NCPA continues work with Senate Finance Committee
to address pharmacy DIR fees
Senate Finance Committee Chairman Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) made progress on their promise to work on pharmacy DIR fee reform over the August recess. Fifteen members of the committee have signed onto a letter they circulated among committee members that urges the Trump administration to reconsider the DIR rule they failed to finalize earlier this year. The letter has a deadline of September 10 for committee members to sign on. If your Senator is a member of the committee, please contact them and urge them to join their colleagues as signatories.
Additionally, NCPA and its industry allies have continued to engage with committee staff and the Congressional Budget Office, as we continue to work towards a legislative solution that could be added into a final drug pricing package.
Sen. Ron Wyden visits community pharmacies
over August Recess
Over the August Recess, Sen. Ron Wyden (D-Ore.), Ranking member of the Senate Finance Committee, visited six community pharmacies during his travels of the state. NCPA Board Chairman Michele Belcher, owner of Grants Pass Pharmacy in Grants Pass Ore., attended several of these visits where Sen. Wyden heard from pharmacists on the importance of addressing pharmacy DIR fees.
NCPA applies grassroots pressure on Congress
to address pharmacy DIR fees
Over the August recess, NCPA ran a grassroots and social media campaign to increase congressional support for addressing pharmacy DIR fees. The campaign, branded “Dog Days of DIR,” invited pharmacists to submit short videos of themselves addressing their legislators urging their support. These videos can be viewed on NCPA’s YouTube channel and Facebook page. Additionally, several NCPA members submitted letters to the editor that were published. These included letters addressing Senate Finance Committee members Pat Roberts (R-Kan.) and Mark Warner (D-Va.).
August was also an active month for in person meetings as 29 community pharmacies either hosted a member of Congress or their staff for a pharmacy visit or participated in an in-district meeting to discuss pharmacy priorities. These meetings resulted in contacts with 24 members of Congress, 9 Senate and 15 House offices. Community pharmacists also continued to contact their legislators and via email and urge support for the Phair Pricing Act (S.640/H.R. 1034) to address pharmacy DIR fees.
NCPA appreciates all pharmacists who took action in support of this critical issue and will continue to encourage robust grassroots engagement.
Judge approves CVS-Aetna merger
This week, United States District Judge Richard Leon approved the controversial merger between CVS and Aetna. "I have concluded that the proposed settlement is well 'within the reaches' of the public interest and the Government's Motion to Enter the Proposed Final Judgment," wrote Leon in a decision that surprised many court watchers. NCPA raised numerous significant competitive concerns with the Department of Justice and state attorneys general and also submitted comments to Judge Leon last year. While the decision is deeply disappointing, NCPA remains committed to advocating on behalf of independent pharmacies – at the state and federal levels – against the anti-competitive practices of the PBMs. In the meantime, click here to see what NCPA has previously said on the merger.
NCPA member testifies at Small Business Administration
Regulatory Fairness Hearing
In August, NCPA member Brian Hose, owner of Sharpsburg Pharmacy in Sharpsburg, Maryland testified at SBA’s National Small Business Regulatory Enforcement Fairness Hearing in Washington, DC. The hearing was focused on unfair regulatory enforcement, excessive fines, retaliation, and other regulatory burdens imposed on small businesses by federal agencies. Hose testified about the dire impact DIR fees are having on his pharmacy and community pharmacies. Click here to read his statement.
NCPA hosts inaugural pharmacy roundtable meeting
In August, NCPA Senior Director of Political and External Affairs, Eric Lundberg, presented at NCPA’s inaugural pharmacy roundtable meeting in Buffalo, NY. The event was cohosted with NCPA Past President and PAC Chairman Steve Giroux and was a great success Twenty-eight attendees received an overview of the NCPA Advocacy Center, identified how they (students and/or pharmacists) could be involved in advocacy, and then received an update on the NCPA PAC. More local roundtables will be organized around the country in the coming months. Please contact Eric Lundberg at eric.lundberg@ncpanet.org to learn more about the roundtable program and NCPA PAC.
NCPA presents at Southeastern Pharmacy Officers Conference
Last month, NCPA Director of State Government Affairs Matt Magner presented at the Southeastern Pharmacy Officers Conference hosted by the Georgia Pharmacy Association in Atlanta. The presentation covered the status of pharmacy law in southeastern states and new trends in pharmacy/PBM legislation.
NCPA presents webinar to NAIC PBM
Regulatory Issues Subgroup
Throughout the month of August, the National Association of Insurance Commissioners PBM Regulatory Issues Subgroup held information gathering calls as a first step in developing model PBM legislation. NCPA Vice President of Federal and State Government Affairs Anne Cassity and Director of State Government Affairs Matt Magner were invited to present community pharmacy’s view. Their comments focused on how PBM practices drive up costs for payers and threaten patient access to community pharmacies. NCPA will continue working with subgroup members as the model legislation process moves forward.
