Congressional midterm election results
Unlike 2016, the results of the 2018 Congressional midterms were unsurprising. Most pundits predicted a “split decision” in that the Democrats would assume control of the House in the 116th Congress while Republicans would retain control of the Senate, and that is what voters delivered. With a return to divided government, questions remain as to what can be accomplished over the next two years legislatively, with infrastructure and prescription drug pricing being mentioned by some pundits as areas that may draw bipartisan support. Beyond legislation, Democrats in the House have promised rigorous oversight investigations of the administration. While in the Senate, Republicans are likely to use their strengthened majority to expedite confirmations of judicial nominees and Executive branch appointees.
While nearly 90% of the candidates supported by the NCPA PAC were successful, the news wasn't as good for those locked in tight races. Washington State was a bright spot for House candidates as voters re-elected a pair of pharmacy supporters who were in close contests, sending Reps. Jaime Herrera Beutler (R-Wash.) and Cathy McMorris Rodgers (R-Wash.) back to Congress. However, several other House pharmacy champions were not so fortunate. Reps. Mike Coffman (R-Colo.), Rod Blum (R-Iowa), David Young (R-Iowa), Pete Sessions (R-Texas), and Barbara Comstock (R-Va.) lost their re-election campaigns while Rep. Bruce Poliquin's (R-Maine) race is too close to call with no candidate receiving 50 percent of the vote. The race will be decided under the state's ranked-choice system where voters list their candidates in order of preference and that process could take a week or more to complete.
In the Senate, the news for pharmacy champions was a little brighter. Sens. Sherrod Brown (D-Ohio), Joe Manchin (D-W.Va.), and Jon Tester (D-Mont.) all won competitive Senate races. There is a race in Mississippi headed to a runoff: pharmacy supporter Sen. Cindy Hyde Smith (R-Miss.) will face Democrat Mike Espy on Nov. 27 to fill the remainder of the term of former Sen. Thad Cochran (R), who retired earlier this year. Smith was appointed by the governor to fill the seat in the interim. The other U.S. Senator from Mississippi, Roger Wicker (R), won his reelection bid.
Along with Congressional elections, voters cast ballots in more than 30 gubernatorial races and in thousands of state legislative contests nationwide. As with the federal results, results at the state level were also mixed. Democrats picked up at least a net of six governor’s seats, including two in important rust belt states, and were able win control of a net 5 legislative chambers. Republicans on the other hand, appear to have prevailed in the gubernatorial races in the states of Florida, Georgia and Ohio and retained their majorities in key state legislatures.
NCPA will have a more detailed analyses of the results in the coming days.
Mini-telethon raises funds for NCPA PAC
This week, several NCPA members arrived at NCPA HQ to raise funds for the NCPA PAC. A special thanks to volunteers Hugh Chancy, Danny Cottrell, AJ Bhatt, Ron Fitzwater, Theresa Tolle, Nasir Mahmood, John Beckner, and Justin Wilson whose mini-telethon efforts raised more than $57,000 for the NCPA PAC from their fellow NCPA members. These are funds that will be used to elect candidates who will fight for community pharmacy owners and be their voice in Congress. If you are an NCPA member who has not invested in the PAC, click here for information on why you should consider doing so.
NCPA participates in ERISA webinar for NCOIL legislators
NCPA participated in an ERISA educational webinar for the National Council of Insurance Legislators (NCOIL) on November 9, 2018. Robert Smith, a partner with Katten Muchin Rosenman law firm, was a panelist on behalf of NCPA and community pharmacy. The purpose of the webinar was to educate state insurance legislators from across the country on ERISA. Smith spoke to actions states could take to regulate PBMs without triggering an ERISA preemption. Smith is also one of the lead attorneys representing the State of North Dakota in a lawsuit challenging North Dakota’s law regulating PBMS. Smith was joined by R.B. Drennan, a professor at Temple University and a neutral third party, and Stephanie Kanwit on behalf of PCMA.
