Short Cycle LTC Dispensing

A relatively little-known requirement in the Affordable Care Act passed by Congress is poised to potentially cause big issues for pharmacies who supply medications to Long Term Care (LTC) Facilities.

Beginning January 1, 2012, pharmacies filling prescriptions for Medicare Part D recipients residing in long term care facilities will be required to dispense medications in 7-day or less supplies.  For those unfamiliar, the current standard practice at many pharmacies supplying LTC facilities is to supply 30-day supplies of maintenance medications.  This change is apparently aimed to reduce wasted medications in the Part D program.

There are certainly situations that drive wasted medications in LTC - patients are transferred to another facility or a hospital, changes are made to a patient's medication regimen, and eventually everyone, well, gets "out," in one way or another.  There are few states that allow medications, once sent to an LTC facility, to be returned to the pharmacy an redispensed.  In most cases, the medications not used by the patient have to be destroyed.

The idea is to reduce the amount of medication sent each time, so that when changes occur, there is less medication wasted.

Much discussion has been had to date, in many forums, including a recent conference held in Dallas, TX, hosted by ASCP (American Society of Consultant Pharmacists) and NCPDP (National Council for Prescription Drug Programs).  For details on the event click here.  Many opinions have been given, but to date, CMS (Centers for Medicare & Medicaid Services), who is responsible for guidance and enforcement related to this requirement, has not published official guidance.  Hopefully soon, as a January 1, 2012 implementation date is closer than you might think.  We ARE talking about a re-configuration of an industry here...

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