CPESN® Kentucky's mission statement is to aid in the financial stability of community-based pharmacies through fostering and enabling the provision of high quality and high integrity patient-centered enhanced services that are integrated with the patient's care team and transcend conventional outpatient pharmacy contract obligations Kentucky's mission statement is to aid in the financial stability of community-based pharmacies through fostering and enabling the provision of high quality and high integrity patient-centered enhanced services that are integrated with the patient's care team and transcend conventional outpatient pharmacy contract obligations.
Leadership & Luminaries
Paula Miller, Managing Network Facilitator
David Figg, Network Lead Luminary
Local Network Requirements
Collection of Vital Signs
The ability to collect heart rate respiration rate, temperature and blood pressure in your pharmacy for patients.
Provide Comprehensive Medication Reviews and In-Depth Counseling
A review of patient medications, including prescription, over the counter, herbal medications, and dietary supplements to identify, resolve, and prevent medication-related problems, including adverse events.
Targeted Medication Therapy Management (MTM)
Methods of selection for these services include, but are not limited to: by patient request, referral from the Primary Care Provider, or through the determination that the patient is of high risk by the pharmacist conducting these services, as determined by factors such as compliance, disease state, MTM services must be schedulable, personalized, and conducted by a community pharmacist in a private setting.
A pharmacy-provided delivery service. Charges and restrictions may apply; call pharmacy for details.
The ability to actively screen patients, educate, and provide the following ACIP recommended immunizations (or at a minimum refer to another provider) influenza pneumococcal (both conjugate and polysaccharide, Tdap and herpes zoster immunizations.
Produce Personal Medication Records
The ability to create a comprehensive list of current patient medications manually or from dispensing software.
Care Plan Development/Reinforcement for Chronic Patients
A document detailing patient information pertinent to helping a patient reach a healthcare goal.
Participate in one or more adherence programs approved by KPCN. These may include: Adherence Reminder Calls, Med Planners, Strip Packaging, Blister Packaging, or special adherence packaging to promote adherence. Adherence packaging shall mean unit dose packaging designed to assist patients with medication organization by incorporating data and time into the unit dose device.
Practice Presumptive Eligible Medication Dispensing
The willingness to dispense medication based on belief that the patient is eligible for Medicaid and is in the application process to be billed to Medicaid once actual eligibility obtained. Medications filled under presumptive eligibility may be placed on an AR account; call pharmacy for details.
Medication Synchronization Services
The proactive process of timing a patient’s routine refills with a pharmacist’s clinical disease state management and monitoring for progression toward desired therapeutic goals. The purpose of medication synchronization is to ensure the patients are refilling and taking their medications as prescribed and to ensure that patients are achieving the therapeutic goals with safe and effective medications. This process is not to be confused with automatic refill.
Participate in a Proactive Waste Management Program
The “Proactive Waste Management Program” is an initiative to minimize the number of prescription fills that are received by the patient but not used and is a mandatory service provision for all KPCN Network Pharmacies. This program is not designed to function like a mail order pharmacy where refills are sent out frequently with no patient contact. At a minimum, Participant will provide training for all staff in the pharmacy on methods to reduce the number of prescription fills for which the patient already has 20% or more of the medication currently in their possession.
Legal, Regulatory, Licensing Compliance
Shall comply with all federal and state laws, rules, and regulations regarding the confidentiality of patient information: This includes, but is not limited to:
- Compliance with the Health Insurance Portability and Accountability Act of 1996, as amended “(HIPAA”) and the Health Information Technology for Economic and Clinical Health Act, as amended (“HITECH Act”), including all applicable rules, regulations, and official guidance promulgated in connection with HIPAA and the HITECH Act, by the U.S. Department of Health and Human Services or otherwise.
- Maintain registration of the pharmacy and all involved pharmacists and technicians with the Kentucky Board of Pharmacy and, at all times, remain in good standing with the Kentucky Board of Pharmacy.
- Maintain a good standing with all federal, state, and local licenses and/or permits as required by applicable law: This includes but is not limited to, maintaining a valid pharmacy license in each state to which provider dispenses prescriptions as required by applicable law. Provider must furnish copies of said licenses and/or permits upon enrollment as a KPCN Member, and as requested by KPCN. Any pharmacy services provided where provider does not possess all required licenses under applicable law shall be deemed to be invalid, and may result in termination from KPCN. All pharmacy services must be provided by or under the direct supervision of a licensed pharmacist and in accordance with the prescriber directions and applicable law.
- Must notify the KPCN central office in writing if: the provider's license or permit is, or is in jeopardy of being suspended or revoked; the provider receives notice of any proceedings related to pharmacy services that may lead to disciplinary action; any disciplinary action is taken against provider or any of its personnel, including, but not limited to, action taken by the board of pharmacy, Officer of Inspector General (OIG), system for award management (SAM), law enforcement, or other regulatory body; there is a subpoena of records related to pharmacy services or provider’s business practices; or there is a seizure by law enforcement of provider’s prescription records, computer systems, financial records, accounts, or real property.
- Respect each patient’s right to choose their own practitioners and pharmacies.
- Complete a motivational interview training that is KPCN Network provided.
- Facility must be open to the public handicap
- Facility shall have access to the Internet
Quality and Data
- Establish a Quality Assurance Program, and provide results if/when requested by KPCN
- Facility shall be willing to share data with KPCN for the purpose of Quality Assurance