Help Community Pharmacy Make its Best Case
to the Supreme Court
As you know, the Supreme Court will hear a case focused on state regulation of PBMs in the case of Rutledge v. PCMA. A decision in the case is expected before June 30. If it comes down in our favor, the decision could significantly empower states to regulate PBMs.
NCPA is seeking to build a coalition of partners to make the best legal arguments. If you have not done so, please consider an investment in NCPA's Legislative/Legal Defense Fund. The LDF can accept both corporate and individual funds, and it supports our entire advocacy operation. This includes attorneys and outside counsel. The better funded the LDF, the more resources we can dedicate to this landmark case.
More Information on the case can be found on this summary page. NCPA has dedicated significant staffing and financial resources supporting related issues for over 15 years, with this current Supreme Court case representing the culmination of those efforts. Please help us ensure we have the necessary resources to prevail by investing in the LDF.
NCPA Releases Advocacy Center Annual Report
Today, NCPA released the NCPA Advocacy Center Annual Report for 2019. The report is a review of the legislative, regulatory, legal, communications, and grassroots activities that NCPA undertook on behalf of our members in Washington and the states. NCPA is proud of the many accomplishments we achieved in 2019 and will continue to work towards even greater success in 2020.
Florida Report Highlights PBM Self-Dealing
in Medicaid Managed Care
A report released this week by the Florida Pharmacy Association and American Pharmacy Cooperative Inc. exposes the way PBMs and Medicaid managed care organizations push prescriptions and taxpayer dollars to pharmacies they own or control. "This report reinforces the need for Congress to reform Medicaid managed care," NCPA CEO Douglas Hoey said. "It's also a bright red flag for policymakers in every state to scrutinize their respective Medicaid programs for this kind of anti-competitive, anti-patient behavior." Read the complete report and NCPA's press release.
Submit Comments to DOJ and FTC
on Vertical Merger Guidelines
The U.S. Department of Justice (DOJ) and Federal Trade Commission (FTC) recently proposed an overhaul of antitrust rules for vertical mergers or those with companies that operate in the same supply chain but don’t directly compete with one another such as CVS/Caremark/Aetna, Cigna/Express Scripts, and UnitedHealth/Optum Rx. The proposal is drawing some criticism, especially from Democratic members of the FTC who say the new guidelines don’t go far enough. If finalized, the guidelines would replace rules that haven’t formally been updated since 1984 despite new thinking about how such deals affect competition. NCPA believes these guidelines need to be stricter and will be submitting comments to that effect. Please take a few moments to completethis survey of how mergers have impacted you which will guide our comments. NCPA also has sample comments available for pharmacists who wish to comment themselves. These can be submitted through NCPA’s Legislative Action Center.
Register Now for the
2020 NCPA Congressional Pharmacy Fly-in
Registration for NCPA’s 2020 Congressional Pharmacy Fly-in now open. 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. You'll fly in, spend a few hours with the NCPA Advocacy Center staff, and then have some face time with your members of Congress and/or their staff. It's your chance to tell them how their votes affect your business and the patients you serve. This year, there is also the added possibility that the Supreme Court may hear oral arguments in Rutledge v. PCMA during the fly-in week. Don’t miss out.
NCPA Asks for Protections in the
Transparency in Coverage Proposed Rule
This week, NCPA submitted comments to the Internal Revenue Service (IRS), Employee Benefits Security Administration (EBSA), Department of Labor (DOL), and the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) on the Transparency in Coverage Proposed Rule. The Departments proposed to require group health plans and health insurance issuers to make cost-sharing information available through an internet-based self–service tool. NCPA urged the Departments to 1) establish clear operating rules around such a tool; 2) prohibit plans and issuers from using this tool to steer patients to select pharmacies; and 3) ensure accurate information is provided to avoid the dissemination of misinformation regarding the cost of prescription drugs. NCPA also recommended that the Departments work with NCPDP on a national standard for this tool to offer consistency throughout the industry.
NCPA Joins Industry to Enhance
Biosimilar Insulin Access
This week, NCPA joined industry stakeholders to show support for FDA’s assessment that if a manufacturer demonstrates its proposed biosimilar insulin is “highly similar” to its reference product, the Agency may waive the need for the manufacturer to conduct additional immunogenicity studies in order for the Agency to deem the product as interchangeable with its reference product. The organizations encouraged the Agency to use its experience with insulin to further streamline regulatory requirements for biosimilar and interchangeable biologics broadly to enhance biosimilar availability.
GAO Recommends HHS Reevaluate
Medicaid and 340B Policies
The U.S. Government Accountability Office (GAO) reported that limitations in the Department of Health and Human Services’ (HHS) oversight of the 340B and Medicaid Drug Rebate Programs may increase the risk of duplicate discounts. Both programs require manufacturers to provide discounts on outpatient drugs in order to have their drugs covered by Medicaid. The 340B program allows certain hospitals and clinics to buy discounted drugs. The Medicaid rebate program allows state Medicaid programs to request manufacturer rebates on certain drugs dispensed to their beneficiaries. Drugs that hospitals and clinics buy through 340B can’t also qualify for Medicaid rebates, as that would create a duplicate discount. GAO found that HHS’ Centers for Medicare & Medicaid Services (CMS) and Health Resources Administration (HRSA) do not track states’ policies for preventing duplicate discounts thoroughly enough. Therefore, GAO recommended that these HHS agencies ensure their policies and procedures incorporate and review covered entities’ compliance.
NCPA Comments on Proposed Calif. Regulations
on Furnishing of HIV PrEP/PEP Medications
This week, NCPA submitted comments to the Calif. Board of Pharmacy commending its efforts on adopting regulations for the independent furnishing of HIV PrEP and PEP medications by pharmacists. NCPA urged the board to allot sufficient training time to address the challenges and knowledge gaps in counseling unique populations, recommending appropriate vaccinations, and understanding HIV disease state and HIV medications along with how and when to exercise appropriate patient follow-up or refer the patient to necessary resources and healthcare providers. A minimum of three hours of HIV training was recommended to ensure a high standard of care in carrying out the responsibilities aligned with lowering the rates of HIV infection throughout the state.
NCPA/APA/NASPA Host Webinar
on SCOTUS Rutledge Case
This week, NCPA cohosted a webinar along with the Arkansas Pharmacists Association and the National Alliance of State Pharmacy Associations covering Rutledge v. PCMA. The webinar, which was presented for leaders of state pharmacy associations, covered the history of the case, the legal arguments, potential results and impacts for other states, and information on how to support the cause.
Virginia Senate Committee Advances
PBM Licensure and Patient Choice Bill
This week, the Virginia Senate Committee on Commerce and Labor reported SB 251 out of committee. This comprehensive PBM reform awaits action on the Senate floor. The bill would require PBMs to register with the commonwealth, limit PBM adjudication fees, and protect patient choice of pharmacy. NCPA sent a letter to the Virginia Senate Commerce and Labor Committee supporting the bill which was originally filed as SB 862.
NCPA Attends Florida Pharmacy Association Conference
Last weekend, Reema Taneja, Director of Policy and Regulatory Affairs, presented on a 2020 Federal Update for Community Pharmacies at the Florida Pharmacy Association’s Regulatory and Law Conference. Taneja presented on timely topics important to the pharmacy space such as the upcoming SCOTUS case, drug pricing, dispensing of controlled substances, compounding, track and trace, and importation.
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