MTM bill introduced to Senate

[WVUPharm2007]

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Medicare and Medicaid patients with a chronic condition will be able to review all their medications in one-on-one sessions with pharmacists under a bill introduced Tuesday by Sen. Kay Hagan (D-N.C.). The Medication Therapy Management (MTM) Expanded Benefits Act would also reimburse pharmacists to follow up and educate patients about their medication regimen.

 

[rxlea]

Maybe the future isn't so bleak after all?

 

[IrishHammer]

Maybe the future isn't so bleak after all?

You can lead a horse to water, but you can't make them drink. Just because the government is requiring these sessions doesn't mean that retail chains will give up any staffing, or time, or money to do it properly. They'll just say that they "believe in their own way of performing patient counseling" (no bull****, I got told at an interview once that "Our version of MTM is different from what they teach in schools") and throw it on top of the pile of everything else pharmacists are expected to do with not enough time or help.

 

[Its Z]

Hope it passes. I wonder how much it will reimburse?

More reason why this should be done at independent pharmacies following a physician referral. Make it a $20 to $30 per visit and now we got a business.

 

[WVUPharm2007]

Hope it passes. I wonder how much it will reimburse?

More reason why this should be done at independent pharmacies following a physician referral. Make it a $20 to $30 per visit and now we got a business.

If I could get $30 free and clear for a 30 min session...I would consider opening my own shop...seriously...let the wife count by 5s in the pharmacy.

...

If this **** passes and the reimbursement is decent - it will open fantastic new doors for those that are willing to open shop and canvass the local specialists for referrals.

 

[WVUPharm2007]

lmao...Al Franken wrote it.

Here is a good link with good info.

 

[Its Z]

You can lead a horse to water, but you can't make them drink. Just because the government is requiring these sessions doesn't mean that retail chains will give up any staffing, or time, or money to do it properly. They'll just say that they "believe in their own way of performing patient counseling" (no bull****, I got told at an interview once that "Our version of MTM is different from what they teach in schools") and throw it on top of the pile of everything else pharmacists are expected to do with not enough time or help.

I wouldn't quite call this a government required sessions but reimbursable pharmacy services. Pharmacies will have to go out and sell this service to local physicians. Simple sales pitch.. " We will review your patient's medication profile and ensure and educate patient's on compliance and what to monitor to prevent ADR, polypharmacy etc." And make this a routine check up...

After a while, you have a "clinic" with routine patients... this can then turn into Anticoag clinic, HTN, Diabetes clinics etc...

This is an important regulatory step in taking our profession back.

I see a tremendous opportunity in this. If it passes, I will most likely get into retail business which was my original career intention anyways.

 

[WVUPharm2007]

You can lead a horse to water, but you can't make them drink. Just because the government is requiring these sessions doesn't mean that retail chains will give up any staffing, or time, or money to do it properly. They'll just say that they "believe in their own way of performing patient counseling" (no bull****, I got told at an interview once that "Our version of MTM is different from what they teach in schools") and throw it on top of the pile of everything else pharmacists are expected to do with not enough time or help.

If there is a mechanism for making money using only our brains - we will not need those douchebags.

 

[Its Z]

lmao...Al Franken wrote it.

Here is a good link with good info.

I saw that... and I think Ross from Arkansas is ether a pharmacist or has pharmacy interests.

 

[joetrisman]

The name of the bill is Medication Therapy Management Expanded Benefits Act of 2010.

Quick link to write your congressmen:
https://writerep.house.gov/writerep/welcome.shtml

Rxlea, I think I'm more for taking the time to do this one than the other.

 

[IrishHammer]

I wouldn't quite call this a government required sessions but reimbursable pharmacy services. Pharmacies will have to go out and sell this service to local physicians. Simple sales pitch.. " We will review your patient's medication profile and ensure and educate patient's on compliance and what to monitor to prevent ADR, polypharmacy etc." And make this a routine check up...

After a while, you have a "clinic" with routine patients... this can then turn into Anticoag clinic, HTN, Diabetes clinics etc...

This is an important regulatory step in taking our profession back.

I see a tremendous opportunity in this. If it passes, I will most likely get into retail business which was my original career intention anyways.

I get what you're saying, and in that light, that could help pharmacy both by expanding our roles and creating new jobs, but by the same token (and I could be wrong here, please correct me if I am) wasn't immunizing also seen by many as a "reimbursible pharmacy service"?

