March 2013 IV Lines

Congressman Kevin Yoder Visits Alternacare

Wednesday, January 30, 2013 Alternacare Infusion Pharmacy was honored by the visit of Congressman Kevin Yoder.  Mr. Yoder met with owners Mike Hayden and Rick Lane regarding the services that Alternacare provides for thousands of local area residents with infectious diseases, immune deficiencies, cancer, short bowel syndrome, cystic fibrosis and other conditions to receive the care they need in the comfort of their own homes.  The Congressman toured the facility and spoke with Alternacare’s pharmacists to learn about the intake process, insurance benefit verification, preparation of medications and delivery staging process.  During the visit, he was able to see the sterile preparation room, warehouse and infusion suites.   Our nurse Sarah shared with Mr. Yoder the importance of patients being able to be cared for in their own home rather than having to stay in a facility to receive intravenous medication or having to make daily visits to a clinic or office to receive medication.  There was also discussion regarding the lack of benefit coverage that a Medicare recipient has for home infusion.  As the picture denotes, Medicare only covers the actual medication.  Medicare does not cover the necessary pumps, supplies and services required to administer the medication.  This lack of coverage creates high out-of-pocket costs for Medicare patients, causing the patient to elect to make regular visits to a facility to receive their medication, to stay in a skilled nursing facility or to have to change to an oral medication, which may not be as effective as the intravenous route of administration.  Many patients in this population would greatly benefit from the home infusion alternative when the therapy is administered in the comfort and convenience of the patient’s own home.  An additional important factor is the cost savings for taxpayers if Medicare covers home infusion.  Currently, two bills (Senate and House) are being scheduled to be re-introduced in late spring or early summer. These bills would address the appropriate changes necessary for this patient population to have the health benefit coverage needed when a physician prescribes home infusion therapy.

To learn more about this legislation, please visit With the potential support of future Medicare Home Infusion Legislation by Congressman Kevin Yoder and other Congressmen and Senators, more innovative healthcare solutions will be available to the Medicare population.  We thank Congressman Kevin Yoder for taking the time to visit Alternacare on this cold, blustery day in January.

Drug Shortages

Drug shortages have always been something that pharmacies have had to deal with over the years, however, we usually found that allocation from manufacturers would get you through the tough times.  Last year, 2012, proved to be much more difficult.  The home infusion industry is a small component of a much larger healthcare industry that has felt the pain of drug shortages and we may continue to feel it in 2013.

According to an article from the New York Times published November 16th, 2012:

Rationing is just one example of the extraordinary lengths being taken to address the shortage, which health care workers say has ceased to be a temporary emergency and is now a fact of life. In desperation, they are resorting to treating patients with less effective alternative medicines and using expired drugs. The Cleveland Clinic has hired a pharmacist whose only job is to track down hard-to-find drugs. (see link below).

Fortunately, Alternacare has some great buyers that continue to find resourceful ways to acquire the medications when they are in short supply.  Many times we can work in conjunction with the physician to see if there is a clinically equivalent substitute or a way to share supply with area hospitals.

Noted below are two websites for reference regarding medications that are in short supply.  One is the Food and Drug Administrations website and the other is on the American Society of Hospital Pharmacists website.



As always, we will continue to focus on patient quality and service, while doing our very best to access the medications that every patient needs.

Recipe for St. Patrick’s Day Blondies











2/3 cup butter

1-1/4 cup brown sugar, packed

1 egg

1 tsp vanilla extract

2 cups flour

1/2 tsp baking soda

1 cup green M&M’s

Preheat the oven to 350 degrees. Spray non stick spray in a 13×9 inch glass dish.  In a small bowl combine the flour, egg, baking soda.  Mix the butter and sugar together with a hand mixer or stand mixer. Add in the egg, mix well. Then add in the vanilla extract.  Mix in the M&M’s into the batter. Pour the batter into the glass dish and bake for 30-35 minutes until the top is golden brown. Allow to cool to room temperature then cut into bars.

Mark your Calendar!

March: Social Work Month

March 13:   Registered Dietitian Day

March 30: National Doctor’s Day

April 1 – 7: National Public Health Week

April 9 – 13: Patient Advocacy Week

April 22: Earth Day

April 21-27: National Healthcare Volunteer Week

April 21 – 27: Healthcare Administrative

I’m Just A Bill…


S.1203 A bill to amend title XVIII of the Social Security Act to provide for the coverage of home infusion therapy under the Medicare


H.R.2195 To amend title XVIII of the Social SecurityAct to provide for the coverage of home infusion therapy under the Medicare

November IV Lines Newsletter

 You Can Make a

Alternacare Infusion Pharmacy encourages YOU to get involved in the expanding Medicare Part D coverage.  As you know, Medicare Part D patients can pose a particular challenge when being discharged with
home infusion needs.  The considerations/alternatives include:

  •  A patient self pay rate for the equipment, supplies, delivery, compounding, and labor, as Medicare does not cover these services for antibiotics in the home. (Medicare Part D does cover
    the medication)
  • The patient can receive their infusion from an outpatient clinic.
  • The patient can go to a Skilled Nursing Facility.
  • The patient might be switched to an oral medicine.

