PA House Unanimously Passes Medicaid Reforms
This week, the Pennsylvania House of Representatives passed a package of bills (HB 941, HB 942, HB 943, and HB 944) that would increase transparency in their Medicaid managed care program. The bills would make PBMs subject to audits by the state, prohibit spread pricing, and protect patient choice of pharmacy. NCPA supported the work of the PA Pharmacists Association and sent a grassroots call to action urging members to voice support for these bills to counter fierce opposition from PCMA. NCPA member and community pharmacist Darrin Silbaugh of See-Right Pharmacy in Harrisburg also submitted his own editorial to the Harrisburg Patriot News to respond to PCMA’s deceptive arguments.
Kentucky report finds that carving pharmacy benefits
out of Medicaid managed care would save
$237.5 million per year
A study commissioned by the Commonwealth of Kentucky Cabinet for Health and Family Services determined that carving pharmacy benefits out of the Medicaid managed care program would save $237.5 million per year. The state’s portion of the savings would be $44.7 million. More information can be found in the full report, which can be accessed here.
NCPA One Pager on Public Disclosure
of Drug Discounts Act
On November 11, 2019, the House unanimously passed H.R. 2115, the Public Disclosure of Drug Discounts Act, sponsored by Reps. Abigail Spanberger (D-Va.), Jodey Arrington (R-Texas), and Brendan Boyle (D-Pa.). The bill would require more disclosure of the discounts drug companies give to pharmacy benefit managers (PBMs) and would also require PBMs to disclose pharmacy DIR fees (a provision that NCPA was successful in getting added to the bill). NCPA was the only organization to endorse the bill and was referenced in Rep. Spanberger’s press release. NCPA has created a one pager (available here) on this bill which provides more background on the bill and NCPA’s involvement.
Trump Administration Proposes
Prescription Drug Transparency Rule
Last week the Department of Health and Human Services (HHS), Department of Labor (DOL) and Internal Revenue Service (IRS) issued a proposed rule that could require insurance companies to disclose the amounts patients are responsible for paying for their prescription drugs in commercial plans. Plans would need to make the information available prior to the patient visiting the pharmacy. This proposal comes on the heels of a final rule to require transparency and disclosure of prices patients pay for services provided at hospitals. NCPA is analyzing this proposal and similar transparency proposals for any impact on community pharmacies.
NCPA Advocates for Community Pharmacy Inclusion
in Value Based Programs
This week NCPA submitted comments to the Centers for Medicare & Medicaid Services’ (CMS) request for information on CMS program integrity. NCPA’s comments focused on pharmacies’ participation in value-based payment programs and arrangements, specifically how payers can ensure that payments in value-based payment programs and arrangements accomplish the goals of improving the value of the care provided. NCPA continues to advocate that community pharmacies, acting as the subject matter experts on medication use and access to patients in the communities, are uniquely positioned to play an integral role in these programs and arrangements by encouraging preventative care and promoting wellness. Any value-based program or arrangement must, therefore, include and adequately reimburse pharmacies for the valuable services and quality/performance they provide.
Wisconsin Expands Access to Immunizations
This week, WI AB 137 was signed by Gov. Tony Evers (D). This bill eliminates age restrictions on vaccines administered by pharmacists and pharmacy students so long as they are pursuant to a prescription order of a physician or other prescribing practitioner. Pharmacists had previously been prohibited from administering vaccines to children under 6 years old.
NCPA Submits Comments to the Minnesota
Department of Commerce on PBM Regulation
NCPA submitted comments to the Minnesota Department of Commerce regarding pharmacy benefit manager (PBM) regulation. After the legislature passed a PBM licensure act earlier this year, the Department requested comments regarding enforcement of the act. NCPA’s comments focused on network adequacy, reimbursement appeals, and retaliatory PBM abuses.
NCPA Advocacy Center Staff Directory
Several new staff members have joined NCPA's Advocacy Center over the past few months. An updated staff directory of current Advocacy Center staff, their areas of responsibility and how to contact them is now available.
NCPA Represented at PQA Board Meeting
and Leadership Summit
This week Ronna Hauser, Vice President, Policy and Government Affairs Operations, represented NCPA at the PQA Board of Directors Meeting, in addition to NCPA staff attending the PQA Leadership Summit: Collaborating to Address National Health Concerns and Caring for the Whole Patient: Leveraging Pharmacists to Address Social Determinants of Health. The meetings focused on the importance of participants sharing strategies and solutions for addressing access to care, interoperability and quality, opioid use disorder and value based models across PQA’s four roles in healthcare quality: convening, measure development, research and education. NCPA staff were able to partner with attendees from health plans, technology partners and academia to dialog about the value of community pharmacists and how that value can be best measured.
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.
Due to the Thanksgiving holiday, the Advocacy Center Weekly Update will not be sent on Nov. 29 and will resume on Dec. 6.
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