Congressional Pharmacy Fly-in
hotel deadline quickly approaching
The hotel deadline for NCPA’s Congressional Pharmacy Fly-in is just over a week away (March 18). If you have not yet registered, don’t miss out on the opportunity to take advantage of the special NCPA rate, while rooms are available. Two pharmacy champions, Reps. Doug Collins (R-Ga.) and Peter Welch (D-Vt.) have confirmed their participation at the Congressional Pharmacy Fly-in. This is also an opportunity to make your voice heard in meetings with your legislators or their key staff members. 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 interests must be represented! Your voice carries additional weight and your attendance is even more critical if you are represented by a member of the Energy and Commerce or Ways and Means health subcommittees, which have jurisdiction over most pharmacy legislation. 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. If you’ve already registered, don’t forget to schedule your hill visits. Visit NCPA’s Legislative Action Center to look up the contact information for your legislators. Contact Michael Rule at michael.rule@ncpanet.org if you have any questions.
House Judiciary Committee investigates impact
of consolidation in health care markets
On Thursday, the House Judiciary Subcommittee on Antitrust, Commercial and Administrative Law held a hearing titled, “Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets.” Ranking Member Doug Collins (R-Ga.) criticized PBMs for failing to lower drug costs as they claim to do. Collins said, "These companies have consolidated horizontally as well as vertically... and they have merged vertically with major pharmacies and health insurers. That means patients' insurers have financial incentives to push the patient toward their pharmacies." He further stated that PBMs “are going full throttle, trying to kill independent pharmacies in our communities. They offer little more than anecdotal evidence they'll save you money." Describing their anticompetitive tactics, Collins exclaimed, “It harms community pharmacists who have to decide between losing money when filling a prescription, or losing customers to big box pharmacies owned by PBMs." NCPA thanks Rep. Collins for his strong comments and for being a fierce community pharmacy champion. Additionally, NCPA submitted a statement for the record for the hearing laying out a detailed case on why consolidation in the PBM and healthcare industry, including the CVS-Aetna merger, has increased costs for patients and harmed community pharmacies.
PBM practices, importance of community pharmacists
discussed at Ways and Means health hearing
On Thursday, the House Ways & Means Subcommittee on Health held a hearing titled, “Promoting Competition to Lower Medicare Drug Prices.” This was the second Ways & Means hearing this year on the cost of prescription drugs. In the hearing, Rep. Mike Thompson (D-Calif.) stated, “I know that PBMs imposing direct and indirect remuneration fees has really hurt my rural folks, and I suspect it is having the same impact in other underserved areas.” In response, one of the witnesses, Robin Feldman, Director of the Institute for Innovation Law, UC Hastings School of Law, said, "In many cases, independent pharmacists are the best friend a patient can have in this process, and they are being mercilessly squeezed by the PBMs." Additionally, Rep. Terri Sewell (D-Ala.) discussed how she seeks out the input of rural pharmacists in her district on how they as providers help patients access and adhere to their medications.
NCPA Advocacy Center staff discuss key policy priorities
Senior members of NCPA’s Advocacy Center staff have recently presented on NCPA policy priorities. Karry LaViolette, Senior Vice President of Government Affairs and Director of the Advocacy Center, presented at NCPA’s 2019 Multiple Locations Conference. LaViolette discussed recent wins and upcoming challenges for community pharmacy as well as how the current landscape and climate will impact NCPA’s priorities.
NCPA’s Senior Vice President of Communications and External Affairs, Scott Brunner also made a similar presentation to Currus in Kansas last week. While Ronna Hauser, Vice President of Pharmacy Policy and Regulatory Affairs has spoken to both the Arkansas and Tennessee Pharmacists Associations in recent weeks.
In each case, presenters discussed NCPA’s federal and state priorities, particularly NCPA’s “wildly important goal” of changing the pharmacy payment model in Medicaid as well as our top federal priority, pharmacy DIR fees.
Make sure your data is included
in the retail/specialty cost of dispense survey
If you have not yet done so, please complete the retail/specialty cost of dispensing survey. Your responses 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. While, the survey is likely to take a few hours to complete and possibly more, depending on the information system and number of pharmacies, the data you provide is immensely important. 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.
NCPA comments on CMS’ Draft Call Letter for 2020
Last Friday, NCPA submitted comments to CMS’ Draft Call Letter for Medicare Part D plans operating in contract year 2020. Of note, NCPA advocated for pharmacies to be measured by pharmacy specific quality metrics in lieu of the current STAR measures developed for health plans. NCPA also highlighted the need for CMS to ensure that administrative fees (such as “network access fees,” “administrative fees,” “technical fees,” or “service fees”) are included in a Part D plan’s bid and are not retroactively charged to pharmacies at a later date. These comments mirror NCPA’s recent comments to CMS’ proposal to change the retroactive application of pharmacy DIR proposed earlier this year. Finally, NCPA supported CMS’ proposals for plans to improve access to opioid-reversal agents, medication-assisted treatment, and Part D vaccines, while providing input on necessary guardrails to implement a voluntary Part D Mail Order Auto-Ship program. The Final Call Letter is expected to be released in early April. NCPA’s comments are available here.
2019 Pharmacy Checklist
NCPA has provided this checklist to assist community pharmacists understand the various federal legislative and regulatory changes that have occurred over the past year. Further, this checklist outlines important dates that community pharmacists should be aware of for 2019. Should community pharmacists have questions regarding this checklist, please reach out to the Policy and Regulatory team in NCPA’s Advocacy Center: https://www.ncpanet.org/advocacy.
NCPA nominates Troy Trygstad for MedPAC Commissioner
Today NCPA nominated Troy Trygstad Pharm.D., PhD, M.B.A. to be considered for a commissioner spot on the Medicare Payment Advisory Committee (MedPAC). NCPA is pleased to recommend Dr. Trygstad for appointment based on his credentials and ability to make significant and valuable contributions as a MedPAC commissioner on behalf of community pharmacies. Selected MedPAC commissioners are expected to be announced later this spring.
NCPA summarizes recent EPA final rule
on disposal of hazardous waste pharmaceuticals
On February 22, 2019, the EPA finalized its rule regarding management standards for hazardous waste pharmaceuticals, which goes into effect on August 21, 2019. The final rule outlines what kinds of products are considered solid waste and thus, would be subject to EPA’s streamlined regulations in the final rule. The final rule also requires healthcare facilities (including pharmacies) to determine what are hazardous or non-hazardous waste pharmaceuticals and whether this waste is potentially creditable or non-creditable at their pharmacy prior to sending the pharmaceutical to a reverse distributor. NCPA has prepared this summary to outline the major portions of the final rule that are important to community pharmacies. NCPA urges you to review the rule for any specific requirements that may be applicable to your pharmacy and NCPA recommends that you discuss upcoming changes that may occur at your pharmacy with your reverse distributors before August 21, 2019.
NCPA attends March MACPAC Meeting
NCPA staff attended the March MACPAC meeting. The Medicaid and CHIP Payment and Access Commission is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid. Of particular interest, was an overview of the proposed rule affecting safe harbors for prescription drug rebates, and its potential impact on state Medicaid programs.
NCPA state legislative activity update
NCPA tracks state legislation related to our top three state priorities: Medicaid managed care payment reform, scope of practice and compensation for services, and PBM reform and regulation. Click the links to view a report of bills that have been introduced so far this session specifically dealing with these three issue areas. You can access the individual bill language and basic information on the bill by clicking on the bill numbers in the attached reports.
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.