Currently, the following two bills are in Congress:

A bill to amend title XVIII of the Social Security Act to provide for the coverage of home infusion therapy under the Medicare Program.

To amend title XVIII of the Social Security Act to provide for the coverage of home infusion therapy under the Medicare Program.

You can help by visiting NHIA’s website (
to send a letter to your Congressmen or Representative expressing your concerns.  For additional information,visit

Recipe for Curry Chicken


  • 4 chicken breasts, skinless, boneless
  • ½ t. salt
  • ¼ t. pepper
  • Dash of garlic powder
  • ¼ t. seasoned salt
  • 1 T. curry powder
  • 2 T. butter
  • 1 T. oil
  • 2 T. scallions, chopped
  • 1 c. chicken broth
  • 3 T. slivered almonds
  • 1 tsp. corn starch
  • ¼ c. heavy cream
  • Optional:  sliced mushrooms and sliced zucchini
Directions:Cut chicken into 1 inch strips.  Coat with spice mixture of salt, pepper, garlic powder, seasoning salt and curry.  Sauté chicken and onions in hot butter and oil till lightly browned.  Stir in broth and almonds (mushrooms and zucchini). Bring to a boil, reduce heat and simmer 25 minutes.  Combine corn starch and cream.  Stir into chicken.  Bring to a boil and stir until the sauce has thickened.   Serve over rice.

Serve this recipe with: Firestone Riesling

Why Do Post-Acute Providers Need Access Prior to

Elizabeth E. Hogue, Esq.

Many post-acute providers; including home health agencies, private duty agencies, hospices, and home medical equipment (HME) companies, place a high value on use of coordinators/liaisons who regularly visit patient floors at hospitals and other inpatient facilities. Some discharge planners/case managers do not understand why such access is needed, especially in view of the availability of various methods of communicating information to post-acute providers. In fact, discharge planners/case managers may view the presence of post-acute providers as nothing more than a nuisance. There are, however, several reasons why the
use of liaisons/coordinators from post-acute providers in institutionalsettings is important.

First, visits by liaisons/coordinators to patient floors are important for the provision of quality of care for patients. It seems increasingly clear that patients are at greater risk during transitions in care. Such transitions include shift changes in inpatient settings as well as movement from one level of care to another. Care transitions during which patients may be at increased risk also include transitions from inpatient care to post-acute care. According to Standards of
Practice for Case Management published by the Case Management Society of America (CMSA) in 1995 and revised in 2002 and 2010, case managers/discharge planners have a duty to assist clients in the “safe transitioning of care to the next most appropriate level.”

While discharge planners/case managers may feel that they communicate all necessary information to post-acute providers, it seems likely that the more communication there is prior to discharge, the more likely it is that the transition will go smoothly. In order to help ensure a safe transition, coordinators/liaisons may be present on patient floors in order to talk directly with patients, to obtain more information from discharge planners/case managers, and to meet with families, especially primary caregivers, to help ensure that they understand their role in the provision of home care and hospice services. Consequently, the activities of coordinators/liaisons on patient floors may help to provide optimum transitions to patients from hospital or facility to home, and may help to manage the risks of both hospitals and facilities and post-acute providers.

It is also appropriate for liaisons/coordinators to be on site to visit patients with whom the post-acute provider has an ongoing relationship to help ensure continuity and quality of care. Home health patients whose episodes of care paid for by the Medicare Program do not end while patients are in the hospital or facility
are still admitted to home health agencies and are still patients of the agencies. Hospice patients remain admitted for hospice care even though they are hospitalized. HME suppliers may maintain equipment in patients’ homes throughout their hospitalizations. Coordinators/liaisons can best stay in touch with patients of their organization and their families by visiting them in inpatient facilities. Post-acute providers need to have current knowledge about
the clinical condition of patients, the availability of primary caregivers, the need for additional equipment and supplies, etc. in order to be able to continue to provide appropriate care upon discharge. Providers are legally prohibited from rendering services to patients whose needs they cannot realistically meet.

Coordinators/liaisons may also need to be on patient floors because they receive referrals that do not come from anyone at the hospital. Referrals may come from a variety of sources and may be received either verbally or in writing. Examples of referral sources include, but are not necessarily limited to: discharge planners, hospital
and facility staff members, physicians, patients, and patients’ friends and family members. It is unnecessary for referrals to be received by the Agency in the form of orders from physicians or other practitioners. Post-acute providers may, for example, receive referrals from family members who seek services for patients. So coordinators/liaisons may need to be on patient floors in response to specific requests from family members to begin the process of coordination of post-acute services.

Based upon the above, liaisons/coordinators have legitimate needs to be on patient floors in inpatient settings. While solicitation of patients is impermissible, violations of this prohibition by some post-acute providers should not interfere with the ability of post-acute providers to meet the legitimate needs described above.

© 2011 Elizabeth E.
Hogue, Esq. All rights reserved.

Dates for your Calendar:

Nov. 14 – 18 Home Care Aide Week
Nov. 24 Thanksgiving
November National Home Care and Hospice Month