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Executive Summary

REP. STARK's PHYSICIAN DISPENSING LEGISLATION will be introduced as part of the California Democrat's MD referral bill, Stark told the American Pharmaceutical Association annual meeting, April 9 in Anaheim, Calif. Noting that a previously introduced measure addressing physician ownership of facilities could be expanded to include physician dispensing, Stark said: "I would rather keep [physician and pharmacy] separate for what I consider ethical considerations . . . and we are going to try to address it in more detail in our bill." The congressman appeared sympathetic to the pharmacists' concern that physicians will end up "skimming the profitable prescription business to their own practice." Maintaining that the "competition that may be provided to [pharmacists] from physician dispensers" is "unfair," Stark said: "It doesn't seem to me much of a problem to expand that [bill] . . . and keep them out of the business." He added that he "would certainly like to work with" the pharmacy profession in the effort. Stark also addressed the fear that pharmacy will be adversely affected by many requirements of participating providers under the Catastrophic Care Act, of which he was a principal sponsor. He seemed particularly supportive of the profession's argument that pharmacies should not have to pay the telecommunications charges associated with electronic claims submissions: "I am inclined to suggest that there is no reason . . . that you should pay for a lot of expensive toll calls, when eight out of 10 of those toll calls won't result in any revenue for you," the congressman remarked. However, Stark did not indicate whether he thought claims processers or Medicare should pick up the costs. Commenting that Congress knows "zip about dispensing of prescription drugs and their cost," Stark urged APhA participation in HHS' rulemaking for the Medicare drug benefit. He added that he would be seeking the advice of APhA members serving on the new Prescription Drug Payment Review Commission (RxPRC) established by the act ("The Pink Sheet" Jan. 16, p. 7). Four commission appointees are APhA members.

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