HHS Sec. Azar visits Chateau Pharmacy in Louisiana
This week, HHS Secretary Alex Azar visited NCPA member pharmacy Chateau Drugs and Gifts in Metairie, La., where he touted the administration's continuing work to lower prescription drug costs. Chateau's owners Kerry and Diane Milano were there, along with a number of other community pharmacists from the area, John O’Brien Azar’s senior advisor for Drug Pricing reform, Ronna Hauser, PharmD NCPA’s pharmacy policy VP and representatives with the Louisiana Independent Pharmacy Association (LIPA). Meeting attendees thanked Sec. Azar for the administration’s recent proposal that would eliminate retroactive pharmacy DIR fees and urged him to move swiftly to finalize it. This was Azar's second official visit to a community pharmacy in four months.
Twenty-nine Senators voice support
for eliminating retroactive pharmacy DIR fees
Last week, 29 senators sent a letter to HHS Secretary Alex Azar, thanking him for the proposal to account for pharmacy DIR fees in the negotiated price and urged the administration to swiftly finalize it. NCPA and NACDS helped shepherd the letter, which states: "We believe the policy outlined in the proposed rule would provide the needed relief from the dire impact pharmacy DIR fees have had on patients' out-of-pocket costs and community pharmacies." NCPA appreciates the leadership of Sens. Shelley Moore Capito (R-W.Va.) and Jon Tester (D-Mont.) for leading the letter, and thanks each senator who signed on. If you are represented by one of the signatories, click here to send them a message thanking them for their support.
Rep. Doug Collins reintroduces pair of PBM bills
This week, pharmacy champion, Rep. Doug Collins (R-Ga.) reintroduced a pair of bipartisan PBM bills addressing NCPA legislative priorities. The Prescription Drug Price Transparency Act (H.R. 1035), introduced along with Rep. David Loebsack (D-Iowa), and 15 additional bipartisan cosponsors, would require PBMs to update their maximum allowable cost lists at least every seven days and disclose their sources on information in determining MAC prices. The Phair Pricing Act (H.R. 1034), introduced with Rep. Vicente Gonzalez (D-Texas), and nine additional cosponsors, would require all pharmacy price concessions in Medicare Part D, excluding positive contingent amounts, to be applied at point of sale. The bill also requires all Part D sponsors to utilize CMS-established quality measures that are standardized and pharmacy-specific. Collins is also scheduled to speak at the 2019 NCPA Congressional Pharmacy Fly-in, April 10-11.
HHS proposed rebate rule a step
towards changing the pharmacy payment model
Changing the pharmacy payment model is a top priority for NCPA, and HHS’ Proposed Rebate Rule released last week is an important component of changing that model. In short, the Proposed Rebate Rule seeks to exclude rebates paid by manufacturers to plans under Medicare Part D and Medicaid MCOs from the discount safe harbor and creates a new safe harbor for point-of-sale price reductions from manufacturers to plans. NCPA has prepared this summary of the Proposed Rebate Rule to aid community pharmacists in understanding the implications of the proposal. Accompanying the summary, NCPA has prepared several questions that are important for the independent community pharmacy industry to answer. NCPA needs your help. Please submit answers to these questions by March 1, 2019 to NCPA’s Policy and Regulatory team at ronna.hauser@ncpanet.org.
Register now to attend 2019 Congressional Pharmacy Fly-in
NCPA’s Congressional Pharmacy Fly-in is two months away, but there’s no reason not to register now to take advantage of the opportunity to meet with your members of Congress, or their staff. With a bipartisan desire in Congress to tackle the high cost of prescription drugs and pro-pharmacy legislation addressing issues such as DIR pending in Congress, your voice needs to be heard! Plus, you can earn up to 3.5 hours of CE credit at briefings on a range of issues, including DIR fees and potential changes to Medicaid. Registration is open, so don’t delay, register now online or by calling 1-800-544-7447.