Regardless, I'm very interested to see how this all plays out.

 

[Its Z]

I think $20 per session at 10 to 15 minutes per session will work well.

There are so much opportunities with this... first thing first...electronic patient profile and record keeping plus e-chart for this purpose would be a great sell.

Marketing material... consultation suite design.. gourmet coffee service...

 

[joetrisman]

I think $20 per session at 10 to 15 minutes per session will work well.

There are so much opportunities with this... first thing first...electronic patient profile and record keeping plus e-chart for this purpose would be a great sell.

Marketing material... consultation suite design.. gourmet coffee service...

I got the coffee covered!!!! 😍

 

[Its Z]

I get what you're saying, and in that light, that could help pharmacy both by expanding our roles and creating new jobs, but by the same token (and I could be wrong here, please correct me if I am) wasn't immunizing also seen by many as a "reimbursible pharmacy service"?

Regardless, I'm very interested to see how this all plays out.

Immunization was a product distribution revenue with a slight procedural fee of administering a shot..which anyone can do.

Only pharmacists can provide MTM which is a fee for "cognitive" service. Night and Day.

 

[Its Z]

I got the coffee covered!!!! 😍

 

[IrishHammer]

Immunization was a product distribution revenue with a slight procedural fee of administering a shot..which anyone can do.

Only pharmacists can provide MTM which is a fee for "cognitive" service. Night and Day.

Gotcha. Thanks for clearing that up.

I think I'm going to keep a close eye on this. I probably don't have the grades to get a residency, which severely hampers my chances at landing a hospital job. I'm not keen on retail, unless it's way out in the sticks, and even then it may only be a matter of time before conditions there go to hell in a handbasket as well. I'm only going to be graduating with about 60K in student loans, so I won't have to worry about selling my soul to pay off a big six figure bill and can look into various pharmacy avenues. Setting up some kind of MTM clinic sounds like a really nice idea.

 

[Its Z]

I would put in an upscale independent pharmacy with 1 to 2 pharmacists...1 doing scripts and the other doing the MTM consults... of course I would expect both pharmacists to be able to do both. I would also hire a marketing rep like Spiriva...and it will help bring the prescription business plus MTM revenue. Own about 5 of these puppies and now you got a business.

 

[Pinser555]

Can we sticky this so please can use the afore mentioned "write to congressmen" to ask for support? Not that were that big of a community but anything is better than nothing.

I'm reminded of the cartoon about bills....

[YOUTUBE]http://www.youtube.com/watch?v=mEJL2Uuv-oQ[/YOUTUBE]

 

[WVUPharm2007]

I wouldn't quite call this a government required sessions but reimbursable pharmacy services. Pharmacies will have to go out and sell this service to local physicians. Simple sales pitch.. " We will review your patient's medication profile and ensure and educate patient's on compliance and what to monitor to prevent ADR, polypharmacy etc." And make this a routine check up...

After a while, you have a "clinic" with routine patients... this can then turn into Anticoag clinic, HTN, Diabetes clinics etc...

This is an important regulatory step in taking our profession back.

I see a tremendous opportunity in this. If it passes, I will most likely get into retail business which was my original career intention anyways.

My first thought - what if that "tech check" thing ever is introduced.

You could counsel MTM in the back and hire a Super Tech to do scripts. The $$$, Z...the $$$...

I just wish I had some seed money. You are very fortunate to have liquid assets right now, man...

...assuming all this goes through...and is good for us...

 

[PharmaTope]

I wouldn't quite call this a government required sessions but reimbursable pharmacy services. Pharmacies will have to go out and sell this service to local physicians. Simple sales pitch.. " We will review your patient's medication profile and ensure and educate patient's on compliance and what to monitor to prevent ADR, polypharmacy etc." And make this a routine check up...

After a while, you have a "clinic" with routine patients... this can then turn into Anticoag clinic, HTN, Diabetes clinics etc...

This is an important regulatory step in taking our profession back.

