NCPA shares pharmacy concerns with HHS Sec. Alex Azar

This week, NCPA CEO Doug Hoey and NCPA Advocacy Center Director Karry La Violette met with Health and Human Services Secretary Alex Azar to talk about a number of issues important to community pharmacists, including the pharmacist’s role as the most accessible health care providers. NCPA appreciates the opportunity to share insights from the front lines and to serve as a resource on the administration’s efforts to lower drug costs and advance pharmacy DIR fee reform, which NCPA took the opportunity to thank Sec. Azar for including in a recent proposed rule.

NCPA responds to HHS’ report that questions value
of any willing pharmacy and network adequacy requirements

This week NCPA responded to a report released by the Departments of Labor, Health and Human Services and Treasury on healthcare competition in America, which stated that any willing pharmacy and network adequacy laws hinder market competition. These points seemingly contradict other parts of the report that highlighted the administration’s dedication to ensuring access to providers in rural and underserved areas. NCPA provided several rebuttal points to support any willing pharmacy and network adequacy standards, including, highlighting that any willing pharmacy enhances competition and patient choice of providers and that network adequacy requirements enhance access in underserved communities. Additionally, NCPA noted that mail order pharmacies, which the report claimed reduce costs, are often a source of prescription waste and actually increase costs.

CVS-Aetna merger judge tells DOJ: Slow down

Last week, Federal Judge Robert Leon scolded DOJ attorneys overseeing the deal for treating his review of the merger as a "rubber stamp," and reportedly told them "You need to slow this down." At a subsequent hearing this week, Judge Leon is reported to have said that he may require the merged firm to hold the CVS and Aetna assets separate until he has more time to consider the settlement," and scheduled another hearing for Dec. 18. The Tunney Act requires the merger to obtain final sign off from a judge. While the judge has raised questions and wants time to thoroughly review the details of the consent decree, most media outlets believe it is highly unlikely Judge Leon will ultimately block the merger. As part of the judicial review process, interested parties have until Dec. 17 to submit their comments on the proposed consent decree between DOJ and CVS-Aetna. NCPA will be submitting comments next week urging the judge to not approve the consent decree due to significant competitive concerns with the transaction that have not been addressed.

CMS to reconsider disapproval
of Washington State’s below-cost dispensing fees

CMS will hold an administrative hearing to reconsider its decision to disapprove Washington Medicaid’s proposed revisions to its pharmacy reimbursement methodology. Under the disapproved methodology, Washington would implement below-cost and lowest-in-the-nation Medicaid pharmacy dispensing fees. NCPA, the Washington State Pharmacy Association, and other pharmacy groups praised CMS’s original decision to disapprove the proposed revisions in September. The reconsideration hearing will be held on January 15, 2019 in Seattle, and more details are available here.

NCPA attends NCOIL conference

This week, NCPA staff members Ronna Hauser, vice president of pharmacy policy and regulatory affairs, and Anne Cassity, vice president of federal and state government affairs, are attending the National Council of Insurance Legislators meeting in Oklahoma City, where there is a strong pharmacy presence among the attendees. In advance of NCOIL’s committee on Health, Long-Term Care & Health Retirement Issues consideration of model PBM regulation legislation on Saturday, Cassity and Hauser have had several positive meetings with committee members. In addition to the meetings, an ERISA panel acknowledged the need for reforms and that states should play a role in regulating health benefits.

NCPA staff attends NCSL Capitol Forum

NCPA state government affairs staff attended the National Conference of State Legislatures annual Capitol Forum this week. Topics addressed during the sessions included rising health care and drug pricing costs, changes affecting the private health insurance market, and different state policy approaches related to opioids and medical marijuana. During the Forum, NCSL’s Insurance Task Force also discussed manufacturer rebates, copay assistance programs, and the federal drug pricing blueprint’s impact on state legislation. NCPA will continue to engage NCSL on topics affecting community pharmacy practice.

NCPA meets with “Main Street” business organizations

This week, Scott Brunner, NCPA’s senior vice president of communications and external affairs, attended a meeting of the Advocates for Independent Business in Chicago. AIB membership is comprised of organizations that represent independent main street retail sectors such as independent book sellers and independent hardware stores. The purpose of the meeting is to discuss common challenges facing independent business owners and ways in which such independent businesses can remain competitive.

NCPA presents at Florida Pharmacy Association’s conference

Last week, Kala Shankle, NCPA director of policy and regulatory affairs, presented on NCPA’s federal regulatory and legislative priorities at the Florida Pharmacy Association’s regulatory conference. Among many topics, the presentation addressed changes made in the 2019 Part D final rule and the pharmacy DIR changes proposed in the administration’s current proposed rule on drug pricing released last week. NCPA staff is available to speak to your local and state pharmacy chapters on both federal and state issues.

NCPA speaks to the FDA
about the future of track and trace

This week, the FDA invited NCPA to a listening session on the current state and future of the Drug Supply Chain Security Act. Christian Tadrus, pharmacy owner and NCPA officer, along with NCPA staff addressed community pharmacy concerns, including upcoming deadlines for dispensers and the need for appropriate solutions in the market to help pharmacies receive and hold transaction data and comply with other requirements under the law. NCPA continues to be engaged in the continuous implementation of the DSCSA through 2023 and beyond.

NCPA joins forces with pharmacy groups
to extend MOU comment deadline

This week, NCPA, along with the American Pharmacists Association and the International Academy of Compounding Pharmacists, urged FDA Commissioner Scott Gottlieb to extend the comment deadline on the FDA’s revised draft memorandum of understanding for interstate pharmacy compounding. The comment deadline is scheduled to close on Monday, Dec. 10, but our organizations asked for a 90-day extension as the pharmacy industry recently became aware of the National Association of Boards of Pharmacy’s intent to submit a revised MOU. The organizations stressed to Gottlieb that an additional 90 days is necessary to give state boards of pharmacy, pharmacy organizations, medical providers, patient groups, and other stakeholders a chance to review the NABP’s revisions and comment accordingly. It was also stated that no states have yet expressed the ability to sign and implement the revised draft MOU, according to NABP’s recent informal poll and the recent survey our three organizations conducted. NCPA will continue to actively engage in the compounding space to ensure the pharmacist’s role is maximized and protected.

Save the date:
NCPA 2019 Congressional Pharmacy Fly-In April 10-11

Successful advocacy is built on relationships. You'll build – and build on – those important relationships at the 2019 NCPA Congressional Pharmacy Fly-In. The format is simple and perfect for a busy owner/pharmacist: Fly in, get briefed, go to Capitol Hill, share your story with members of Congress, fly home. It couldn't be easier – or more effective. So, save the date – April 10-11. We'll see you there!

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.