Don’t forget to complete cost-of-dispensing survey
Your responses to this survey will assist in estimating costs of dispensing nationally and in each state. These estimates will then be used to inform policy questions related to reimbursing costs of dispensing across the US. It’s your opportunity to provide information on costs of dispensing and underlying factors, for consideration by Medicaid agencies and other payers. Findings from prior surveys have been used by Medicaid agencies to determine their cost of dispensing rates. The survey is likely to take a few hours to complete and possibly more, depending on the information system and number of pharmacies. You may complete the survey by paper, online, or through a spreadsheet for multiple pharmacies at once. To complete the survey online, please access the survey here.
New issue brief highlights potential cost savings
through reforming Medicaid Managed Care
NCPA had created a new issue brief (attached) highlighting different variations of Medicaid Managed Care (MMC) reform. Additionally, the 1-pager includes states who have implemented specific reforms and studies highlighting potential savings. Some of the reforms could result in potential cost savings to states. Reforming the pharmacy payment model in MMC is one of NCPA’s top priorities, and the issue brief addresses three possible solutions. Each solution would increase transparency and potentially save states tens of millions of dollars. The brief will be helpful in demonstrating these facts to state legislators and policymakers.
NCPA asks for appropriate reimbursement
for home infusion services
NCPA signed onto a joint letter with the National Home Infusion Association (“NHIA”) and other stakeholders to express appreciation for Congress’ bipartisan, bicameral action in passing the home infusion services payment structure in section 50401 of the Bipartisan Budget Act of 2018 and section 5012 of the 21st Century Cures Act of 2016. However, we expressed concern with the Centers for Medicare and Medicare Services (CMS) CY 2019 Home Health Rule, as CMS implements the law in a way that runs counter to Congress’ directive and could impair Medicare beneficiaries’ access to home infusion services. Specifically, the final rule limits infusion therapy reimbursement only to days when a nurse or other health-care professional is at the patient’s residence. The letter noted that this ruling is directly contrary to Congress’ intent to provide meaningful coverage and reimbursement for each infusion day during which intravenous and subcutaneous medications are administered in the home setting and called on Congress to enact legislation that would reverse CMS’ ruling and require CMS to implement the transitional payment as Congress originally intended.
NCPA meets with NAIC
NCPA’s state government affairs team met with staff from the National Association of Insurance Commissioners (NAIC) to discuss how NCPA can be a resource for NAIC’s members. Inspired by the model PBM legislation recently passed by National Council of Insurance Legislators (NCOIL), NAIC will be looking to develop model PBM legislation of its own and plans to create a subcommittee to address PBM issues.
New York State Ways and Means Committee Hearing
on the Executive Budget
New York Governor Andrew Cuomo (D) included a prohibition on spread pricing in his executive budget. Additionally, he included licensure requirements for PBMs operating in the State of New York. Debi Barber, President of the Pharmacists Society of the State of New York (PSSNY), testified in support of the executive budget. Additionally, she asked the members of the Ways and Means Committee to consider enacting a fee-for-service floor reimbursement in the Medicaid managed care program.
NCPA submits comments
to State Medical Board of Ohio
This week, NCPA submitted comments to the State Medical Board of Ohio on proposed rules that would regulate physician-pharmacist consult agreements. NCPA found several sections of the proposed rules to be overly burdensome or in direct contradiction to the intent of the legislation authorizing consult agreements, and we suggested several edits to amend the rules before they are finalized.
NCPA provides written testimony
to Florida Board of Pharmacy
NCPA’s state government affairs team provided written testimony to the Florida Board of Pharmacy this week supporting the Florida Pharmacy Association’s petition that the Board revisit a recent finalized rule regarding direct supervision of pharmacy technicians.
NCPA submits comments
to Texas State Board of Pharmacy
This week, NCPA submitted comments to the Texas State Board of Pharmacy regarding a proposed rule that would add several definitions to sections on sterile and nonsterile compounding. The comments focused on the proposed definitions for “easily substitutable dosage strength” and “essentially a copy of a commercially available product.”
NCPA weekly state legislative update
Click on the following links to view weekly state legislative updates for two of NCPA’s top state priorities: Medicaid managed care payment, comprehensive PBM regulation and pharmacist scope of practice/compensation for services. To see the full bill text, please click on the bill number in the report.
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.