United States Supreme Grants Cert in Arkansas PBM
Today, the United States Supreme Court decided to hear in the Arkansas PBM case, which will determine the extent to which states can regulate PBMs. NCPA has been working with the Arkansas Pharmacists Association on Rutledge vs PCMA, urging the Court to uphold Arkansas’ right to impose reasonable regulations on PBMs. The Eighth Circuit Court of Appeals struck down an Arkansas PBM law, citing an ERISA preemption, and the state has asked the U.S. Supreme Court to hear the case. The US Solicitor General, the administration’s top litigator, strongly disagreed with the Eighth Circuit and recommended that the Supreme Court settle the matter.
New York Pharmacists Rally in Response to Veto
New York Gov. Andrew Cuomo (D) vetoed a PBM regulation bill last month, and independent pharmacists across the Empire State aren't taking it quietly. More than 200 white coat-clad pharmacists converged on the state capital Wednesday morning to protest as the governor delivered his state of the state speech. The Pharmacists Society of the State of New York (PSSNY) and FixRx sponsored and organized the successful rally where Anne Cassity, NCPA’s Vice President of Federal and State Government Affairs attended. Several New York state legislators stopped by to speak at the rally, including community pharmacy champions Assemblyman John McDonald (D) and Senator James Skoufis (D). Cuomo did not speak to the pharmacists. Click here for a photo from the rally.
Registration Opens Wednesday
for 2020 Congressional Pharmacy Fly-in
Registration for NCPA’s 2020 Congressional Pharmacy Fly-in opens on Wednesday, January 15. The Fly-in, which will be held April 21-22, is an opportune time to meet with legislators or their key staff about community pharmacy’s legislative priorities.
Maryland Medicaid Report Finds $72 million PBM Spread
Maryland released a report showing PBMs serving the state Medicaid plan pocket $72 million through spread pricing. As a result of the audits, the Department of Health will prohibit spread pricing beginning in 2021 and recommended additional Medicaid reforms to prevent pharmacy access issues, particularly for rural patients.
House E&C Committee to Hold Hearing on Cannabis Policy
The House Energy and Commerce Committee announced that the Health Subcommittee will hold a hearing entitled “Cannabis Policies for the New Decade,” on Wednesday, January 15, 2020. Committee Chairman Frank Pallone, Jr. (D-N.J.) and Health Subcommittee Chairwoman Anna Eshoo (D-Calif.) stated that, “As public opinion continues to evolve and cannabis policies change at all levels of government, it’s important to bring federal agency officials together to discuss current and future federal cannabis policies.” The Chairs added that they are “particularly interested in examining the implications of changing marijuana’s schedule listing, the potential of cannabis research, and federal efforts to review and approve cannabidiol products.”
Feedback Requested on Scope of Practice
As a follow up to President Trump’s Executive Order #13890 Protecting and Improving Medicare for Our Nation’s Seniors, CMS is requesting additional input on eliminating specific Medicare regulations that require more stringent supervision than existing state scope of practice laws, or that limit health professionals from practicing at the top of their license. NCPA will be submitting comments and requests member input regarding the following question:
- Does your state reimburse pharmacists for certain services that Medicare does not, such as diabetes counseling, opioid treatment services, or other enhanced pharmacy services?
Please submit any input to Reema Taneja by January 15th.
NCPA Urges OIG to Include Pharmacies
Under New Safe Harbors
The Department of Health and Human Services (HHS) released two proposed rules on October 9, 2019 to modernize and clarify the regulations that interpret the Federal Anti-Kickback Statute (AKS) (AKS Proposed Rule) and Physician Self-Referral Law (Stark Law) (Stark Law Proposed Rule). The AKS and Stark Law Proposed Rules are part of HHS’ regulatory sprint to remove potential regulatory barriers to care coordination and value-based care. NCPA submitted comments to HHS’ Office of Inspector General (OIG) on the AKS Proposed Rule, which modifies existing, and creates new, safe harbors. Of particular concern to community pharmacy was OIG’s proposal to not include pharmacies under its new value-based arrangement safe harbors. These safe harbors aim to promote care coordination and remove barriers to value-based care. OIG expressed concern that because pharmacies primarily provide items, that pharmacies’ participation in value-based arrangements may not further care coordination. NCPA provided numerous examples of how pharmacies are successfully providing value-based services to their patients on a regular basis through medication adherence counseling, chronic disease management, and by participating in clinically integrated networks.
New Hampshire Proposal Would Grant Pharmacists
Prescriptive Authority for HIV Prevention Meds
HB 1404, recently introduced in New Hampshire, would allow pharmacists to dispense a limited supply of pre-exposure prophylaxis for the HIV virus. Following in the steps of California, this legislation is a prime example of utilizing pharmacists to save lives and taxpayer dollars. This legislation would authorize a pharmacist to initiate and furnish at least a 30-day supply, and up to a 60-day supply, of HIV pre-exposure prophylaxis once every two years to a single patient without a physician’s prescription and pending certain conditions:
- Patient is HIV negative, as documented by HIV negative test obtained within the previous 7 days from an HIV antigen/antibody test or antibody-only test or from a rapid, point-of-care fingerstick blood test
- The patient does not report any signs or symptoms of acute HIV infection on self-reported checklist of acute HIV infection
- The patient does not report taking any contraindicated medications
- The pharmacist provides counseling to the patient on the ongoing use of pre-exposure prophylaxis
- The pharmacist notifies the patient’s primary care provider on completion of the requirements
Georgia House Hearing Focuses on PBM Practices
and a Possible Medicaid Carve-out
NCPA member Jen Shannon, owner of Lily's Pharmacy in John's Creek, was among those who testified Tuesday at a Georgia House Insurance Committee and House Special Committee on Access to Quality Healthcare hearing. The meeting comes as the committee begins to explore the negative impact PBMs and Medicaid CMO practices are having on patients, prescription drug prices, community pharmacies, and Georgia taxpayers. The committees announced plans to explore initiatives to bring transparency to prescription drug prices, including potentially carving pharmacy benefits out of the Medicaid managed care system and administering the benefits through the more transparent fee-for-service system.
Here's a story on the hearing and video of some of the testimony.
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