NCPA submits comments to HHS on patient access
and effective drug enforcement
In August, NCPA submitted comments to HHS’ Office of the Assistant Secretary for Planning and Evaluation regarding a request for information on ways to ensure patient access and effective drug enforcement of controlled substances. NCPA advocated for the need for standardization of federal or state based policies that limit initial and partial fills of opioids across all retail locations. NCPA also advocated for the prohibition of delivering controlled substances to patients via the mail as a policy that could have a positive impact on mitigating or preventing abuse by offering added assurances against diversion.
NCPA supports the adoption of the NCPDP SCRIPT standard
for electronic prior authorization transactions
In August, NCPA submitted comments in support of CMS’ proposed adoption of the NCPDP SCRIPT standard for electronic prior authorization transactions. NCPA further urged CMS to provide enough time for stakeholders to adopt the NCPDP SCRIPT standard, which may extend beyond the January 1, 2021 adoption date in the proposed rule.
NCPA supports small business relief
proposed in ACA regulations
In August, NCPA offered comments to HHS’ Office of Civil Rights (“OCR”) in support of a proposed rule that seeks to provide clarifications and changes regarding section 1557(c) of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. The proposal highlights OCR’s ability to exempt providers with 15 employees from the auxiliary aids and services requirements under the ACA. NCPA urged OCR to act on this discretion to provide the needed flexibility for small business community pharmacies from this requirement. The proposal also seeks to repeal all section 1557 provisions related to taglines, the use of language access plans, and notices of nondiscrimination. NCPA’s comments supported the total repeal of these provisions as well.
NCPA advocates for clarification of and relief from
paperwork retention policy
NCPA submitted comments to a CMS request for information on burdens related to paperwork that are impacting providers from providing needed care to patients in federal programs. NCPA has long advocated that some record retention policies have had an undue burden on small business community pharmacies, including the 10 year medical record retention policy in the Medicare program. To relieve this burden, NCPA requested that CMS clarify via regulation or guidance that the media format by which medical records in Medicare are maintained may be either paper or electronic. NCPA further requested that CMS clarify that the preference for keeping such medical documents in a particular media format is the sole decision of the provider not the plan sponsor.
NCPA and APhA Express <797> Concerns with USP
In August, NCPA along with the American Pharmacists Association issued a formal letter to USP expressing community pharmacy concerns with the overly restrictive beyond use date (BUD) provisions in USP General Chapter <797> that was finalized on June 1st. We expressed support for the overarching principles of the formal appeals that were submitted to USP on behalf of pharmacies. Specifically, we stated that the inflexible BUD provisions will restrict patient access to medically necessary compounded medications as pharmacists will not be permitted to assign or extend BUDs even when direct scientific testing supports an extension. NCPA will continue to discuss these issues with USP on behalf of community pharmacy.
NCPA submits comments to the FDA
on its Oxitriptan (bulks list) guidance
In August, NCPA submitted comments to the FDA in regard to the agencies guidance on Oxitriptan. NCPA noted that stakeholders, such as prescribers and pharmacists, receive inconsistent information regarding what can and cannot be compounded per FDA guidances. In addition, FDA is not clear in how pharmacists should document that the compounded oral Oxitriptan is being used for a patient with BH4 deficiency. NCPA requested FDA to thoroughly evaluate a nominated drug before issuing a decision to exclude it from the 503A bulks list to prevent prescriber and pharmacist confusion.
NCPA LTC advisory council visits
LTC division member pharmacy
Last month NCPA LTC Division member Rick Rondinelli, owner of In Touch Pharmaceuticals in Valparaiso, IN, hosted the NCPA LTC Advisory Council for a live meeting. The meeting included a tour of the pharmacy and discussions surrounding timely NCPA LTC advocacy efforts on the Hill as well as at the state level. Attendees also discussed challenges and opportunities in LTC. Thanks to Rick for hosting this meeting.Learn more about NCPA’s LTC Division at www.ncpaltc.org
In the states:
Illinois Gov. J.B. Pritzker (D) signed HB 465, creating the state’s first comprehensive regulatory framework for PBMs.
New Hampshire Gov. Chris Sununu (R) recently signed SB 226 into law. The bill requires PBMs to register with the insurance commissioner, establishes MAC transparency requirements, and prohibits arbitrary, retroactive reimbursement adjustments.
New Jersey Gov. Phil Murphy (D) signed S 2690, protecting patients from PBM abuses, such as copay clawbacks and “gag” clauses.
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.