Legal Considerations and Challenges for Hospital and Health-System Specialty Pharmacies

May 20, 2021

Current pharmacy benefits landscape in the context of the drug supply channel, and in particular, the role that health system pharmacies play will be discussed.  This session will focus primarily on payor and PBM concerns for health system pharmacies (including heightened barriers of entry, disproportionate copay tiers versus PBM-owned pharmacies, and unreasonably low reimbursement rates).  The presentation will include real world, practical advice to pharmacists and administrators on how to navigate these difficult payor challenges and look for opportunities for growth.  The presentation will also cover other laws and legal principles, including Board of Pharmacy considerations, 340B regulations, antikickback and self-referral laws, and more.

Target Audience

  • Pharmacists
  • Pharmacy technicians

Learning Objectives

Pharmacist learning objectives

  1. Discuss current pharmacy benefits landscape in the context of the drug supply channel, and the role that health system pharmacies play
  2. Identify payor network admission criteria for various PBM networks requirements, and learn to navigate nontransparent, unclear, continuously changing, and onerous requirements
  3. Address the framework of laws and regulations that impact health system pharmacies, including rules regarding network access, benefits design, fair audits, and reimbursement rates

Pharmacy technician learning objectives

  1. Define the NCPDP fields relevant to 340B claims billing

Additional Information

AttachmentSize
PDF icon Helpful Tips for Users.pdf157.72 KB
File Instructions for Obtaining CE Credit - Legal Considerations and Challenges.docx29.99 KB
Course summary
Available credit: 
  • 1.00 ACPE Pharmacist
  • 1.00 ACPE Pharmacy Technician
  • 1.00 General CE - Attendance
Course opens: 
05/20/2021
Course expires: 
07/09/2021
Event starts: 
05/20/2021 - 1:00pm CDT
Event ends: 
05/20/2021 - 2:00pm CDT
Add to calendar: 
Live via webinar
United States
Relevant financial relationships: Planning committee members and presenters have nothing to disclose
 
Planning committee members
 
Jackie Stokes, BS
Manager, Pharmacy Program Services
Vizient, Inc.
 
 
Gretchen Brummel, PharmD, BCPS
Consulting Director, Pharmacy
Vizient, Inc.
 
Course reviewer
 
Gretchen Brummel, PharmD, BCPS
Consulting Director, Pharmacy
Vizient, Inc.
 
Presenter
 
Jesse C. Dresser, Esq.
Attorney at Law
Frier Levitt Attorneys at Law

 

Joint Accreditation Statement:
 
In support of improving patient care, Vizient, Inc. is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
____________________________________________
 
Designation Statements:
 
PHARMACY
Vizient, Inc. designates this activity for a maximum of 1.00 ACPE credit hours.
Universal Activity Number: JA0006103-0000-21-114-L03-P
Universal Activity Number: JA0006103-0000-21-114-L03-T
CEU
Vizient, Inc. will award CEUs to each participant who successfully completes this program. The CEU is a nationally recognized unit of measure for continuing education and training programs that meet certain criteria (1 contact hour = 0.1 CEU).

Available Credit

  • 1.00 ACPE Pharmacist
  • 1.00 ACPE Pharmacy Technician
  • 1.00 General CE - Attendance
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