Help NCPA tell your story on pharmacy DIR fees
NCPA has developed a short survey to get better insights on how pharmacy owners are dealing with some important challenges, including changes in the marketplace and DIR fees. If you are a pharmacy owner, please take a few minutes to complete this survey to give us a better sense of your priorities and concerns. The survey results will help us provide Congress, the White House, the media, and the public a clear sense of what you think on the most important issues facing your businesses. The survey closes at noon ET, Monday, Oct. 14.
Ways and Means Committee announces drug pricing hearing
This week, House Ways and Means Committee Chairman Richard Neal (D-Mass.) announced that the committee will hold a hearing entitled “Investing in the U.S. Health system by lowering drug prices, reducing out of pocket costs, and improving Medicare benefits” on Thursday, Oct. 17. This will be the final hearing by the three House committees of jurisdiction before they begin marking up Speaker Nancy Pelosi’s (D-Calif.) drug pricing legislation, H.R. 3, the Lower Drug Costs Now Act.
NCPA member hosts fundraiser for Ranking Member of Energy and Commerce Health Subcommittee
Last weekend, NCPA member Kelly Selby, owner of Community Pharmacy in Denton, TX, hosted dozens of pharmacists and pharmacy allies at a fundraiser in his home for Rep. Michael Burgess (R-Texas). Burgess serves as the Ranking Member of the Energy and Commerce Health Subcommittee and the event, which was attended by NCPA staff, allowed area pharmacists to express their concerns and to hear directly from the Congressman on the political landscape in Washington regarding drug pricing legislation, including a fix to pharmacy DIR fees. NCPA encourages members to host similar events. For more information, contact Eric Lundberg at eric.lundberg@ncpanet.org.
CA Gov. Gavin Newsom signs bill granting pharmacists prescriptive authority for HIV prevention meds
California Governor Gavin Newsom recently signed SB 159 into law. This bill increases access to life saving drugs by authorizing pharmacists to furnish pre-and post-exposure prophylaxis (PrEP and PEP) without a physician’s prescription pending conditions. Additionally, this new law:
- Expands Medi-Cal schedule of benefits to include PrEP and PEP as pharmacist services.
- Allows pharmacists to be reimbursed for their services, as well as dispense the potentially lifesaving medication
- Allows pharmacists to determine if the patient meets the clinical criteria for PrEP or PEP consistent with federal guidelines.
Congratulations to the California Pharmacists Association which worked very hard on this bill which could serve as a model for other states.
NCPA creates pharmacist resources for Medicare Open Enrollment
The annual Medicare open enrollment period begins on Oct. 15 and runs until Dec. 7, and NCPA has created resources to help pharmacists and patients navigate the upcoming plan year. The first document is a quick reference guide for pharmacists to use with their patients that explains, among other things, the thresholds for various benefit phases in Part D. The second document is a fact sheet prepared specifically for pharmacists to understand the 2020 Part D landscape, including information on whether certain Part D plans include independent pharmacies in their preferred networks. There is also a bag stuffer available for pharmacists to use that helps patients and caregivers navigate the open enrollment period.
Trump administration clarifies scope of federal agency guidances and enforcement actions
This week, the Trump Administration issued the following Executive Orders (EO): Promoting the Rule of Law Through Improved Agency Guidance Documents and Promoting the Rule of Law Through Transparency and Fairness in Civil Administrative Enforcement and Adjudication. The first EO recognizes that agencies inappropriately use non-binding guidance documents to regulate the public without following proper rulemaking procedures. This EO explicitly requires that agencies treat guidance documents as non-binding both in law and in practice, except as incorporated into a contract, take public input into account when appropriate in formulating guidance documents, and make guidance documents readily available to the public. The second EO prohibits agencies from enforcing regulations they have not been made public in advance to avoid unfair surprise. NCPA will continue to monitor the Administration’s efforts to ensure agencies are following proper procedures when issuing guidances affecting community pharmacy. This is especially important in regards to FDA issues such as compounding.
HHS proposes changes to Stark and AKS
This week, the Department of Health and Human Services released proposed rules to modernize and clarify the regulations that interpret thePhysician Self-Referral Law (Stark Law) and the Federal Anti-Kickback Statute (AKS). Through these proposals, HHS aims to provide greater certainty for healthcare providers and professionals in participating in value-based arrangements to provide coordinated care for patients
In particular, CMS proposes new exceptions to the Stark Law for certain value-based compensation arrangements among physicians, providers, and suppliers. Further, the Office of Inspector General proposes changes to AKS and the Civil Monetary Penalties Law by adding new safe harbors to offer flexibility for innovation and coordinated care that are enhanced in outcome-based payment arrangements. NCPA is analyzing these proposed rules for any opportunities for or implications on community pharmacy.
Administration and CMS enhance transparency in LTC facilities
The Trump Administration and the Centers for Medicare & Medicaid Services (CMS) announced that beginning Oct. 23, a consumer alert icon will be added to the Nursing Home Compare website next to nursing homes that have been cited for incidents of abuse, neglect, or exploitation. This icon will supplement existing information, including the Nursing Home Five-Star Ratings, helping consumers develop a more complete understanding of a facility’s quality. This critical move toward improved transparency is yet another way CMS is delivering on the agency’s five-part approach to ensuring safety and quality in nursing homes, which Administrator Seema Verma announced in April 2019.
NCPA asks NASEM to hear from experts on compounded hormone therapy
NCPA, along with the International Academy of Compounding Pharmacists and the American Pharmacists Association, submitted a letter to the National Academies of Science, Engineering and Medicine (NASEM) asserting the need for NASEM to hear from experts regarding the clinical utility of compounded biodentical hormone therapy (cBHRT) as it moves through its study – Clinical Utility of Treating Patients with Compounded Bioidentical Hormone Replacement Therapy, commissioned by the Food and Drug Administration (FDA). The organizations expressed interest in aiding NASEM to gather experiential and scientific data to inform the clinical utility of cBHRT. In addition, the letter urged NASEM to schedule an additional hearing to provide a forum for physician and compounding pharmacist practitioners to testify on the importance of cBHRT to patients. NCPA is pleased to report that NASEM has responded and we are working with them to address our requests.
NCPA advocates for the pharmacist’s role in preventing opioid abuse
NCPA submitted comments to CMS’ Request for Information for the Development of a CMS Action Plan to Prevent Opioid Addiction and Enhance Access to Medication-Assisted Treatment to advocate for the community pharmacist’s role in preventing and treating opioid addiction. We stressed that community pharmacists are experienced and well-versed in helping treat patients with acute/chronic pain and substance use disorders (SUDs), but that our ability to provide opioid abuse services is sometimes limited due to regulatory barriers. Specifically, NCPA shed light on how pharmacists are already providing Medication-Assisted Treatment (MAT) as well as counseling for patients with SUDs, and urged CMS to consider ways in which community pharmacists can be utilized and reimbursed in expanding these services. NCPA will continue to work with CMS to offer possible solutions and ideas for collaboration to address the rising tide of substance abuse.
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 linked reports. 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.