I see a tremendous opportunity in this. If it passes, I will most likely get into retail business which was my original career intention anyways.

well let me say this, there is one MAJOR problem. you need a PHARMACY to bill for the service. a PHARMACIST cannot bill independently which is the problem. i dont really see MTM being anything that can save pharmacy going forward. that is me personally. people dont want to go see a pharmacist or anyone else unless they HAVE TO. which is why people dont see their doctor until things have gotten REALLY BAD usually. even if it is free, people wont want to wait around and junk.

also

"Currently 12.9 percent of seniors in the Medicare prescription drug program — all of whom have multiple chronic illnesses — are eligible to participate in MTM programs."

you cannot expect to have a sustainable income from something like this. 12.9% of all seniors in medicare nationwide are eligible. so likelihood of you seeing them..... less than likely. couple that with that this isn't a re-occurring billable service when you read the fine print.

 

[p-rog]

I would put in an upscale independent pharmacy

This is for medicare and medicaid patients only, right? I know a couple insurance companies offer reimbursement for MTM but it's hardly profitable for most pharmacies due to the paperwork for documentation. If it's govt run, that aspect of it can't be any better.

Am I missing something?

 

[PharmaTope]

This is for medicare and medicaid patients only, right? I know a couple insurance companies offer reimbursement for MTM but it's hardly profitable for most pharmacies due to the paperwork for documentation. If it's govt run, that aspect of it can't be any better.

Am I missing something?

nope you hit the head on the nail.

 

[joetrisman]

"Currently 12.9 percent of seniors in the Medicare prescription drug program — all of whom have multiple chronic illnesses — are eligible to participate in MTM programs."

you cannot expect to have a sustainable income from something like this. 12.9% of all seniors in medicare nationwide are eligible. so likelihood of you seeing them..... less than likely. couple that with that this isn't a re-occurring billable service when you read the fine print.

That's the hitch, the bill is designed to allow mtm for medicare/medicaid pts that have one chronic illness instead of multiple ones.

According to an article I read:

In 2007, the North Carolina Health and Wellness Trust Fund Commission launched Checkmeds NC to provide MTM services to North Carolina seniors. During the program's first year, more than 15,000 North Carolina seniors and 285 pharmacists participated. The program saved about $10 million.

I'm going to try and dig up some info on how it actually worked out in NC though...

 

[WVUPharm2007]

This is for medicare and medicaid patients only, right? I know a couple insurance companies offer reimbursement for MTM but it's hardly profitable for most pharmacies due to the paperwork for documentation. If it's govt run, that aspect of it can't be any better.

Am I missing something?

There are pharmacists in WV that do diabetes MTM via the gov't insurance (PEIA). It is profitable enough that Rite Aid hires a woman to just do MTM counseling in my hometown.

That's PEIA.

Will they do the same for Medicaid....well...somebody find a copy of the bill.

 

[joetrisman]

There are pharmacists in WV that do diabetes MTM via the gov't insurance (PEIA). It is profitable enough that Rite Aid hires a woman to just do MTM counseling in my hometown.

That's PEIA.

Will they do the same for Medicaid....well...somebody find a copy of the bill.

I looked on the congressional website, franklin's, and hagan's. None of them have it. Looks like the congressional website is a few days behind on their continuity.

 

[WVUPharm2007]

If anybody cares, this is the policy for the one in WV - which is pretty highly regarded. You are reimbursed $80 for the initial visit and $20 for a 15 minute "unit." It's a RPh/patient choice as to whether its 1 or 2 "units" per visit. Anyway, a fully booked RPh gets $80/hr. And PEIA pretty much requires them to go to a pharmacist...it's seriously a pretty sweet program if you can get the clientèle.

 

[bacillus1]

well let me say this, there is one MAJOR problem. you need a PHARMACY to bill for the service. a PHARMACIST cannot bill independently which is the problem. i dont really see MTM being anything that can save pharmacy going forward. that is me personally. people dont want to go see a pharmacist or anyone else unless they HAVE TO. which is why people dont see their doctor until things have gotten REALLY BAD usually. even if it is free, people wont want to wait around and junk.

also

"Currently 12.9 percent of seniors in the Medicare prescription drug program — all of whom have multiple chronic illnesses — are eligible to participate in MTM programs."

you cannot expect to have a sustainable income from something like this. 12.9% of all seniors in medicare nationwide are eligible. so likelihood of you seeing them..... less than likely. couple that with that this isn't a re-occurring billable service when you read the fine print.

CURRENTLY 12.9%. This bill will expand this #.

 

[Its Z]

well let me say this, there is one MAJOR problem. you need a PHARMACY to bill for the service.

