NCPA Congressional Pharmacy Fly-in
is less than 2 weeks away

NCPA’s Congressional Pharmacy Fly-in is less than 2 weeks away (April 10-11) and more of the programming is being finalized. If you have not yet registered, don’t miss out on the opportunity to hear from a recently confirmed VIP speaker (more information will be forthcoming) and two pharmacy champions, Reps. Doug Collins (R-Ga.) and Peter Welch (D-Vt.) who have both 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. Advance registration closes at midnight on Tuesday April 2, so don’t delay, register now online or by calling 1-800-544-7447, otherwise you will need to register on site. If you’ve already registered, don’t forget to schedule your hill visits. Due to the revised schedule, we suggest requesting house visits for after 1:00 on April 10 and Senate visits for April 11. Go to 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.

Note: For those who will be arriving for the fly-in early, NCPA PAC will be hosting a breakfast fundraiser for Sen. Joni Ernst (R-Iowa) on Tuesday, April 9 at 7:15am at the Alexandria Hilton, and we cordially invite you to attend. Click here to see the invitation for more information.

Minimum requirements necessary
to support HHS’ proposed rebate rule

NCPA has talked to stakeholders and analyzed the implications of a proposed HHS rule for community pharmacies, including but not limited to potential legal, commercial, financial, and regulatory impacts. NCPA has also been working closely with industry veterans and consultants to prepare NCPA's comments, which will serve as an important voice for community pharmacies' role in a world without rebates, and has created a document listing what we believe are the minimum requirements for NCPA to support the proposed rule. NCPA also has sample comments available which can be submitted through NCPA’s grassroots portal outlining the seven minimum requirements. The comment deadline is April 8.

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. The extended deadline to complete is Tuesday, April 9.

5 PBMs to testify before Senate Finance Committee on April 9

The Senate Finance Committee invited representatives from five PBMs to testify before the committee on April 9. The hearing will focus on prescription drug pricing and the PBM industry. Those testifying are representatives for Humana, CVS, Cigna, OptumRx and Prime Therapeutics. The committee previously heard from executives representing manufacturers on this subject in February. NCPA is working with several offices of committee members to submit questions for the record. If your Senator is a member of the Finance Committee, call them and thank them for having the hearing and urge that they ask the PBMs tough questions about pharmacy DIR and other PBM practices that increase patient costs.

House subcommittee to investigate insulin price increases

House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.) and Oversight and Investigations Subcommittee Chairwoman Diana DeGette (D-Colo.) announced the Subcommittee will hold a hearing on rising insulin costs on April 2, 2019 at 10:30 a.m. “The skyrocketing cost of insulin is a direct threat to the health and financial wellbeing of the millions of Americans living with diabetes,” Pallone and DeGette said. “Next week’s hearing will be an important opportunity to hear directly from stakeholders including patient advocates on the challenges of insulin affordability and the financial and health consequences on patients’ lives.” The hearing is the first of two planned on insulin prices in April.

Bipartisan legislation addresses FDA overreach
related to compounding

This week, Reps. Morgan Griffith (R-Va.) and Henry Cuellar (D-Texas) introduced H.R. 1959 The Preserving Patient Access to Compounded Medications Act, which seeks to address FDA overreach in regard to compounding. Specifically, the bill would authorize office use compounding by 503A pharmacies; define the terms “distribute” and “dispense” consistent with the NABP model pharmacy act; and require FDA to go through formal rulemaking procedures rather than creating policies under DQSA via guidance documents. NCPA appreciates the work of Reps. Griffith and Cuellar to ensure patients maintain access to compounded medications.

Leadership and staff changes at FDA

Earlier this month, FDA Commissioner Scott Gottlieb announced he was resigning his post effective April 5, 2019. Subsequently, HHS. Sec. Alex Azar announced that Dr. Ned Sharpless, an official who runs the government's cancer research arm, would head the FDA on an interim basis. Last week, another official at FDA, Julie Dohm, who heads up the agency’s work on compounding announced she was also leaving the FDA effective March 29, 2019.

