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Health Care & Law

How does the Patient Protection and Affordable Care Act (ACA) of 2010 differ from the act as it stands today? Many changes have occurred, in Medicaid expansion, private insurance coverage, the American Health Benefit Exchanges, and the individual mandate.
Patrick R. LaFontaine PharmD
F. Randy Vogenberg PhD, RPh
Laura T. Pizzi PharmD, MPH
As marijuana legalization and use expands across the U.S., health care systems are struggling to keep abreast of the changes and trends in regulations. Considering marijuana’s federal illegality and other restrictions on its use, the limited evidence for its clinical efficacy, and the myriad psychological adverse events, caution is recommended when establishing policies and procedures regarding coverage of marijuana and CBD products.
James O’Donnell PharmD, MS, FCP
F. Randy Vogenberg BSc Pharm, PhD
In the complex setting of obstetrics and reproductive medicine, the medication-related injuries leading to the most litigation involve some of the most commonly used drugs, rather than the newer, more complicated therapies. The authors present a number of cases illustrating how sophisticated treatment of high-risk pregnancies can be jeopardized by a simple negligent act.
James T. O’Donnell PharmD, MS, FCP
James J. O’Donnell PhD
F. Randy Vogenberg BSc Pharm, PhD

The authors underscore the importance of understanding standards and procedures as they discuss two lawsuits that arose from drug injury.

James T. O’Donnell PharmD, MS, FCP
F. Randy Vogenberg BSc Pharm, PhD

Despite a slow legislative start by President Trump, new federal and state regulatory health care changes will have important implications for pharmacists, P&T committees, and patients.

F. Randy Vogenberg BSc, PhD, RPh
Rita Marcoux BSc, MBA, RPh

Over the past few years, P&T committees have been evolving to deal with care at expanding sites within an organization, across a larger system, or involving multiple organizations. The authors consider one aspect of this expansion—medication system failures—that requires the attention of P&T policy.

James T. O’Donnell PharmD, MS, FCP
F. Randy Vogenberg RPh, PhD
The HEAT Initiative Is Gaining Momentum

The pharmacy benefit management (PBM) industry has recently fallen into the crosshairs of government investigations about the high cost of pharmaceuticals. The authors focus on the PBM-based P&T and formulary practices under scrutiny.

Martha M. Rumore PharmD, JD, MS, LLM, FAPhA
F. Randy Vogenberg RPh, PhD

The authors consider market stakeholder consolidation, market-driven efficiency demands, consumerism, and legal enforcement of patient rights related to access to appropriate drugs and posit how future P&T committees may approach these issues.

F. Randy Vogenberg RPh, PhD
Rita Marcoux RPh, MBA
Martha M. Rumore PharmD, JD, MS, LLM, FAPhA

Telehealth is becoming mainstream in the U.S., as more consumers, employers, hospital systems, and even insurers adopt the technology. The authors explore the challenges of regulation, reimbursement, and licensing as the modality evolves.

Rita M. Marcoux RPh, MBA
F. Randy Vogenberg RPh, PhD

Biosimilars represent a potential savings opportunity for both payers and patients, but how and when the new agents will be accepted and prescribed is uncertain.

Martha M. Rumore PharmD, JD, MS, LLM, FAPhA
F. Randy Vogenberg PhD, RPh, FASHP

Involving pharmacists in the process of comparing the medications that should be ordered for a patient with the new medications that are currently ordered and resolving differences improves accuracy, decreases mortality, and improves transitions of care.

Jennifer Splawski PharmD, BCPS
Heather Minger PharmD, BCPS

Although the health care marketplace is changing rapidly, some things have not changed, including the need for P&T committees and organizations’ management to beware of ethical and legal issues such as discrimination, quotas, and understaffing.

James O’Donnell PharmD
F. Randy Vogenberg RPh, PhD
Part 2: Risk Management Recommendations

A malpractice claims analysis by an insurer, Healthcare Providers Service Organization, provides recommendations for avoiding errors and injuries. Case examples relate these suggestions to situations that are common in health care settings.

James O’Donnell PharmD
F. Randy Vogenberg RPh, PhD
Part 1: Deconstructing Dispensing Errors

A comprehensive analysis of malpractice claims experience from a professional liability insurer, Healthcare Providers Service Organization, can help P&T committees better understand the risks and challenges they encounter each day.

James O’Donnell PharmD
F. Randy Vogenberg RPh, PhD
Legislative and regulatory efforts to address controlled substance diversion and overuse of narcotics are affecting prescription drug utilization and patient care. These initiatives can influence formulary drug selection, prior authorization procedures, and drug utilization strategies.
E. Paul Larrat RPh, PhD
Rita M. Marcoux RPh, MBA
F. Randy Vogenberg RPh, PhD

State policies vary regarding the legal use of marijuana for medicinal purposes. Pharmacists, physicians, and P&T committee members must become familiar with the laws in their states before assuming that this controlled substance can be legally prescribed or dispensed to patients.

Rita M. Marcoux RPh, MBA
E. Paul Larrat RPh, PhD
F. Randy Vogenberg RPh, PhD
Drugs in short supply, especially those needed in oncology, can create legal and patient-safety problems for risk-bearing providers.
James T. O’Donnell PharmD
F. Randy Vogenberg RPh, PhD
New Features in 2013

Among the health care changes this year: revenues to hospitals will be lower, payments to physicians will be modified, and more patients will be covered by Medicaid.

E. Paul Larrat RPh, PhD
Rita M. Marcoux RPh, MBA
F. Randy Vogenberg RPh, PhD
Pitfalls and Recommendations
Medication errors, with methotrexate in particular, are all too common—especially when patients are moved from one site of care to another. The authors discuss ways to improve appropriate medication use during patient transitions.
James O’Donnell PharmD, MS
F. Randy Vogenberg RPh, PhD
An Improvement Over HMOs?

The ACO model is considered an important achievement of health care reform legislation. However, ACOs might not be able to deliver on their promises in part because of the slowly recovering economy. It is also not clear how much money will be saved, and not all hospitals plan to participate.

Rita M. Marcoux RPh, MBA
E. Paul Larrat RPh, PhD
F. Randy Vogenberg RPh, PhD
Enhancing Pharmacy Practice and Limiting Risk
James O’Donnell PharmD, MS
F. Randy Vogenberg RPh, PhD
E. Paul Larrat RPh, PhD
Rita M. Marcoux RPh, MBA
F. Randy Vogenberg RPh, PhD
James O’Donnell PharmD, MS
F. Randy Vogenberg RPh, PhD