Why is that a problem? Set up an Indy.

i dont really see MTM being anything that can save pharmacy going forward. that is me personally.

Good. Less competition for some of us who'd like to participate if this bill passes.

people dont want to go see a pharmacist or anyone else unless they HAVE TO. which is why people dont see their doctor until things have gotten REALLY BAD usually. even if it is free, people wont want to wait around and junk.

That generalization is not true. People don't want to go see dentists..or get invasive procedures done. But people don't mind picking up scripts at a pharmacy and shoot the bull with the druggist.

also

"Currently 12.9 percent of seniors in the Medicare prescription drug program — all of whom have multiple chronic illnesses — are eligible to participate in MTM programs."

Private payers usually follow Medicare/Medicaid trend and pay structure.

you cannot expect to have a sustainable income from something like this. 12.9% of all seniors in medicare nationwide are eligible. so likelihood of you seeing them..... less than likely.

12.9% is actually quite a number. If not sustainable, it will supplement prescription business.

couple that with that this isn't a re-occurring billable service when you read the fine print.

But chronic medication prescriptions are.

 

[Its Z]

This is for medicare and medicaid patients only, right? I know a couple insurance companies offer reimbursement for MTM but it's hardly profitable for most pharmacies due to the paperwork for documentation.

That's what computer programs are for.

If it's govt run, that aspect of it can't be any better.

Care to elaborate?

Am I missing something?

Quite a lot.

 

[p-rog]

That's what computer programs are for.

You know of one that make MTM documentation easier? I'm sure there are ways around this issue (i.e. getting an MA-type staff member to do most of the documentation), but it does seem to be a pretty common hangup from what I hear.

Care to elaborate?

Just alluding to the stereotype of govt red tape and whatnot. I wouldn't ever expect for a gov't run reimbursement system to have less documentation issues than privately run one.

 

[p-rog]

It is profitable enough that Rite Aid hires a woman to just do MTM counseling in my hometown.

Just out of curiosity, this woman is a RPh right?

 

[Its Z]

You know of one that make MTM documentation easier? I'm sure there are ways around this issue (i.e. getting an MA-type staff member to do most of the documentation), but it does seem to be a pretty common hangup from what I hear.

No I don't. But it wouldn't be very difficult to have a programmer write one. And if it's good, I would have an interface to billing program built... Then sell it.

Just alluding to the stereotype of govt red tape and whatnot. I wouldn't ever expect for a gov't run reimbursement system to have less documentation issues than privately run one.

Every entity and provider from small clinics to large mega institutions taking care of Medicare patients do it. So what's the big deal... Something worthwhile is never easy. The ones who overcome difficult tasks succeed.

 

[p-rog]

Well if it all works out and catches on, one thing is sure.... community pharmacy residencies and residents will be happy.

 

[jinga]

This is honestly exciting. There is hope.

Merry Christmas, Charlie Brown!

Honestly, if Z and WVU like it, I like it.

I'll admit I've heard jokes about MTM...

 

[PharmaTope]

Why is that a problem? Set up an Indy.



Good. Less competition for some of us who'd like to participate if this bill passes.



That generalization is not true. People don't want to go see dentists..or get invasive procedures done. But people don't mind picking up scripts at a pharmacy and shoot the bull with the druggist.



Private payers usually follow Medicare/Medicaid trend and pay structure.



12.9% is actually quite a number. If not sustainable, it will supplement prescription business.



But chronic medication prescriptions are.

setting up an independent isnt so simple. there are overhead costs etc. now if you could setup an LLC and get a certification or bill using your pharmacist license number or a billing number then you wouldnt have to worry about counter space with certain dimensions, sink with this and that, all those other bull**** pharmacy regulations.

basically setup an office nad have people come to the office. heck you could even see them in a physician office as well.....

 

[Its Z]

setting up an independent isnt so simple. there are overhead costs etc. now if you could setup an LLC and get a certification or bill using your pharmacist license number or a billing number then you wouldnt have to worry about counter space with certain dimensions, sink with this and that, all those other bull**** pharmacy regulations.

basically setup an office nad have people come to the office. heck you could even see them in a physician office as well.....

I used to own a DME co with an independent closed door retail pharmacy. Setting up the pharmacy was easy.