NCPA staff provides legislative and regulatory updates
at pharmacy meetings

This week Kala Shankle, NCPA’s Director of Policy and Regulatory Affairs, spoke at the Missouri Pharmacy Association’s Legislative Day in Jefferson City, MO. The presentation focused on current federal policy issues impacting community pharmacies, including the President’s push to lower drug pricing and NCPA’s initiatives to address pharmacy DIR. Later in the week, Ms. Shankle gave a federal and state advocacy update for community pharmacy at ComputerRx’s Pharmacy System Conference in St. Louis, MO. The presentation focused on current legislative priorities and regulations impacting the practice of community pharmacy and discussed wins, challenges, and unknowns that have a significant impact on small business community pharmacies.

NCPA supports Indiana bills

NCPA provided letters of support to the Indiana General Assembly for HB 1180 and HB 1246. Proposed amendments to those bills would require PBM licensure, establish network adequacy standards, and require annual reports from PBMs to the insurance commissioner. The language mirrors provisions from the National Council of Insurance Legislators (NCOIL) model PBM act, which was heavily influenced by NCPA and other pharmacy advocacy groups.

NCPA supports three bills in Maryland

NCPA provided letters of support to the Maryland General Assembly for a trio of bills establishing PBM regulations. HB 589 would increase transparency in the state’s Medicaid managed care program by requiring the Maryland Medical Assistance Program to audit the state’s PBMs; HB 754 would expand MAC appeal protections to all forms of reimbursement methods; and HB 759 would limit PBM conflicts of interest by prohibiting a PBM from requiring a beneficiary to use a pharmacy in which the PBM has an ownership interest.

NCPA supports New Mexico PBM reform bills

NCPA provided a letter of support to New Mexico’s Office of the Governor this week for SB 394, relating to pharmacy audits, and SB 415, related to reimbursement transparency. NCPA provided clarification and additional information regarding concerns from the governor’s office related to certain provisions in the two bills.

NCPA submits comments to Virginia Board of Pharmacy
on technician training

This week, NCPA submitted comments to the Virginia Board of Pharmacy on an agenda item related to pharmacy technician education and training. NCPA expressed concerns related to the potential bill language under consideration by the Board for the 2020 legislative session which would require all technician training programs approved by the Board to be accredited by ASHP/ACPE.

Georgia Pharmacy Association priority bills pass Senate

Georgia HB 323 and HB 233 both passed the Senate this week. HB 323, which includes PBM reporting requirements and additional patient protections, and HB 233, which addresses patient steering to pharmacies by prohibiting pharmacies owned by PBM affiliates from obtaining patient information for non-patient care purposes and from receiving self-dealing referrals, are both priority bills for the Georgia Pharmacy Association. Both bills have been sent back to the House for agreement on amendments made in the Senate before being sent to the governor.

PBMs face new regulations in Montana

Independent pharmacists in Montana are cheering last week's passage of SB 83, a bill to establish allowable and prohibited practices for PBMs. The bill was sponsored by Republican Sen. Steve Fitzpatrick and easily passed both the House and Senate. Read the entire bill here. Montana joins Arkansas, Georgia, New Mexico, North Carolina, South Carolina, Texas, and Virginia in limiting the retroactive take-back of fees once the claim has been adjudicated. The new Montana law:

• Places limits on adjudication and performance-based fees charged by PBMs.
• Prohibits gag clauses and copay clawbacks.
• Prohibits a PBM from requiring pharmacy accreditation standards that exceed federal and state requirements.

NCPA staff attend APhA and NASPA meetings

NCPA staff attended the APhA Annual Meeting and Exposition and the NASPA Spring Meeting in Seattle, WA over the weekend. Staff members engaged in discussions around state provider status and pharmacist scope of practice, pharmacists’ role in combatting the opioid epidemic, and innovations emerging in community pharmacies. NCPA also participated in the APhA House of Delegates.

NCPA state legislative activity update

Click the links to view a report of bills that have been introduced so far this session specifically dealing with NCPA’s top three state priorities: Medicaid managed care payment reform, scope of practice and compensation for services, and PBM reform and regulation. 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.