West Virginia Medicaid saves $54.4 million
with prescription drug carve-out

When the West Virginia Medicaid agency started managing the Medicaid managed care prescription drug benefit directly in July 2017, state officials were relying on an actuarial study forecasting a $30 million savings for the state. This week, the West Virginia Bureau for Medical Services released a report showing actual savings of $54.4 million to the state Medicaid program for the first year of that carve-out. The report also notes that in addition to the savings, the prescription drug benefit carve-out resulted in $122 million paid to West Virginia pharmacies in the form of fixed dispensing fees. Those funds could be used for other state priorities like roads, education, and law enforcement to better serve the state's taxpayers. In response. NCPA CEO Douglas Hoey stated “As public policy goes, this is an extraordinary success: Taxpayers save $54 million. The West Virginia economy gets an infusion of $122 million – money that had formerly gone to out-of-state pharmacy benefit managers. Citizens of West Virginia get greater access to care, and pharmacies get reimbursed a fair rate.” West Virginia should serve as a case study for other states looking into Medicaid managed care reform on how to bring transparency, accountability, and fair reimbursements to the Medicaid system.

Congressional Pharmacy Fly-in:
Hotel deadline March 18

The hotel deadline for NCPA’s Congressional Pharmacy Fly-in is only 3 days 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.

Hoey stresses lower costs, transparency
as part of Sen. Scott health care working group

On Wednesday, NCPA CEO Douglas Hoey participated in a Health Care Working Group convened by Sen. Rick Scott (R-Fla.). NCPA was one of several players in the drug supply chain invited to participate, including other pharmacies, insurers, PBMs, manufacturers, and other health care stakeholders, as well as additional senators. Hoey shared community pharmacy priorities for lowering drug costs and improving transparency. He also stressed that the top regulatory policy with the potential to lower drug costs would be CMS's proposed rule to reform pharmacy DIR fees. NCPA thanks Sen. Scott for the invitation, and we look forward to working with him and other members of Congress on a permanent legislative solution on drug pricing and transparency.

Sec. Azar presented with pharmacy DIR questions
in Senate and House hearings

This week, HHS Secretary Alex Azar was on Capitol Hill testifying about President Trump’s FY2020 budget. On Tuesday, he was before the House Energy and Commerce Committee where two pharmacy champions discussed pharmacy DIR fee reform with the Secretary. Rep. Morgan Griffith (R-Va.) commented that DIR fees are an “inequitable” situation and expressed his appreciation to the Secretary for the proposed rule that would address these fees. Rep. Buddy Carter (R-Ga.) also weighed in with his support stating that “DIR fees are atrocious.” In a subsequent hearing with the Senate Finance Committee, Sen. James Lankford (R-Okla.) also expressed support for the proposed rule and noted that "DIR fees and that retroactive clawback process that has been so painful for independent pharmacies around the country… especially in rural areas." Sen. Lankford reminded Sec. Azar of his questioning on the same topic at an Appropriations Committee hearing last year and how the Secretary committed to an HHS Inspector General investigation on the impact of pharmacy DIR fees to community pharmacies. Secretary Azar said he expected that investigation is close to wrapping up and the results would be released.

E&C Health Subcommittee examines various approaches
to reduce drug costs

On Wednesday, the House Energy and Commerce Health Subcommittee held a legislative hearing on drug pricing. The Subcommittee examined 7 bills to reduce barriers to competition through Food and Drug Administration (FDA) reforms addressing: generic drug exclusivity, REMS abuses, patent settlements, and patent listing. Subcommittee Chairwoman Anna Eshoo (D-Calif.) emphasized brand and generic manufacturers have abused the patent system to stop competition and expressed optimism the Committee can bring costs down while preserving innovation. Democratic and Republican Members acknowledged the complex issues addressed by the bills and the need to balance access with incentives for cures. Democratic Members generally supported the legislation, while numerous Republican Members raised concerns about unintended consequences, such as excessive litigation, arising from provisions in the legislation.

NCPA joins effort to suspend
the Health Insurance Tax for 2020 and 2021

This week, NCPA signed onto a letter led by the Stop the HIT Coalition urging Congressional leadership to take action to suspend the health insurance tax for 2020 by passing S. 172/H.R. 1398, which are bipartisan bills that would suspend the HIT through 2021. The letter was signed by 24 organizations representing small business interests.

NCPA meets with ONDCP to discuss opioid reform

This week, NCPA’s Advocacy Center and Innovation Center met with Mr. Kemp Chester, Associate Director of the White House Office of National Drug Control Policy (ONDCP) and the Chief of its National Opioids and Synthetics Coordination Group (NOSCG). NCPA commended the office for releasing the National Drug Control Strategy, which establishes a comprehensive approach to drug abuse prevention, treatment, and reducing the availability of illicit drugs. NCPA expressed an interest in collaborating with ONDCP to help curb the opioid epidemic by advancing the pharmacist’s role in treatment and prevention of opioid use. For example, NCPA shared ways community pharmacists can further participate in Medication Assisted Treatment (MAT) and help facilitate a wider distribution of naloxone. Further, NCPA pointed to an increased opportunity for collaboration between the Drug Enforcement Agency (DEA) and community pharmacists with any expansion of DEA Take-Back Days. NCPA will continue to engage with the ONDCP to help stem the tide of the opioid crisis.

NCPA submits PCAC nominations

This week, NCPA nominated the following three compounding pharmacists to serve as nonvoting representatives on FDA’s Pharmacy Compounding Advisory Committee (PCAC):

• Rich Moon of Pharmacy Innovations
• Gus Bassani of PCCA
• Matt Martin of PCCA

Selected members will serve a four-year term beginning Nov. 1. NCPA also submitted a letter of interest to participate in the selection process.

NCPA presents at HDA Distribution Management Conference

This week, Ronna Hauser, NCPA Vice President of Pharmacy Policy and Regulatory Affairs, presented at the Health Distribution Alliance (HDA) Distribution Management Conference about NCPA’s involvement in the Allied Against Opioid Abuse (AAOA) initiative. The conference is attended by representatives of manufacturers, distributors and others in the pharmaceutical supply chain.

NCPA attends NCOIL spring meeting

This week, Anne Cassity, NCPA Vice President of Federal and State Government Affairs, attended the National Council of Insurance Legislators (NCOIL) spring meeting in Nashville. One of the health committee agenda items is consideration of a resolution in support of amending ERISA to allow state policymakers to enact more meaningful healthcare reform.

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 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 here to access 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.