 

[p-rog]

Take home point: Let Z figure out how to get it all working, then copy his setup verbatim

 

[psychoandy]

Multiple chronic illnesses? 80% of the people I saw admitted/discharged from medicine had the awesome HTN/DM/HL/CAD/COPD combination, +/- HF, AF, CRF, stents, etc.

My thoughts of an ideal scenario would be a pharmacy very close to a major hospital (one without an amcare clinic) where people could theoretically come by after their clinic appts, where you collaborate with residents running the clinics (they're overworked and prob wouldnt mind help from pharmacy), and see more chronically ill pts compared to a normal retail setting.

Of course, this is assuming that the AMA doesnt try and block it because if you think big picture pharmacists would be taking money from their big pot of medicare money that they already have difficulty getting.

 

[Its Z]

Take home point: Let Z figure out how to get it all working, then copy his setup verbatim

If I figure it out, y'all will have to pay me to learn how to do it. I would certainly start an MTM PGY1 residency and you can bet ya it will be done by my residents. ...which means a portion of their salary will be paid by the CMS...

Of course I'd bonus them accordingly.

 

[PumpkinSmasher]

If I figure it out, y'all will have to pay me to learn how to do it. I would certainly start an MTM PGY1 residency and you can bet ya it will be done by my residents. ...which means a portion of their salary will be paid by the CMS...

Of course I'd bonus them accordingly.

Here is a nice upscale version of what the pharmacy could look like...

I just emailed my representative.

 

[WVUPharm2007]

Just out of curiosity, this woman is a RPh right?

Indeedy. She does 0% dispensing. Graduated from Duquesne...no residency...just did it out of graduation.

 

[jinga]

I wouldn't quite call this a government required sessions but reimbursable pharmacy services. Pharmacies will have to go out and sell this service to local physicians. Simple sales pitch.. " We will review your patient's medication profile and ensure and educate patient's on compliance and what to monitor to prevent ADR, polypharmacy etc." And make this a routine check up...

After a while, you have a "clinic" with routine patients... this can then turn into Anticoag clinic, HTN, Diabetes clinics etc...

This is an important regulatory step in taking our profession back.

I see a tremendous opportunity in this. If it passes, I will most likely get into retail business which was my original career intention anyways.

Wonderful. It's encouraging to hear you say this as it's the reason I entered pharmacy as well - as daunting as the prospect might be. I loved working in that warehouse...learned so much.

 

[Sparda29]

 

[Tom Applewood]

Actually, this is not good.

We shouldn't wait for government to be involved, and of course screwing things up and bogging us down with more pointless rules & regs, to implement MTM.

If you want to earn money for counseling patients, for doing MTM, (or vaccinations or any other service) then JUST DO IT. Why do you need to wait for the government to pay you or make some law about it to design and implement a new business and service model in your pharmacy? Really? Why do you need to wait? Are you afraid people won't pay for it? ... well obviously you aren't offering a good service that they want, then, if you're afraid they won't pay for it.

Pharmacy doesn't need to wait for government to help us "take back our profession". We can perfectly well take it back ourselves, if we take our own initiative.

Patients are desperate to talk to someone, anyone, besides doctors and nurses that require stupid amounts of paperwork, long boring waits in the office, and then only 15 minutes with an actual doctor and being limited to "only 1 concern" at a time, and a office visit copay. They will most certainly pay out of pocket, cash, to talk to a pharmacist.

We need to forget about insurance companies and government and work on solving things ourselves.

 

[WVUPharm2007]

Actually, this is not good.

We shouldn't wait for government to be involved, and of course screwing things up and bogging us down with more pointless rules & regs, to implement MTM.

If you want to earn money for counseling patients, for doing MTM, (or vaccinations or any other service) then JUST DO IT. Why do you need to wait for the government to pay you or make some law about it to design and implement a new business and service model in your pharmacy? Really? Why do you need to wait? Are you afraid people won't pay for it? ... well obviously you aren't offering a good service that they want, then, if you're afraid they won't pay for it.

Pharmacy doesn't need to wait for government to help us "take back our profession". We can perfectly well take it back ourselves, if we take our own initiative.

Patients are desperate to talk to someone, anyone, besides doctors and nurses that require stupid amounts of paperwork, long boring waits in the office, and then only 15 minutes with an actual doctor and being limited to "only 1 concern" at a time, and a office visit copay. They will most certainly pay out of pocket, cash, to talk to a pharmacist.

We need to forget about insurance companies and government and work on solving things ourselves.

