The presidential candidates on education issues......

Go to the OEA website to see where the candidates stand on issues important to us. There are also some downloads with a lot of good information.

From Shirlee Zerkel: Advice for retirees needing ostomy supplies

From Shirlee Zerkel, September 5, 2008
Subject: Re: Another question!

STRS retirees, I have asked these questions about ostomy supplies because I know they are covered by Medicare B and there are people out there who can not function without these supplies if they have had an ostomy due to rectal or bowel cancer or some other bowel surgery.

Both ostomy and diabetic supplies are listed on the Medicare website as Durable Medical Equipment. Diabetic supplies are supplied by Express Scripts at no co-pay but ostomy supplies are not. I want to know why, for those who live with this need. If you need these ostomy supplies, please question Express Scripts or STRS.

Shirlee Zerkel

Sandy Knoesel to Shirlee Zerkel, September 5, 2008
Subject: Re: Another question!

Pharmacy Benefit Managers (PBMs) typically negotiate and hold contracts with manufacturers of diabetic supplies; so, even though these supplies are considered DME under Medicare, the coverage is provided through the prescription benefit. Another way to look at this is that diabetic supplies monitor how the body is functioning; they do not replace a body function. I hope this information is helpful.

Sandy Knoesel

Sign of the times: Kostyu axed from Canton Repository

We have learned that Paul Kostyu, noted journalist, Pulitzer Prize nominee, tireless and prolific investigative reporter in the 2003 STRS scandal was recently released from his long time position with the Canton Repository in a budget cutting move by that newspaper. His loss will be keenly felt by many; we hope it is only temporary and that we will be reading his columns again soon. We wish him all the best and an even brighter future in journalism. KBB

Dave Sereno to John Curry, September 4, 2008

Subject: Re: Paul Kostyu

Mr. Kostyu was let go in a recent round of corporate cutbacks. I miss him, too.

Dave Sereno
City Editor
330-580-8317
Fax 330-454-5754
Repository

From John Curry, September 3, 2008
Subject: Paul Kostyu

Sirs,

Where has Paul Kostyu gone? I miss his articles. Can you help me?

Thank you,

John Curry

From John Curry, September 4, 2008

I just got off the phone with Paul Kostyu. He, at present, is not working anywhere but is currently following up on job "leads."

He did mention that the current trend of newspapers laying off journalists, as well as other positions, is due to the economy. This is a sad day for those of us who appreciate investigative journalism...a very sad day indeed. He certainly aided in the reform at Ohio STRS!

Paul advised that he would contact me when he begins his new career.

John

Shirlee to Sandy: Another question

From Shirlee Zerkel, September 3, 2008
Subject: Another question!

Dear Ms. Knoesel;

I thank you for your prompt answer of last week on my no co-pay question. You state that ostomy supplies are not on the zero co-pay because they are Durable Medical Equipment. So also are diabetic monitors and nebulizers on the DME, yet they are on the STRS/Express Scripts list to be covered at no co-pay? Please explain the difference to me!

Shirlee

Will those in charge at Ohio STRS read this? Let's hope so!

From John Curry, September 3, 2008

From Sharon Treat to John Curry, September 3, 2008
Subject: Special Report: Texas Auditor Shows the Way on PBM Oversight

NLARx Special Report
September 3, 2008

IS IT TIME TO AUDIT THOSE PBMS?

Texas Auditor Shows the Way in Report; Identifies Opportunities for Savings to State, Protection of Patient Privacy

Texas Report Identifies Many Opportunities for Greater Regulation, Transparency and Recovery of Savings in State Programs that Use Pharmacy Benefit Managers

In a move that can only benefit consumers, Texas last month became the latest state to take action to curb possible abuses by Pharmacy Benefit Managers (PBM), the middlemen who administer and negotiate drug benefits for health plans, businesses and government programs.
The Texas auditor's report issued in August recommended that state agencies including the state employees and teachers' retirement and state university systems have greater power to audit PBM contractors to verify drug plan costs, ensure compliance with contracts, protect consumer privacy and address what it calls other "high-risk areas."

The report, "An Audit Report on Pharmacy Benefit Manager Contracts at Selected State Agencies and Higher Education Institutions" recommends that contract provisions should be strengthened to:

• Insure audit rights in order to verify prescription drug plan costs and PBM contractors' compliance with their contracts;

• Reveal the true costs discounts associated with the plans;

• Regulate drug substitution practices;

• Protect confidential data and regulate PBM sales of plan data; and

• Insure contract monitoring for compliance with requirements and to disclose any policies, practices, or business relationships that could conflict with their obligations under PBM contracts.

The report also recommended that additional guidance and expertise be provided to agencies and higher education institutions to strengthen their PBM contracts to insure greater consistency of the provisions and state access to key information including rebate amounts. In general, the Auditor recommended that agencies and higher education institutions adopt specific practices to insure that contract provisions clearly recognize and benefit the interests of their plans and members.

