD, BCACP, NBC-HWC

Raewyn Snodderly, PharmD

Treasurer

Chair, TSP

Past President

Casey White, PharmD, MBA, BCPS, BCNSP, BCCCP, FASHP

Haley Watson, PharmD Candidate

Jason Kizer, PharmD

Speaker, House of Delegates

President, TSSP

Immediate Past President

Mike Wasson, RPh

Hope Ballard Presley, CPhT

Anthony Pudlo, PharmD, MBA*

Chair, TSCP

Chair, TSPT

Executive Director

Chris Finch, PharmD, FCCM, FCCP

Leslie Shepard Wolfe, PharmD

President, TSHP

Past President

| TENNESSEE PHARMACIST | WINTER 2021-2022

* Non-Voting Board Member

Association News

IT’S YOUR CAREER. You can’t afford to be wrong.

PHARMACISTS MUTUAL IS COMMITTED to providing you with coverage designed with your needs in mind. With over 110 years’ experience in the pharmacy profession, we understand the risk and challenges you face. As you know, the pharmacy profession is ever-changing and expanding. With these changes, there is increased professional liability exposure.

The Pharmacists Mutual professional liability policy is tailored specifically to meet your evolving needs.

LEARN MORE AT: phmic.com/pharmacy-professional-liability Professional | Commercial | Personal | Life & Disability

phmic.com

Policy terms and conditions control. Coverage may not be available in all states. Life and disability insurance are written through PMC Advantage Insurance Services, Inc., a wholly-owned subsidiary of Pharmacists Mutual Insurance Company.

WINTER 2021-2022 | TENNESSEE PHARMACIST | 27

Tennessee Pharmacists Association

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