You pipedreamin' child.

 

[Praziquantel86]

Actually, this is not good.

We shouldn't wait for government to be involved, and of course screwing things up and bogging us down with more pointless rules & regs, to implement MTM.

If you want to earn money for counseling patients, for doing MTM, (or vaccinations or any other service) then JUST DO IT. Why do you need to wait for the government to pay you or make some law about it to design and implement a new business and service model in your pharmacy? Really? Why do you need to wait? Are you afraid people won't pay for it? ... well obviously you aren't offering a good service that they want, then, if you're afraid they won't pay for it.

Pharmacy doesn't need to wait for government to help us "take back our profession". We can perfectly well take it back ourselves, if we take our own initiative.

Patients are desperate to talk to someone, anyone, besides doctors and nurses that require stupid amounts of paperwork, long boring waits in the office, and then only 15 minutes with an actual doctor and being limited to "only 1 concern" at a time, and a office visit copay. They will most certainly pay out of pocket, cash, to talk to a pharmacist.

We need to forget about insurance companies and government and work on solving things ourselves.

You're willing to bet your livelihood on little old ladies paying you out of pocket? Keep in mind, these are the same people who can hardly afford a $3.00 copay for $600 worth of Lipitor...and that's an actual tangible, physical product.

 

[Its Z]

Actually, this is not good.

We shouldn't wait for government to be involved, and of course screwing things up and bogging us down with more pointless rules & regs, to implement MTM.

If you want to earn money for counseling patients, for doing MTM, (or vaccinations or any other service) then JUST DO IT. Why do you need to wait for the government to pay you or make some law about it to design and implement a new business and service model in your pharmacy? Really? Why do you need to wait? Are you afraid people won't pay for it? ... well obviously you aren't offering a good service that they want, then, if you're afraid they won't pay for it.

Pharmacy doesn't need to wait for government to help us "take back our profession". We can perfectly well take it back ourselves, if we take our own initiative.

Patients are desperate to talk to someone, anyone, besides doctors and nurses that require stupid amounts of paperwork, long boring waits in the office, and then only 15 minutes with an actual doctor and being limited to "only 1 concern" at a time, and a office visit copay. They will most certainly pay out of pocket, cash, to talk to a pharmacist.

We need to forget about insurance companies and government and work on solving things ourselves.

Who let a high school kid post????

 

[PharmDstudent]

If you want to earn money for counseling patients, for doing MTM, (or vaccinations or any other service) then JUST DO IT. Why do you need to wait for the government to pay you or make some law about it to design and implement a new business and service model in your pharmacy? Really? Why do you need to wait? Are you afraid people won't pay for it? ... well obviously you aren't offering a good service that they want, then, if you're afraid they won't pay for it.

Patients are desperate to talk to someone, anyone, besides doctors and nurses that require stupid amounts of paperwork, long boring waits in the office, and then only 15 minutes with an actual doctor and being limited to "only 1 concern" at a time, and a office visit copay. They will most certainly pay out of pocket, cash, to talk to a pharmacist.

If something isn't covered by a patient's insurance, then most likely that they won't buy it. I thought that was common knowledge?

 

[UNMorBUST]

Actually, this is not good.

We shouldn't wait for government to be involved, and of course screwing things up and bogging us down with more pointless rules & regs, to implement MTM.

If you want to earn money for counseling patients, for doing MTM, (or vaccinations or any other service) then JUST DO IT. Why do you need to wait for the government to pay you or make some law about it to design and implement a new business and service model in your pharmacy? Really? Why do you need to wait? Are you afraid people won't pay for it? ... well obviously you aren't offering a good service that they want, then, if you're afraid they won't pay for it.

Pharmacy doesn't need to wait for government to help us "take back our profession". We can perfectly well take it back ourselves, if we take our own initiative.

Patients are desperate to talk to someone, anyone, besides doctors and nurses that require stupid amounts of paperwork, long boring waits in the office, and then only 15 minutes with an actual doctor and being limited to "only 1 concern" at a time, and a office visit copay. They will most certainly pay out of pocket, cash, to talk to a pharmacist.

We need to forget about insurance companies and government and work on solving things ourselves.

 

[joetrisman]

I may or may not have posted a link to writing your house rep when the bill is in the senate 😳

Senate rep links:
http://www.senate.gov/general/contact_information/senators_cfm.cfm