House Passes Drug Pricing Legislation

This week, the House of Representatives passed H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, a bill that for the first time would require the government to directly negotiate prices for costly prescription drugs. The measure passed 230-192, with two Republicans breaking ranks to support the measure. The legislation delivers on a long-sought Democratic priority that’s repeatedly run up against opposition from Republicans.

Specific to pharmacy, the bill also includes language to standardize pharmacy quality measures as a step toward addressing pharmacy DIR fee reform. NCPA worked with other pharmacy partners and congressional champions to secure this provision. NCPA also supported an amendment by Rep. Mary Gay Scanlon (D-Pa.) to ban the use of spread pricing by PBMs as it relates to Medicaid. Additionally, the amendment would require Medicaid managed care PBMs to reimburse pharmacies based on ingredient cost and a professional dispensing fee, which must be no less than the professional dispensing fee under the fee-for-service program. Ingredient cost would be based on data from the National Average Drug Acquisition Cost (NADAC) report. Pharmacies would be required to participate in the survey and the monthly responses would be publicly available. The amendment was agreed upon by voice vote with Democrats and Republicans both supporting a ban on spread pricing. However, Senate Majority Leader Mitch McConnell (R-Ky.) has already ruled out taking up the House package in the Senate, and President Trump has said he would veto the House bill should it reach his desk.

NCPA will continue to work with the House and Senate in the hopes of getting a bipartisan drug pricing bill passed next year that would meaningfully address pharmacy DIR fee reform, as well as ban spread pricing in Medicaid and set a reimbursement floor for pharmacies in the program.

NCPA’s Ronna Hauser to Testify
at Senate Judiciary Committee Hearing

Next Tuesday, the Senate Judiciary Committee will convene a hearing titled, “Tackling the Opioid Crisis: A Whole-of-Government Approach.” The hearing will look at the implementation of two pieces of legislation targeting the opioid crisis,CARA and the SUPPORT Act, as well as looking forward on what else needs to be addressed. The hearing will feature a government panel with witnesses from the Office of National Drug Control Policy, the Substance Abuse and Mental Health Services Administration, and the Drug Enforcement Administration, as well as a non-governmental panel of witnesses. NCPA was invited to have a witness on the second panel to represent the pharmacist’s role in helping with the opioid crisis, and Ronna Hauser, PharmD, Vice President, Policy and Government Affairs Operations, will be testifying on NCPA’s behalf.

NCPA Joins Pharmacy Allies in Opposing
Well Intentioned, but Flawed, Spread Pricing Bill

This week, NCPA, along with the American Pharmacists Association (APhA), Food Marketing Institute (FMI) and National Grocers Association (NGA), sent a letter to Reps. Kurt Schrader (D-Ore.) and Greg Gianforte (R-Mont.) to highlight pharmacy concerns with their bill, HR 5304, the PBM Transparency in Prescription Drug Costs Act. While well intentioned, NCPA and its allies are concerned that the bill as written may not curb the practice of spread pricing and could exacerbate fees and pharmacy clawbacks imposed by PBMs. NCPA looks forward to working with these offices on this bill and others to increase PBM transparency and lower the cost of prescription drugs. A copy of the letter is available here.

NCPA Attends Event with Sen. Cassidy in Salt Lake City

Last week, Ronna Hauser, PharmD, Vice President, Policy and Government Affairs Operations, represented NCPA at an event in Salt Lake City with Sen. Bill Cassidy (R-La.). NCPA member Jeff Bray, owner of Medquest Pharmacy, hosted the Senator for a tour of his facility and discussion of issues important to the pharmacy community, which Hauser attended. The tour was followed by a larger pharmacy event where about 50 individuals were able to discuss pharmacy issues with the Senator.

Senate Confirms Stephen Hahn to Head FDA

This week, the Senate confirmed the nomination of Texas oncologist and hospital administrator Stephen Hahn, to lead the Food and Drug Administration. Senators voted 72-18 in support of Hahn, a relative unknown in Washington. Hahn will replace former Administrator Scott Gottlieb, who left the agency in the spring, as the head of a vast federal agency that oversees food, drugs, medical devices, animal health, tobacco and cosmetics.

2020 Congressional Pharmacy Fly-in: April 21-22

NCPA’s Congressional Pharmacy Fly-in will be held April 21-22. This is an opportune time to meet with legislators or their key staff about community pharmacy’s legislative priorities. Note: The dates have changed slightly from previous announcements due to the Congressional schedule that was recently released.

Michigan Extends Comment Period
for Medicaid Managed Care Pharmacy Benefit
Carve Out Proposal

In September, the Michigan Medical Services Administration requested public comment on a proposal to carve pharmacy benefits out of the Medicaid managed care program. The Administration has extended the deadline for public comments until January 17, 2020. NCPA submitted comments supporting the proposed carve out in November.

NCPA Represented at Meetings
of State Insurance Commissioners
and Insurance Legislators

This week Ronna Hauser, PharmD, Vice President, Policy and Government Affairs Operations, represented NCPA at both the National Association of Insurance Commissioners (NAIC) and National Council of Insurance Legislators (NCOIL) meetings in Austin, Texas. These were excellent opportunities to interact with insurance commissioners and legislators who are passing and regulating PBM related laws in the states. Of note, NAIC staff updated the Health Insurance and Managed Care (B) Committee on the current federal Senate Finance Committee bill that contains a ban PBM spread pricing. This is the committee under which NAIC is working to create a PBM Model law. At NCOIL, the Health Insurance Committee passed a Drug Pricing Transparency Model Act to hold PBMs more accountable. NCPA was active at the meeting interacting with policymakers and educating them on importance of PBM oversight.

USP <795> and <797> Appeal
Hearing Dates Confirmed

NCPA previously reported on the appeals that were submitted to USP on chapters <795> and <797> for concerns with beyond-use-date restrictions. Per USP’s bylaws, USP has confirmed a hearing date for January 21-22, 2020 after denying the written appeal submitted by the Alliance for Pharmacy Compounding (APC), Innovation Compounding, and Wedgewood Pharmacy. NCPA and the American Pharmacists Association (APhA) expressed support for the substantive <797> concerns addressed in these appeals in a letter sent to USP on August 15th. At the hearing, the pharmacy groups will be permitted to offer process and scientific arguments relevant to their concerns with the BUDs provisions in the chapters. Due to these appeals, USP has indefinitely postponed enforcement of <795> and <797> until the current appeals process resolves.

NCPA Attends Washington Health Law Summit

This week, NCPA’s Reema Taneja, Director of Policy and Regulatory Affairs attended the American Bar Association’s Annual Washington Health Law Summit. Healthcare industry stakeholders presented on various topics that are most notable in healthcare and pharmacy at the moment, including drug pricing and transparency, changes to the Anti-kickback Statute and Stark Law, HIPAA, antitrust in healthcare, and substance use disorders.

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. Click each issue for a report 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