NCPA Advocacy Update

Week ending Nov. 16

Author: APCI Staff/Monday, November 19, 2018/Categories: Legislative Affairs

NCPA Analysis: Clear Democratic tide
in 2018, but no tidal wave

Previously, NCPA provided a snapshot of the 2018 midterm elections and how some of our pharmacy champions fared on Election Day. This has been supplemented with a more in depth look at the next Congress’ leadership and key committee outlook as well as a state level analysis. You can also see how NCPA PAC supported candidates fared on Nov. 6 by clicking here.

Moreover, with more than 90 new members arriving on Capitol Hill in January, now is the time to start building relationships. If your pharmacy is located in a district with a newly elected member of Congress, invite that official to visit your store. Give them a tour and brief them on the challenges PBM business practices present for your business and your patients. NCPA's Michael Rule (michael.rule@ncpanet.org) is happy to assist you with one pagers and other briefing materials to help you prepare.


Pharmacy ally to chair Sen. Finance Committee
in 116th Congress

Sen. Chuck Grassley (R-Iowa) announced that he plans to trade his Senate Judiciary Committee gavel to lead the Finance Committee next year. The Senate Finance Committee has broad jurisdiction over healthcare, including Medicare and Medicaid. Sen. Grassley has been a longtime champion of community pharmacy issues, and NCPA looks forward to continuing to work with the Senator and his staff to address DIR fees, PBM transparency, provider status, and other important pharmacy issues. Grassley’s move will put Sen. Lindsey Graham (R-S.C.) in line to replace him as Judiciary chairman.


Senior E&C Committee member calls out
unfair PBM practices in speech on House floor

On Friday, Rep. John Shimkus (R-Ill.) delivered a speech on the House floor highlighting the importance of community pharmacies and unfair PBM practices that threaten their ability to take care of patients and operate their businesses. Rep. Shimkus, a senior member of the House Energy and Commerce Committee, said, “A healthy market requires transparency and a level playing field.” Thank you Congressman Shimkus for being a community pharmacy champion. You can watch the full speech here.


NCPA promotes DIR fix in high level hill meetings

Over the past two weeks, NCPA has been meeting with key committee and leadership staff in light of the proposed rule titled "Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out of Pocket Costs (CMS-4180-P)" that is under review at OMB. NCPA has met with the Republican and Democratic staff of the House Energy and Commerce Committee and the Senate Finance Committee, as well as staff for House Republican Leader Kevin McCarthy (R-Calif.) and House Democratic Leader Steny Hoyer (D-Md.). More meetings are in the works as we seek to update these influential policymakers on our DIR efforts and the possibility that this pending rule may include a solution that would benefit patients and community pharmacies.


Trygstad participates in House Science roundtable

CPESN Executive Director Troy Trygstad participated in a House Committee on Science, Space, and Technology roundtable in Washington this week about interdisciplinary research and medical innovation. He shared insights from his more than 15 years of experience with multi-disciplinary care teams and intervention development under alternative payment and support models. Many thanks to community pharmacy champions Reps. Neal Dunn, MD (R-Fla.) and Roger Marshall, MD (R-Kan.) for hosting the discussion and inviting NCPA and CPESN to participate.


NCPA submits comments to the FTC
regarding PBM market power

The Federal Trade Commission (FTC) invited comment from stakeholders after its public hearing on the state and quality of monopsony power in the economy and whether there are specific markets where monopsony power is more prevalent. This week, NCPA submitted comments shedding light on PBMs’ monopsony power (or buyer power), stressing that as buyers in the healthcare market, PBMs purchase pharmacy services via contract and limit the amount of services they buy by restricting their networks. In order to address PBM market dominance, NCPA argued for additional scrutiny of inherent PBM conflicts of interest, fair contract negotiation between PBMs and independent pharmacies, and increased transparency in PBMs’ business practices. NCPA will continue to monitor the FTC hearings process to ensure community pharmacists’ voices are heard.


HHS’ Semiannual Regulatory Agenda Released

Late this week, HHS released its Semiannual Regulatory Agenda, which provides information on the status of HHS rulemakings that are “likely to have a significant economic impact on a substantial number of small entities” and would require financial analysis under the Regulatory Flexibility Act. Notable regulatory actions in the Agenda include a proposed modification to the HIPAA Privacy Rule, which seeks to change the requirement that health care providers make a good faith effort to obtain from individuals a written acknowledgment of receipt of the provider’s notice of privacy practices. A proposed rule from the FDA on medication guides would require a new form of patient labeling, Patient Medication Information, for certain blood products used, dispensed, or administered on an outpatient basis. All of the larger drug pricing proposed rules, including the Medicare drug price transparency proposed rule that NCPA has been following, were not highlighted in the Agenda. The Office of Management and Budget, however, has designated many of these drug pricing proposed rules as “economically significant” to the government. NCPA continues to monitor regulatory activity that has an impact on small business community pharmacies, including those proposed drug pricing rules slated to be released in the upcoming months.


NCPA to host Part D webinar on Nov. 28

On Nov. 28 at 2:00 ET, NCPA will host a fee webinar, 2019 Community Pharmacists Checklist, to review recent regulatory changes to Part D plans that you and your patients should know for contract year 2019. NCPA's policy and regulatory team will also review other regulatory and legislative actions that have happened over the past year that impact the pharmacy space, including the recent passage of gag clause and opioid abuse legislation. Finally, this webinar will review regulatory initiatives on the horizon and what those actions may mean for community pharmacists. Click here to register.


NCPA participates in discussions
on value based best practices

This week NCPA staff attended both the Pharmacy Quality Alliance (PQA) social determinants of health forum and the annual leadership summit. Both meetings focused on bringing together payers and providers and other key partner stakeholders to discuss medication access and quality. Several discussions focused on community pharmacy and value based best practice models. In addition Ronna Hauser NCPA’s VP of pharmacy policy and regulatory affairs attended the PQA 4th quarter Board of Directors meetings where she serves as a member of the board.


NCPA meets with FDA’s Office of External Affairs

This week, NCPA’s advocacy center met with staff from the FDA’s Office of External Affairs. The meeting consisted of a discussion regarding NCPA’s policy priorities and brainstorming on where NCPA and the FDA can collaborate in the near future. NCPA will be following up with the FDA’s staff to help push community pharmacy priorities involving compounding, reimbursement, and PBM transparency.


NAMD discusses prescription drug
transparency in Medicaid

NCPA’s Matt Magner attended the National Association of Medicaid Directors’ annual meeting in Washington, DC, where transparency in the Medicaid prescription drug benefit was discussed. Medicaid officials from New York, Oklahoma, and Ohio discussed those states’ efforts to increase transparency in Medicaid, including Ohio’s recent move to pass-through PBM contracts.


Due to the Thanksgiving holiday, the Advocacy Center Weekly Update will not be sent on Nov. 23 and will resume on Nov. 30.

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.

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