Senate Finance Committee advances
bipartisan drug pricing legislation
This week, the Senate Finance Committee voted 19-9 to send the Prescription Drug Pricing Reduction Act, an overhaul of Medicare and Medicaid drug payments, to the chamber's floor, advancing a long-awaited bipartisan effort. The Congressional Budget Office estimated that the proposal would save taxpayers $100 billion over 10 years through both Medicare and Medicaid changes.
The bill, as amended, includes a provision which requires HHS to establish a standardized pharmacy quality metrics program for DIR in Part D. A fix on retroactive pharmacy DIR fees was not included in the initial package. However, Sen. Sherrod Brown (D-Ohio) introduced an amendment along with Sens. Bill Cassidy (R-La.), James Lankford (R-Okla.), Tom Carper (D-Del.), Maggie Hassan (D-N.H.), and Steve Daines (R-Mont.), which would have provided for a 5 year freeze to retroactive pharmacy DIR fees. This amendment was withdrawn after both Chairman Charles Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) made strong commitments to address pharmacy DIR during the legislative process. Both Senators cited the problems posed by these clawbacks for community pharmacies, especially in rural areas. The Chairman further added that the Administration “threw a curveball” by not finalizing a proposed rule to ensure rebates are passed to seniors at the pharmacy counter and that this would also be something they seek to address. Other provisions in the bill included positive language regarding public disclosure of PBM data and prohibiting all Medicaid spread. Click here to see a summary for more information on the contents of the bill. The mark-up was just the first step in the process, and NCPA will continue to work with our Senate champions, along with Chairman Grassley and Ranking Member Wyden to advocate for a DIR fix before this package comes to the Senate floor after the August recess.
NCPA runs print ads in major publications
This week, an advance of the Senate Finance Committee mark-up, NCPA ran full page print ads in the Washington Post and the Wall Street Journal, urging policymakers to rein in pharmacy benefit managers to help lower drug costs. These ads complement NCPA's ongoing efforts in its years-long campaign to reform pharmacy direct and indirect remuneration (DIR) fees.
Rep. Vicente Gonzalez supports Phair Pricing Act
in testimony to Energy and Commerce Committee
This week, the House Energy and Commerce Committee held its “Member Day” hearing. The hearing was on issues within the Committee’s jurisdiction in the 116th Congress and provided an opportunity for all members of the House of Representatives to highlight specific legislation or issues of importance to them, their constituents, and districts. Community pharmacy champion, Rep. Vicente Gonzalez (D-Texas) testified before the committee to advocate for passage of H.R. 1034, the Phair Pricing Act. This NCPA endorsed legislation would require pharmacy-negotiated price concessions, or pharmacy DIR fees, to be included in negotiated prices at the point-of-sale under part D of the Medicare program. Rep. Gonzalez highlighted how these fees are forcing community pharmacies to close and how they contribute to forcing seniors more quickly into the donut hole. Committee member Rep. Buddy Carter (R-Ga.) was in attendance to echo Rep. Gonzalez’s comments on the need for Congress to pass pharmacy DIR reform and to share a statement from the bill’s other sponsor, Rep Doug Collins (R-Ga.) who could not be in attendance. Health Subcommittee Chairwoman Anna Eshoo (D-Calif.) highlighted the committee’s work on pharmacy DIR fees so far this Congress, expressed concern about what the PBMs were doing with these increasing fees, and said the committee will continue working with Reps. Gonzalez, Carter, Collins, Welch (D-Vt.), Griffith (R-Va.), and others to address this matter. NCPA thanks all of these pharmacy champions for their commitment to fixing pharmacy DIR fees to protect the sustainability of community pharmacies and lower drug costs for seniors.
Congress’ August Recess starts today
The House of Representatives adjourned for its August recess today, the Senate is expected to follow next week, and is not expected to return to Washington until September 9. Many legislators will be looking for opportunities to connect with constituents, so why not invite them to visit your pharmacy or 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.
Senate delays consideration of Lower Health Care Costs Act
This week, Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander (R-Tenn.) announced that the Senate would not consider the Lower Health Care Costs Act, legislation to address surprise medical billing, prescription drug costs, health care transparency and other initiatives, prior to the August congressional recess. This bill includes NCPA supported legislation to bring more transparency to PBM practices and review their consolidation and anticompetitive tactics. Chairman Alexander said there is not enough time to complete consideration of the bill on the floor before the Senate leaves for the August recess next week.
NCPA Advocacy Center staff present at wholesaler shows
NCPA Advocacy Center staff recently presented at meetings of Cardinal, AmeriSourceBergen and Smith Drug highlighting the important advocacy efforts NCPA is engaged in on behalf of our members. Topics covered included federal legislation on prescription drug pricing, state activity, and resources to become a stronger advocate for independent community pharmacy. NCPA appreciates the partnerships with these organizations.
Medicaid Managed Care transparency legislation
passes Massachusetts legislature
The Massachusetts General Court passed H.4000, which increases Medicaid managed care transparency. Under the bill, PBMs must disclose information regarding income and reimbursements, and the secretary of health and human services must investigate and develop a report regarding methods for increasing transparency on pharmacy services provided by PBMs in the managed care program. The bill is now awaits action by Gov. Charlie Baker (R).
Help NCPA tell your story by completing
the Annual Census Survey
NCPA’s Annual Census Survey is now open. This is your chance to be part of the bigger story to enable NCPA to communicate to legislators, regulators, the media, and patients the important role independent pharmacies play in their communities. All we need is 8-9 minutes of your time. There are no financial questions, and you can take the census on your mobile phone, tablet, or desktop computer. Your input helps NCPA compile critical statistics about the state of community pharmacy today and tell the larger story about the extraordinary difference you make. The information collected in this year's census will be compiled in the NCPA Digest, sponsored by Cardinal Health, which will be released at the NCPA Annual Convention, Oct. 26-29, in San Diego.
USP <800> Assessment of Risk Template now available
NCPA has developed a blank USP <800> risk assessment template, and a sample template for testosterone, to help you create your own risk assessments for each hazardous drug as required by USP <800>. USP General Chapter <800>'s implementation date is coming up on Dec. 1, 2019. Under USP <800>, certain hazardous drugs on the NIOSH list must follow the chapter’s containment requirements unless an assessment of risk is performed and implemented. USP defines an assessment of risk as an “evaluation of risk to determine alternative containment strategies and/or work practices.” The assessment of risk of these hazardous drugs must be documented every 12 months. The assessment of risk must, at a minimum, consider the following: type of hazardous drug (e.g., antineoplastic, non-antineoplastic, reproductive risk primarily; dosage form; risk of exposure; packaging; and manipulation). If an assessment of risk approach is taken, the entity must document what alternative containment strategies and/or work practices are being employed for specific dosage forms to minimize occupational exposure.
Access the USP 800 Risk Assessment Templates here.
NCPA state legislative activity update
NCPA tracks state legislation related to our top three state priorities: Medicaid reform, scope of practice and compensation for services, and PBM reform and regulation. Linked below are reports 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 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.