State of Arkansas Files its Brief in Rutledge v. PCMA
This week, Arkansas Attorney General Leslie Rutledge submitted her legal brief with the Supreme Court on behalf of the state of Arkansas in the case ofRutledge v. PCMA. In the brief Rutledge noted that the Arkansas law, which the state is asking the Supreme Court to revive, is a necessary attempt to rein in an “obscure but singularly powerful industry.” Oral arguments in the case 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. There will be a pharmacy rally at the Supreme Court on April 27 to coincide with oral arguments.
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 and Congressional Pharmacy Champions Lead Charge
with FTC and DOJ Advocating for Stricter
Vertical Healthcare Merger Guidelines
Pharmacy Industry Urges Reimagined Antitrust Policy
NCPA, along with the Alliance for Pharmacy Compounding, American Pharmacists Association, American Society of Consultant Pharmacists, and National Alliance of State Pharmacy Associations, urged “reinvigorated and reimagined antitrust enforcement policy” in joint comments submitted to the Federal Trade Commission and the Department of Justice Antitrust Division. Earlier this year, the agencies proposed new guidelines for determining how to evaluate and whether to approve potential mergers seeking to combine companies that don’t compete with one another but operate in the same supply chain. Building on NCPA’s individual comments already submitted, the pharmacy orgs urge the agencies to use this opportunity to create a regulatory regime that does not allow these transactions to unduly harm healthcare access, quality, and service.
Reps. Collins and Welch Lead Congressional Support
for Tougher Merger Guidelines
Reps. Doug Collins (R-Ga.) and Peter Welch (D-Vt.) are circulating a sign-on letter among their House colleagues addressed to the Department of Justice and Federal Trade Commission. The letter urges the agencies to adopt stricter guidelines for evaluating vertical mergers. As the letter notes, agencies must strengthen their approach to vertical merger enforcement, in order to better promote market competition and protect consumers. This is particularly critical in the pharmacy sector where the 3 largest PBMs control more than three quarters of all prescriptions filled in America- equaling over 3.3 billion prescriptions.
NCPA has a letter available on the Legislative Action Center that can be sent to Representatives urging them to sign-on to this letter. The deadline for signing on is Thursday March 5, so please contact your Representative as soon as possible.
Kentucky Senate Passes Major Medicaid Reform Bill
Last week, Kentucky SB 50, sponsored by Sen. Max Wise (R), unanimously passed the Senate and is now before the House Appropriations committee. Although SB 50 is no longer the original "carve-out" bill, it does provide some major Medicaid managed care reforms. In its current form, SB 50 provides that a single PBM will administer the pharmacy benefit in Kentucky's Medicaid managed care program. The state will choose the PBM, and the single PBM will administer the benefit for all participating MCOs. Additionally, the state Medicaid agency, not the PBM, will determine the minimum reimbursement a pharmacy can be paid for ingredient cost and professional dispensing fee. Finally, the state will establish a single preferred drug list for all MCOs. Although there is much work to be done, this legislation is a first step in providing transparency and much needed oversight in Kentucky's Medicaid managed care program.
NCPA Supports PBM Legislation in Annapolis
NCPA’s Matt Magner travelled to Annapolis, MD to support HB 1273. The bill would strengthen existing pharmacy audit protections by shortening the audit period. Also testifying in support were the Maryland Pharmacists Association, EPIC Pharmacies, and individual independent pharmacy owners. The bill was introduced by independent pharmacy owner, Del. Steve Johnson.
Sec. Alex Azar Supports Congressional Action
on Pharmacy DIR Fees in Hill Testimony
This week, HHS Secretary Alex Azar testified before four Congressional committees on the Trump Administration’s budget proposal and response to the coronavirus outbreak. Sec. Azar testified before the House and Senate Labor-HHS Appropriations subcommittees, the House Energy and Commerce Committee, and the House Ways and Means Committee. While the overwhelming majority of testimony and questioning centered on coronavirus, community pharmacy champions, Reps. Morgan Griffith (R-Va.) and Buddy Carter (R-Ga.), raised the issue of pharmacy DIR fees and the need for PBM transparency. Sec. Azar reiterated his concern about the impact of DIR fees on independent pharmacies and expressed disappointment for not being able to finalize the proposed rule to address pharmacy DIR fees because of the threat that PBMs would “jack up” premiums for seniors. He also shared his hope that Congress would pass drug pricing legislation, including a pharmacy DIR fix, this year.
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. You will also have the opportunity to participate in a press event at the Supreme Court prior to the oral arguments in Rutledge v. PCMA and larger rally the following week on April 27.
Senate Finance Committee Demands Answers
on Insulin Prices from Express Scripts
This week, Senate Finance Committee Chairman Charles Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore) released a letter sent to Express Scripts threatening to subpoena the company if they fail to provide documents and information regarding rising insulin prices. The Senators are seeking information on “how the actions of pharmacy benefit managers” affect the insulin drug supply chain and patient costs.
The letter specifically discusses the Committee’s request for records from Express Scripts regarding formulary placement, rebate negotiation processes, and “Cigna’s Value Assessment Committee.” The Senators set a March 10, 2020 deadline for Express Scripts to respond to the Committee’s request for information.
Missouri House Committee Hearing on HB 2304
NCPA submitted a letter of support to the Missouri House Committee on Professional Regulation and Licensing on HB 2304. HB 2304 would increase patient access to HIV PrEP and PEP medications by authorizing pharmacists to initiate and furnish these lifesaving medications. The letter of support encouraged a reimbursement provision for pharmacist-provided HIV PrEP and PEP patient care services to bolster the intended success of HB 2304.
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