Invite your legislator for a visit

during the in-district work period

Members of Congress are in the middle of a two week in-district work period until April 28. This is an excellent opportunity to invite legislators to visit your pharmacy or to schedule a group meeting with multiple community pharmacists with legislators and discuss priority issues.

Pharmacy visits and face-to-face meetings are tremendously effective ways to communicate with legislators and to establish yourself as a resource to them as issues arise. Visit NCPA’s pharmacy visits webpage or contact Michael Rule at michael.rule@ncpanet.org for tips on arranging a visit with your legislator.

The next in-district work period is scheduled for May 25-June 2.

Thanks to our NCPA PAC Telethon callers

We’re grateful to the following NCPA leaders, who donated their time recently as callers in our annual NCPA PAC Telethon. Together, they raised more than $111,000 for the PAC. Thank you to: Steve Giroux, Middleport, NY; Nasir Mahmood, Pine Plains, NY; Cole Sandlin, Hamilton, AL; Dared Price, Winfield, KS; Ed Horton, Stephenville, TX; Carter High, Rhome, TX; Jonathan Marquess, Acworth, GA; Matt Savoie, Pensacola, FL; Mike Kim, Washington, DC; AJ Bhatt, Kannapolis, NC; Audra Conwell, Austin, TX; Ben McNabb, Eastland, TX; Cathy Hudek, Spokane, WA; Christian Tadrus, Moberly, MO; Hashim Zaibek, Milwuakee, WI; Kristen Riddle, Conway, AR; Leighton Thumm, Henrico, VA; Marci Stovall, Denver, CO; Mark Riley, Little Rock, AR; Matt Lester, San Antonio, TX; Megan Baker, Nine Mile Falls, WA; Nate Rockers, Paola, KS; Troy Simons, Perry, OK; Lea Wolsoncroft, Hoover, AL

Administration tightens federal regulators’

use of guidance documents

On behalf of the White House, Office of Management and Budget (OMB) acting Director Russell Vought issued a memo last week directing federal agencies to submit nonbinding guidance documents to OMB for review, which would add another layer of review for rules that could have a large impact on the economy. The memo allows Congress to reject these guidances and subjects them to the same scrutiny as federal regulations. It also calls on federal agencies to regularly notify the Office of Information and Regulatory Affairs (OIRA) of any upcoming guidances. Any guidance that OIRA deems “major” would be sent to Congress, which would have the ability to strike it down under the Congressional Review Act (CRA). Acting Director Vought asserted that the CRA applies to more than just formal notice-and-comment rules; it covers guidance documents, general statements of policy, and interpretive rules. This memo furthers the administration’s effort to regulate agency documents that don’t go through the formal notice-and-comment process but are still used to control industry behavior. The memo takes effect in 30 days.

PHIT Collaborative releases March 2019 report

and issues guidances

Last week, the Pharmacy Health Information Technology Collaborative issued its report on March accomplishments. The PHIT Collaborative also issued two guidance documents for pharmacies. The Guidance for Use of Transitional Care and Chronic Care Management CPT Codes is intended to assist to assist pharmacists who contribute to care that may be billed under two sets of team-based Current Procedural Terminology^® (CPT) codes. The Health IT System Requirements for Pharmacists to Document Chronic Care Management Services document provides guidance to pharmacists regarding the value of working with their pharmacy management system vendors.

NCPA presents at Michigan Pharmacy Association meeting

This week NCPA staffer Kala Shankle spoke at the Michigan Pharmacists Association’s Law and Policy Symposium. The presentation focused on impending dates for community pharmacists to know under the Drug Supply Chain Security Act (aka the track and trace law) and NCPA’s work related to PBM regulation at the state and federal level. Of particular note, the presentation emphasized that after Nov. 27, 2019, wholesalers can only accept pharmaceutical product that has a DSCSA compliant product identifier. This is important for community pharmacists to know because it may impact saleable returns and inventory management at the pharmacy level.

NCPA meets with Department of Defense on TRICARE

This week NCPA staff met with leadership of the Defense Health Agency of the U.S. Department of Defense to discuss a pilot project allowing community pharmacies to purchase brand-name medications at the same price that Express Scripts and military treatment facilities are able to purchase the medications in the TRICARE program. Other attendees at the meeting included NACDS, PhRMA, and Express Scripts. NCPA will continue to fight for our members and for a level playing field in the TRICARE pharmacy program.

State roundup

Arkansas SB 520 was signed by the governor this week. The new law includes the following provisions:

• Prohibits spread pricing.
• Prohibits DIR fees, GERs, and BERs and other aggregate level take it or leave it “clawback” terms from PBMs and health plans that create unfair market conditions and dangerous patient care environments.
• Sets a payment floor (state government health plans AND commercial plans) for ingredient cost payment to pharmacies that is not less than NADAC or WAC (when no NADAC exists).
• REQUIRES quarterly rebate reporting by PBM to the Arkansas Insurance Department of all rebates and ALL payments from pharmaceutical manufacturers (drug companies) to Pharmacy Benefit Managers, health plans, and pass through to community pharmacies. This data should increase transparency and lead to better rate reviews and policies for the state.
• Closes loopholes on the definition of Maximum Allowable Cost, to include all drugs and all payment methodologies.
• Clarifies in law that Managed Care Medicaid programs and PBMs are regulated by these statutes (and previous PBM licensure laws) and enforceable by the Arkansas Insurance Department.

Illinois HB 465, a PBM registration and reform bill, passed the House this week and is now in the Senate.

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.