Texas thus joins efforts by an increasing number of states to regulate an industry targeted in numerous fraud cases and other litigation. In 2003, Maine became the first state in the country to pass legislation aimed at ensuring transparency, reducing conflict of interest and applying other ethical standards to the PBMs. In the past few years, at least 13 states have passed laws addressing PBM practices and transparency, including Kansas, Vermont, Iowa, Louisiana, North and South Dakota, Mississippi, District of Columbia, and, earlier this year, Maryland.

The battle to rein in PBMs has been led by the National Legislative Association on Prescription Drug Prices (NLARx), a non-partisan organization of state legislators working to reduce prescription drug costs and increase access to medicines. NLARx has developed model legislation to insure that PBM contracts serve the interests of their clients, not those of PBMs and drug companies.

NLARx Executive Director Sharon Treat lauded the Texas report as a road map for other states. "There is no doubt in my mind that the vast majority, if not all, of the 50 states have similarly flawed contracts with PBMs, or lack the audit skills and authority necessary to insure that their citizens are getting the full value of these pharmacy contracts," Treat said.
Treat stated: "This report should be read by every state auditor and higher education and retirement system financial manager. Not only do new regulations need to be adopted, but states need to exercise their audit rights to find out what's really going on in these contracts." She added, "To do otherwise is to abdicate responsibility and hand over to these middlemen literally millions of dollars of taxpayer money that could be buying needed medications and balancing already precarious state budgets."

The Texas report follows a flurry of state activity aimed at PBMs this year. Treat noted that even in Maine, which has a PBM law on the books, PBMs hired by state agencies are not fully complying with the state's rebate pass-through and transparency standards. This year Maine legislators passed a bill to require the state's Department of Corrections to renegotiate its pharmacy contract to recoup a greater share of rebate money and to insure compliance with the law.

In West Virginia, legislators discovered that a PBM administering the Medicaid pharmacy benefit was selling patient data, a problem also identified in the Texas report. The state moved promptly to end the practice.
Also this year, Maryland enacted a comprehensive package of legislation to regulate PBMs. It includes registration with the state to allow tracking and evaluation, and far-reaching disclosure requirements. The provisions cover conflicts of interest, disclosure of fee schedules and other information during the contracting process and instances when a prescription switch or "therapeutic interchange" is made. Of the comprehensive nature of the law, Attorney General Douglas Gansler said, "It is crucial to regulate this previously unregulated business".

The Texas report could lead to both administrative and legislative action in the next legislative session. The Legislature has previously considered adopting PBM regulations but opted for the study that resulted in the Auditor's report.

According to NLARx director Sharon Treat and other advocates for PBM regulation, the kind of changes recommended in the Texas Auditor's report are necessary to lower prescription drug costs and ensure that PBMs do what in fact they are paid to do: serve their clients' interest by getting them the lowest price for drugs, rather than serving the interests of the PBMs or those of drug companies.

When the Maine law was upheld by the federal courts, the decision noted that whether or how a PBM actually saves an individual benefits provider money "is largely a mystery" and "This lack of transparency (introduces) a layer of fog to the market that prevents benefits providers from fully understanding how to best minimize their net prescription drug costs."

Above all, Treat says, stricter transparency, conflict of interest and audit standards will remove the "layer of fog" cited in Maine's court case, making the marketplace more competitive and ultimately effective. That, in turn, will protect patients' health, the optimum medical outcome.

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About the National Legislative Association on Prescription Drug Prices: NLARX is a nonpartisan, nonprofit organization of state legislators from across the country working to lower prescription drug costs and improve access to affordable medicines. Members include legislators from Alaska, Arizona, Colorado, New York, Maryland, Pennsylvania, Texas, Oklahoma, Hawaii, South Carolina, the District of Columbia and all the New England states. For more information and to sign up for our bi-weekly newsletter, visit our website at www.reducedrugprices.org.

Who's Who at STRS (senior staff members)

State Teachers Retirement System of Ohio
Columbus, OH 43215-3771

275 E. Broad St.
1-888-227-7877

Past STRS Ohio News E-mails

STRS Ohio News for Active Members

STRS Ohio News for Benefit Recipients

STRS Ohio Senior Staff

Michael Nehf nehfm@strsoh.org
Executive Director (since July 2008)

Sandra L. Knoesel Knoesels@strsoh.org
Deputy Executive Director — Member Benefits

Stephen A. Mitchell mitchels@strsoh.org
Deputy Executive Director — Investments

Robert A. Slater slaterr@strsoh.org
Deputy Executive Director — Finance Chief Financial Officer

Terri Meese Bierdeman BierdemT@strsoh.org
Director, Governmental Relations

Eileen F. Boles bolese@strsoh.org
Executive Assistant

Laura R. Ecklar EcklarL@strsoh.org
Director, Communication Services

Andrew J. Marfurt, Director, Human Resource Services

William J. Neville, General Counsel

David Tackett, Manager, Internal Audit

Gregory A. Taylor, Director, Information Technology Services