NCPA Advocacy Update

Week ending May 9

Author: APCI Staff/Monday, May 13, 2019/Categories: Legislative Affairs

Rep. Buddy Carter leads House floor discussion

on PBM transparency

This week, community pharmacy champion Rep. Buddy Carter (R-Ga.) led a Special Order on the House floor to show support for the Administration’s efforts to take on the PBM’s in the two proposed DIR and rebate rules. He was joined in the effort by Reps. Rick Allen (R-Ga.), Neal Dunn, MD (R-Fla.), Roger Marshall, MD (R-Kan.), and Austin Scott (R-Ga.). NCPA is thankful to Rep. Carter for his leadership in organizing the special order and to our other pharmacy champions that joined with him to speak in support of these proposed rules and the benefits they would have for patients and pharmacies.


E&C Health Subcommittee examines the drug supply chain

and high cost of prescriptions

On Thursday, the House Energy and Commerce Subcommittee on Health held a hearing to examine high prescription drug prices. In the first panel, lawmakers heard from pharmaceutical companies Pfizer, Amgen and Exelixis and pharmacy benefit managers (PBMs) Express Scripts and Navitus Health Solutions. In the second panel, representatives from Blue Cross Blue Shield of North Carolina, Walgreens, the American Medical Association, and AARP rounded out witnesses from the drug supply chain. Rep. John Shimkus (R-Ill.) highlighted the importance of community pharmacies in serving rural patients like those in his home state of Illinois and how the current drug pricing model and PBMs threaten these pharmacies. Members also discussed the problems posed by DIR fees and vertical integration in the supply chain. NCPA especially appreciates Reps. Morgan Griffith (R-Va.), Peter Welch (D-Vt.), and Buddy Carter (R-Ga.) for their continued support of proposed rulemaking to reform DIR fees. Subcommittee Chairwoman Anna Eshoo (D-Calif.) summarized the hearing and sent a warning to non-transparent players in the supply chain that the committee intends to “follow the money and restore sanity.”


First-in-the-nation anti-steering bills

signed into law in Georgia

This week, Georgia governor Brian Kemp signed two PBM anti-steering bills into law. HB 233 is a bill that prohibits pharmacies from profiting off of prescriptions “steered” from their PBM and insurance affiliates, and HB 323 restricts PBM and insurer patient “steering,” strengthens anti-mandatory mail order, adds additional audit protections, prohibits PBMs from knowingly misleading patients, and restricts mining of patient data. Shout out to the Georgia Pharmacy Association and all the Georgia pharmacists who worked hard to get these bills over the finish line. NCPA’s official statement on this development is available here.


Texas House passes reimbursement floor

for prescriptions in Medicaid managed care

Last week, Texas HB 3388, a Medicaid managed care reform bill, passed the Texas House of Representatives. The legislation would require a fee for service or NADAC reimbursement floor plus a professional fee for prescriptions dispensed through Texas' MMC program. NCPA has worked with its local partners to support the measure, which would bring greater transparency and uniformity in establishing true drug costs for the Medicaid system. If the bill passes the state senate, Texas would join Iowa, Kansas, Mississippi, Louisiana, North Carolina, and Arkansas (recently passed) in requiring a Medicaid FFS reimbursement floor for prescriptions dispensed through MMC.


HHS requires manufacturers to disclose list prices

in direct to consumer advertising

This week, CMS finalized a proposal requiring drug manufacturers to publish the wholesale acquisition cost, or list price, for any medication featured in direct-to-consumer television advertisements. The final rule only applies to prescription medications covered by Medicare or Medicaid that have a price equal to or greater than $35 for a month's supply or the usual course of therapy. These ads may appear as early as this summer. More information is available here.


Memorial Day Congressional recess is fast approaching,

invite your legislator for a visit

The Memorial Day in-district work period is only two weeks away. Congress will be away from Washington from May 24-June 23. Schedules are coming together so if you have not done so, extend an invitation to your legislator to visit your pharmacy during this week or to schedule a group meeting with multiple community pharmacists with legislators and discuss priority issues. These carry extra value if your legislator is new to Congress so you can familiarize them with community pharmacy and our issues or if they are a member of the Energy and Commerce or Ways and Means health subcommittees, the starting points for much of community pharmacy’s legislation in the House.

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.


Iowa auditor says state will audit PBMs

Iowa State Auditor Rob Sand announced last week that his office plans to audit the PBMs that serve Iowa's Medicaid managed care program. Iowa joins Pennsylvania, Ohio, Kentucky, and other states that have investigated the practices of PBMs operating in their Medicaid programs. Iowa State Rep. John Forbes (D), who is also a pharmacist, has been instrumental in bringing attention to the state Medicaid program.


NCPA, along with APhA and NACDS, ask FDA

to reconsider its naming convention for biosimilars

Under FDA’s nonbinding draft guidance titled Nonproprietary Naming of Biological Products (“Naming Guidance”), newly approved innovator biological and biosimilar products will be given a “proper name.” The proper name comprises a “core name” that is shared by the innovator biological and any reference biosimilars, plus a distinguishing, random four-letter suffix, giving each product a unique nonproprietary name. In our joint comments, APhA, NACDS, and NCPA, raised concerns that this Naming Guidance will undermine prescriber and patient confidence in biosimilar products due to its inconsistency with already existing naming conventions. We also asserted that the naming convention is not improving pharmacovigilance as intended, as FDA’s own Adverse Events Reporting System indicates that a suffix is rarely reported. Lastly, our organizations commented on FDA’s consideration to remove vaccines from the naming convention, stating that currently available identification systems associated with the administration of vaccines sufficiently ensure safe dispensing practices.


NCPA secures favorable vote at NCPDP

This week, NCPA representatives participated in NCPDP’s quarterly work group meeting. The purpose of this meeting was, in part, to approve codes that would be used in billing transactions. Of particular note, NCPDP is anticipating codes to operationalize a world without rebates should the proposed rule to amend the safe harbor to assess all rebates at this point of sale finalized. These codes were successfully approved despite specific objection from some in the PBM community. Overall, community pharmacy representation at this meeting was critical to ensure implementation could occur starting Jan. 1, 2020.


Louisiana Senate passes PBM reform legislation

Louisiana SB 41, a PBM reform bill that requires PBM licensure, strengthens and expands current MAC laws, and prohibits spread pricing by PBMs without prior notice to the insurer, passed the state Senate this week and is headed to the House.


NCPA presents at NPSC Meeting

This week, Karry La Violette, NCPA Advocacy Center Director and Senior Vice President of Government Affairs, presented at the Northeast Pharmacy Services Corporation 2019 EXPO in Springfield, MA. La Violette provided an advocacy update on NCPA federal and state advocacy priorities highlighting NCPA’s efforts to address pharmacy DIR fees and Medicaid managed care pharmacy payment reforms.


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 report. Bills that have moved this week are listed at the top in the “Recently Updated” section.


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.

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