CMS Proposes Medicaid Managed Care Regulatory Changes
Late this week, CMS released a proposed rule that seeks to relax certain federal requirements for Medicaid managed care programs. Of note, the proposed rule seeks to replace the requirement for states to establish time and distance standards with a more flexible requirement that states establish quantitative network adequacy standards. In 2016, NCPA advocated for state network adequacy standards to include robust access to community pharmacies, a requirement that ultimately was included in the final rule on Medicaid managed care. NCPA will be filing comments on this proposed rule in coordination with NCPA’s continuous work at the state level to revamp Medicaid managed care programs and highlight abuses that have hurt community pharmacies. Comments on the proposed rule are due in January.
CMS finalizes revisions
to the DMEPOS Competitive Bidding Program
Last week, CMS finalized a rule that updated the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP). CMS highlights several changes to the program, including: (1) establishing “lead item bidding,” in which suppliers only need to submit one bid per product category; (2) applying the single payment amounts for items in each product category to the lead item in the category; (3) increasing DMEPOS fee schedule rates; and (4) establishing a “temporary gap period” in the DMEPOS CBP and National Mail Order CBP from January 1, 2019 until new contracts are awarded under the DMEPOS CBP. CMS expects the temporary gap period to be in place until December 31, 2020; during this time, “Medicare beneficiaries will continue to receive DMEPOS items from any Medicare-enrolled DMEPOS supplier and in most cases, they won’t need to switch suppliers.” These regulations are effective January 1, 2019. As it applies to community pharmacists, non-mail order diabetic testing supplies are still excluded from the CBP.
NCPA submits comments
to the CDC/Office of the Surgeon General
On Monday, NCPA submitted comments to the Centers for Disease Control and Prevention (CDC), the lead agency to support the Office of the Surgeon General, which published a Call to Action. The Surgeon General’s document titled “Community Health and Prosperity” requested recommendations and data about how investing in communities can improve health and prosperity. NCPA advocated for the community pharmacist’s role in advancing public health through services they provide, such as medication adherence, chronic disease management, and immunization clinics. NCPA urged the Surgeon General to explicitly recognize pharmacists in their final report and to utilize CPESN and Pharmacist eCare Plan services in their effort to enhance community health.
NCPA staff shares DIR expertise
at American Society for Pharmacy Law conference
This week Kala Shankle, NCPA Director of Policy and Regulatory Affairs, and Jenifer Mallon, NCPA’s General Counsel, spoke at the American Society for Pharmacy Law on DIR fees. The presentation outlined the history of DIR fees, the types of DIR fees, as well as the implications of these fees on community pharmacists. NCPA’s subject matter expertise on DIR fees and other issues concerning community pharmacy continue to be a driving force behind NCPA’s advocacy efforts.
NCPA participates at pharmacy tech education meeting
NCPA staff attended the ASHP-ACPE Stakeholder Advisory Committee on Uniform Standards for Pharmacy Technician Education last week. The meeting was organized to ask stakeholders to identify how to foster a requirement for standards-based pharmacy technician education. NCPA has taken a conservative approach to this issue weighing whether standards-based education prepares technicians better for work in community pharmacy, particularly pharmacies that belong to a clinically integrated network such as CPESN USA against the likelihood of higher wages to recruit graduates of an accredited education program and/or workforce shortage. The outcome of the meeting is that a resolution will be prepared for the NABP District 4 meeting to update a footnote in Article III, Section 307 of the NABP Model Act to reflect that ASHP-ACPE have published standards; it could move forward to the NABP annual meeting in May 2019. At this time the changes will not explicitly model a requirement for education program accreditation, but individual states can, and do, require accreditation.
NCPA’s Advocacy Center Update provides a weekly detailed summary of recent and breaking legislative, regulatory, and state developments impacting independent community pharmacy and NCPA’s efforts to affect policies benefitting its membership and the industry. The weekly update is distributed to NCPA leadership, steering committees, allied organizations/stakeholders and major contributors to the NCPA LDF and PAC.