April 27: Community Pharmacy
to Have its Day in Court, Hold Rally
The Supreme Court announced that oral arguments in the case of Rutledge v. PCMA will be held April 27, 2020. This is the first time the Court with hear a case focused on state regulation of PBMs. A decision in the case is expected before June 30, and, if it comes down in our favor, the decision could significantly empower states to regulate PBMs. NCPA will be holding a rally at the Supreme Court on April 27 to coincide with the oral arguments, please be on the lookout for additional information regarding the rally.
The PBMs see this case a threat to them and are sparing no expense to try and influence the outcome. PCMA has hired Seth Waxman, the former Solicitor General of the United States, to represent them. We understand Mr. Waxman charges $4,000/hour for his services and we know PCMA and the PBMs they represent have the resources to cover such a bill. To counter the well-funded opposition, NCPA is seeking to build a coalition of partners to make the best legal arguments. But this also takes resources. If you have not done so, please consider an investment in NCPA's Legislative/Legal Defense Fund (LDF). 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 and better prepare for the legislative battles in the states once a decision is rendered.
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 Urges FTC and DOJ to Exercise Greater Vigilance
in Evaluating Supply Chain Mergers
This week, NCPA commented on new guidelines for evaluating vertical mergers that were proposed by the Federal Trade Commission (FTC) and the US Department of Justice Antitrust Division (DOJ). NCPA noted that the three largest pharmacy benefit managers (PBMs) now control more than three quarters of all prescriptions filled in America—equaling over 3.3 billion prescriptions. All of them have corporate ties to large pharmacy chains and health insurers. Drug prices haven't gone down for patients, however, and in many cases the monster mergers have left many local communities without a pharmacy.
NCPA further noted a health insurer or PBM that merges with a large retail pharmacy chain may have the incentive to exclude competing pharmacies from preferred networks or to provide financial incentives to utilize the acquired pharmacies over the patients' pharmacy of choice. NCPA urged the FTC and DOJ to be more vigilant in enforcing anti-trust laws to prevent such abuses from occurring.
NCPA also has sample comments available for pharmacists who wish to comment prior to the Feb, 26 deadline. These can be submitted throughNCPA’s Legislative Action Center.
Graphics Illustrate Impacts of Pharmacy DIR Fees
NCPA previously shared this excellent analysis published by XIL Consulting that focused on how PBMs are manipulating the Medicare Part D system with DIR fees and hurting pharmacies and patients. To go along with the report, there are several graphics that effectively illustrate the impacts of pharmacy DIR fees on patients and pharmacies and how they have skyrocketed overtime. These graphics can be effective when discussing pharmacy DIR fees with policymakers and NCPA encourages their use. Also, if you have not already we encourage you to share the following through your social media channels.
NCPA news release
NCPA LinkedIn post
NCPA Twitter thread
NCPA Facebook post
Direct link to XIL Consulting analysis
XIL Press Release
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.
NCPA Emphasizes Minimum Requirements
to Support Importation
NCPA submitted comments to the FDA on its Importation Draft Guidance, expressing concerns with unintended consequences that could arise from importation such as patient safety, the possibility of standards lower than those established by the Drug Supply Chain Security Act, disappointing cost savings that fail to deliver on the hope for better patient access, and the lost opportunity for patient counseling to enhance medication adherence. NCPA stated that it would oppose any importation proposals that do not meet several minimum requirements for independent pharmacies. We will continue to advocate that importation policies must take community pharmacies into account before they are finalized. NCPA will also be submitting comments to the FDA in March on its Importation Proposed Rule.
What You Need to Know for 2020
We've made a 2020 checklist and you'll want to check it twice to make sure your pharmacy is in compliance. NCPA’s 2020 Checklist reflects recent changes to Part D plans, as well as other important regulatory and legislative actions that impact the pharmacy space, your patients, and your business. Some of the specific implementation dates relate to opioid policies, track and trace laws, and compounding.
Sec. Azar to Testify Twice Next Week on Capitol Hill
Next week, HHS Secretary Alex Azar will testify at two house committee hearings. On February 26, he will come before the Energy and Commerce subcommittee on Health, where he will discuss President Trump’s Fiscal Year 2021 HHS Budget and provide an update on the Administration’s response to the Coronavirus outbreak. On February 27, he will appear before the Ways and Means Committee to again discuss the budget proposal and take questions.
NCPA Submits Letter of Support
for Kansas PBM Reform Legislation
This week, the Kansas House Insurance Committee held a hearing on HB 2598. The bill would require PBMs to become licensed with the state, require PBMs to become fiduciaries of their plan sponsors, bring transparency to pharmacy reimbursements, and limit PBM conflicts of interest and patient steering. NCPA submitted comments explaining that PBM practices have taken a significant toll on patient access to community pharmacies in Kansas recently.
Wisconsin PBM Bill Passes the Assembly
The Wisconsin Assembly passed AB 114, which would require PBMs to become licensed in the state, limit retroactive claim reductions, prohibit gag clauses/copay clawbacks, and establish pharmacy audit protections. The bill now moves to the Senate for consideration.
New Mexico Bill Allows for Reimbursement
for Clinical Services
HB 42 recently passed both chambers of the New Mexico state legislature and is headed to the Governor to be signed into law. This bill would allow pharmacists to practice at the top of license by requiring reimbursement of pharmacist clinician services for pharmacists with prescribing authority. Congratulation to the New Mexico Pharmacists Association and all the advocates who worked tirelessly on this legislation. NCPA joined the American Pharmacists Association (APhA), American Society of Health-System Pharmacists (ASHP), National Association of Chain Drug Stores (NACDS) and National Alliance of State Pharmacy Association (NASPA) on a letter of supportfor this very important legislation.
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