[Congressional Record Volume 149, Number 88 (Monday, June 16, 2003)]
[Senate]
[Pages S7931-S7932]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. JOHNSON (for himself and Mr. Cochran):
  S. 1270. A bill to amend title XVIII of the Social Security Act to 
provide for coverage of medication therapy management services under 
Part B of the Medicare program; to the Committee on Finance.
  Mr. JOHNSON. Mr. President, I am pleased to introduce legislation 
today that will provide for important health care quality and 
medication safety improvements in the Medicare program. The Medication 
Therapy Management

[[Page S7932]]

Services Coverage Act of 2003 will enhance the Medicare program by 
providing coverage of pharmacists' medication therapy management 
services for those beneficiaries at risk for potential medication 
problems due to the presence of multiple or complex chronic diseases. 
These services, which are coordinated in direct collaboration with 
physicians and other health care professionals, help patients make the 
best possible use of their medications.
  The members of this body know very well the vital role that today's 
powerful and effective medications play in the maintenance of health 
and well-being of our Nation's seniors. The substantial and important 
discussion now underway on how best to craft and implement a 
prescription drug benefit for Medicare beneficiaries is an explicit 
recognition of this vital role. But access to the medications, even at 
the most affordable prices possible, is only one part of the solution 
to achieving the kinds of health care outcomes that patients and their 
health care providers desire. That is where today's pharmacists play a 
pivotal role.
  In addition to the important and continuing responsibility for 
assuring accurate, safe medication dispensing and counseling services, 
pharmacists now provide many direct patient care, consultative, and 
educational services. Forty states, the Veterans Administration, and 
the Indian Health Service, among others, all recognize the value of 
collaborative medication therapy management services as a way to 
provide optimal patient care using the specialized education and 
training of pharmacists. In addition, several state Medicaid programs 
have active demonstration projects or waiver programs in place that 
deliver these important services to their citizens.
  More specifically, in its June 2002 report to the Congress, the 
Medicare Payment Advisory Commission noted that it ``sees potential for 
a Medicare drug therapy management benefit to facilitate access to an 
important health care service for some beneficiaries'' and recommended 
to Congress that the Secretary of Health and Human Services ``. . . 
assess models for collaborative drug therapy management services in 
outpatient settings.'' This is a very important recommendation, because 
there is no more vulnerable group than our Nation's seniors when it 
comes to the potential for medication-related problems and the presence 
of multiple chronic diseases. If other health care systems and programs 
provide such services, Medicare must be reformed to provide them as 
well. Indeed, Medicare should be the leader in this regard.
  The pharmacist's specialized training in medication therapy 
management has been demonstrated repeatedly to improve the quality of 
care patients receive and to control health care costs associated with 
medication complications. As an essential infrastructure component of 
any type of Medicare prescription drug benefit, it makes sense to take 
this proven initial step to improve the medication use process for our 
seniors. This will serve all Medicare beneficiaries by ensuring that 
each precious dollar, regardless of who is paying the ``bills for the 
pills,'' is spent wisely on a safe and effective medication regimen. 
This is a benefit that we can all support and deliver now, as we work 
to also resolve the economic and political challenges in crafting a 
truly effective and affordable prescription drug benefit.
  Because pharmacists improve the efficacy and cost-effectiveness of 
medication regimens and reduce medication-related problems and adverse 
effects, the addition of their services represents real value and 
enhances the prospects of achieving both an affordable Medicare drug 
benefit and improved health outcomes for Medicare beneficiaries. In 
fact, numerous studies over the past decade have demonstrated returns 
on investments of up to $17.00 for every single dollar invested in the 
provision of pharmacists' clinical and patient care services.
  Our legislation provides a logical and very affordable first step in 
establishing the essential infrastructure of a Medicare prescription 
drug benefit. As the 1999 Institute of Medicine report ``To Err is 
Human: Building a Safer Health System'' stated:

       Because of the immense variety and complexity of 
     medications now available, it is impossible for nurses and 
     doctors to keep up with all of the information required for 
     safe medication use. The pharmacist has become an essential 
     resource . . . and thus access to his or her expertise must 
     be possible at all times.

  Our legislation will assure that the Medicare program leads, rather 
than follows, on this important health care quality issue. Pharmacists' 
collaborative medication therapy management services can and will make 
a real difference in the lives of Medicare beneficiaries. I urge my 
colleagues on both sides of the aisle to give this proposal their very 
serious consideration.

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