Senate Finance Committee members urge Trump administration to address pharmacy DIR fees
As a result of a month long lobbying effort by NCPA and other pharmacy stakeholders this week, 23 members of the Senate Finance Committee sent a letter to HHS Secretary Alex Azar and CMS Administrator Seema Verma urging them to revive proposals to address pharmacy DIR fees that were not finalized in the recent Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses rule. The letter, led by Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.), noted that reforming pharmacy DIR fees “will help preserve beneficiary access to community pharmacies and lower out-of-pocket costs – both of which will improve prescription drug adherence and health outcomes.”
Only five members of the committee declined to join the letter, Sens. Richard Burr (R-N.C.), John Cornyn (R-Texas) Pat Toomey (R-Pa.), Tim Scott (R-S.C.) and Todd Young (R-Ind.). All but Sen. Young also voted against the committee’s drug pricing package in July.
All politics is local during an in-district work period
Over the August recess, 32 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 27 members of Congress, 10 Senate and 17 House offices, as Sen. Ron Wyden (D-Ore.), the ranking member of the Senate Finance Committee, visited six community pharmacies during his travels in the state. The visits over August bring the total to nearly 70 pharmacy visits for 2019. NCPA sincerely thanks all members and who have taken time to graciously host lawmakers and give them a first-hand look at community pharmacy or to otherwise meet with them.
The next congressional in-district work period is scheduled for Sept. 28-Oct. 14 and provides another topportunity to meet with legislators while they are back home. Click here for tips on arranging a pharmacy visit with your legislator or contact Michael Rule at NCPA at michael.rule@ncpanet.org for assistance.
NCPA staff presents on pharmacy DIR panel
In an effort to continue educating congressional staff on pharmacy DIR fees his week, NCPA Director of Congressional Affairs Adam Harbison participated in a panel discussion on pharmacy DIR fees hosted by the Food Marketing Institute. Harbison told the approximately 40 attendees that pharmacy DIR fees have increased 45,000 percent in less than 10 years, raising drug prices and putting many pharmacies out of business. Harbison explained how DIR fees hurt consumers and pharmacies. The briefing allowed staffers to hear directly from both supermarket and community pharmacy businesses who are feeling the firsthand effects of DIR fees. Attendees also heard from congressional staff who are championing the bipartisan Phair Pricing Act of 2019 (H.R. 1034/S.640) to learn how the legislation would benefit both patients and pharmacies. Click here to send a message to your legislators to urge them to cosponsor the Phair Pricing Act.
NCPA submits comments to CMS on patient access
in the Medicaid fee-for-service program
This week, NCPA submitted comments to CMS in response to a proposed rule that would weaken safeguards which currently exist to ensure Medicaid payments in fee-for-service (FFS) systems are sufficient to enlist enough providers to assure beneficiary access to covered care and services consistent with the Medicaid statute. Specifically, CMS proposes to remove a requirement that states develop an access monitoring review plan (“AMRP”) to have procedures in place to monitor continued access after a reduction or restructuring in payment rates. Additionally, CMS proposes removing language requiring states, when proposing to reduce or restructure Medicaid payment rates, to undertake a public process that solicits input on the potential impact of the proposed changes on a patients access to care. NCPA opposes both of these proposed rule changes because of the impact on patient access and the potential reduction in transparency in the Medicaid FFS program.
NCPA comments on pharmacy level measures proposal
NCPA recently submitted comments to the Pharmacy Quality Alliance (PQA) in response to PQA’s proposed standard measure set for pharmacy in value-based models. NCPA has long encouraged PQA to develop pharmacy level measures that are based on pharmacy data, not plan/claims data. NCPA supports PQA working swiftly on a dual track to adapt plan-level measures for use at the pharmacy level for plan year 2021 while also creating pharmacy-level measures for plan years 2022 and beyond.
NCPA updates Texas Pharmacy Association
This week Ronna Hauser, NCPA’s VP of Policy and Government Affairs Operations presented at the Texas Pharmacy Association’s (TPA) council meetings in Austin, discussing federal pharmacy priorities and progress on issues such as direct and indirect remuneration (DIR) fees and pharmacy benefit manager (PBM) legislation. In particular, she explained that the chairman, ranking member, and an overwhelming bipartisan majority of the Senate Finance Committee members have asked the Trump Administration to reform pharmacy DIR.
NCPA gives federal and state legislative update at EPIC meeting
NCPA’s director of state government affairs, Matt Magner spoke to EPIC’s state lobbyists during a meeting which also included presentations from lawmakers, government officials, and other pharmacy stakeholders. NCPA’s presentation included an update on federal and state legislative initiatives addressing PBMs, Medicaid, DIR, reimbursements, and other pharmacy-related issues.
Comments submitted on proposed home health rule
NCPA joined forces with the National Home Infusion Association (NHIA) and multiple other organizations relaying our concerns regarding a CMS proposed home health rule. We have concerns that this policy will impair quality, increase the potential for medication errors and adverse events, and lead to higher rates of emergency department visits and rehospitalizations.
TRICARE Request for Information
NCPA convened a call this week for members servicing TRICARE beneficiaries to discuss a recent TRICARE Request for Information on a Preferred Retail Pharmacy Network. NCPA will be responding to the RFI reiterating our displeasure that TRICARE has not yet moved forward with a pilot program authorized by Congress that would allow community pharmacies to purchase brand name drugs at the same rate that mail order does. Instead TRICARE is collecting information on preferred networks, in which independent pharmacies are routinely blocked from participating. NCPA will relay these and other concerns to TRICARE by the September 19 deadline.
Ways and Means LTC Inquiry
NCPA was one of two LTC pharmacy organizations that recently received a request from the House of Representatives Ways and Means Committee to respond to an inquiry about the use of antipsychotics in nursing homes. NCPA is working with our NCPA LTC Division Members on a response to the inquiry and will be meeting with committee staff on September 23rd.
Republicans win both special elections in North Carolina
This week, Republicans scored a pair of victories in special elections in North Carolina. In the much watched race in the state’s 9th congressional district, conservative state senator Dan Bishop (R) defeated Dan McCready (D) by two points. McCready narrowly lost his bid for the seat in 2018 by 900 votes, however, evidence of election fraud emerged forcing a “do-over” in the race. President Trump carried the district by twelve points in 2016 so the closeness of this race could have ramifications in his campaign for re-election. In the third district which was left vacant by the death of pharmacy champion Walter Jones (R), state representative Greg Murphy (R) defeated former Greenville Mayor Allen Thomas (D), 62 percent to 38 percent. After these races, Democrats now have a 235-199 advantage in the House of Representatives, with one independent.
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.