242 Organizations Urge Swift Congressional Action
to Address Pharmacy DIR Fees

This week, 242 organizations representing pharmacists, patients and healthcare providers sent a letter to Congressional leadership urging swift action to address pharmacy DIR fees. The letter, led by NCPA along with the American Pharmacists Association, National Association of Chain Drug Stores, and National Association of Specialty Pharmacies notes that pharmacy DIR fees have risen an astounding 45,000% since 2010 and are not used to lower costs for seniors and special needs populations.

While we continue the push for DIR reform, NCPA continues to promote action on Fight4Rx, a platform for both pharmacists and patients to take action. NCPA has created a toolkit of resources that can be used in the pharmacy. It’s easy to engage, simply text Fight4Rx to 52886. You can also keep up on the latest though Fight4Rx’s Facebook and Twitter feeds. Please utilize these resources and share them with your stakeholders.

NCPA Advocates for PPP Tax Deductibility

This week, NCPA signed onto an organizational letter to House Ways and Means Committee Chairman Richard Neal (D-Mass.) and Senate Finance Committee Chairman Charles Grassley (R-Iowa) regarding the recent IRS Notice 2020-32 denying the deductibility of costs associated with PPP loan forgiveness. In all 152 organizations signed onto the letter noting this notice is contrary to Congressional intent and urging it to be corrected.

Senators Menendez and Cornyn Lead Letter
to Raise PPP Non-Payroll Forgiveness Cap

U.S. Senators Bob Menendez (D-N.J.) and John Cornyn (R-Texas) led a letter signed by 21 Senators urging Treasury Secretary Mnuchin and Small Business Administrator Carranza to raise the Paycheck Protection Program’s (PPP) non-payroll forgiveness cap from 25% to 50%. PPP loans allow loan proceeds used towards payroll, utilities, mortgage interest, and rent payments to be forgiven when at least 75% of the loan is spent on payroll. NCPA has been advocating to raise the cap to allow small businesses to spend up to 50% of the loan proceeds on the statutorily allowed non-payroll expenses such as rent, utilities and mortgage interest payments.

Senate Judiciary Committee Hearing Will Consider
Business Liability Protections

This week, Chairman Lindsey Graham (R-S.C.) announce that the Senate Judiciary Committee will be holding a hearing on Tuesday, May 12 titled, “Examining Liability During the COVID-19 Pandemic.” NCPA has been working with a coalition of grocery and convenience stores and other essential businesses who are open during the pandemic to secure targeted liability protections, and this hearing demonstrates progress towards securing these protections in an upcoming relief package.

NCPA Joins America’s Recovery Fund Coalition

NCPA has joined the America’s Recovery Fund Coalition (ARFC) with more than 100 other business organizations to push for Congress to create the “America’s Recovery Fund,” which would build on federal economic assistance efforts. The coalition, which formally launched earlier this week, is advocating for additional federal support, over a longer period. The existing PPP program is aimed at getting businesses to retain or rehire employees, ARFC’s focus is on needs of consumer-facing businesses which may require grants that can be spent over a much longer period, with the flexibility to spend more on expenses like rent, utilities, taxes and debt. ARFC underscored the importance of longer-term economic assistance in a letter sent to the White House and House and Senate leadership.

CMS Releases Additional Guidance on Pharmacies
Providing COVID-19 Testing

On May 8, CMS released an MLN Matters Article stating that pharmacies may temporarily enroll as an Independent Clinical Diagnostic Laboratory under Medicare to help address COVID-19 testing.

• Pharmacies currently enrolled in Medicare may enroll temporarily as an Independent Clinical Diagnostic Laboratory during the COVID-19 public health emergency via the provider enrollment hotline. Your Medicare Administrative Contractor will collect certain information, including your CLIA certificate number, from you through the hotline and notify you of your temporary Medicare billing privileges and effective date via email within 2 business days.
• Pharmacies who are not currently enrolled in Medicare and want to enroll as an Independent Clinical Diagnostic Laboratory, must submit a CMS-855B enrollment application to the Medicare Administrative Contractor (MAC) serving your geographic area.

Please see NCPA’s updated member summary for detailed information on how to appropriately enroll as an Independent Clinical Diagnostic Laboratory for COVID-19 testing during the PHE.

Pharmacist Announces Run for Congress

Diana Harshbarger, PharmD, owner of Premier Pharmacy in Kingsport, Tenn., is running to represent Tennessee's 1st District. Diana is an NCPA member who has served her community for over 30 years as a pharmacist and small business owner. Check out her announcement video, "The Right Medicine. "NCPA PAC is proud to support Diana's run for Congress with the maximum $5,000 contribution. Later this month, NCPA PAC will host a webinar (details coming soon) with Diana and Rep. Buddy Carter (R-Ga.) so you can learn more about her campaign. If you have any questions, please email Eric Lundberg or call him at 703-600-1184.

Deadline to Sign Attestation, Accept Terms and Conditions
for Provider Relief Fund Extended

This week, HHS extended the deadline for health care providers to attest to receipt of payments from the Provider Relief Fund and accept the terms and conditions. Providers now have 45 days, increased from 30 days, from the date they receive a payment to attest and accept the terms and conditions or return the funds. Additional information on the Provider Relief Fund and link to attestation form can be found here.

CMS Finalizes Standards for Issuers and Exchange Plans

CMS issued a final rule to implement benefit and payment parameters for 2021 Affordable Care Act (ACA) coverage and related requirements. CMS In our comments to CMS on the proposed rule, NCPA supported CMS’ proposal that medical loss ratio (MLR) regulations must require issuers to 1) deduct from incurred claims any prescription drug rebates and price concessions received and retained by pharmacy benefit managers (PBMs) and 2) report these rebates and price concessions as non-claims costs. This proposal was finalized and will begin with the 2022 MLR reporting year. CMS states that “these changes will help lower premiums by helping ensure that consumers’ premiums reflect the full benefit of prescription drug rebates and are not artificially inflated.”

NCPA Creates CLIA-waiver Information Resource

Before performing CLIA-waived tests, including COVID-19 tests, a pharmacy must obtain the appropriate CLIA certificate. Additionally, many states have their own requirements that must be satisfied before CLIA-waived tests may be performed. NCPA has created a new resource to help members find their state's requirements so they can prepare to administer COVID-19 tests. The resource can be found with NCPA's Coronavirus Information on the Testing for Coronavirus and Coronavirus Advocacy pages.

Connecticut and Virginia Authorize
COVID-19 Testing By Pharmacists

In accordance with efforts to establish broad COVID-19 testing, Connecticut Gov. Ned Lamont (D) of Connecticut issued an EO authorizing pharmacists to order and administer EUA approved, CLIA-waived COVID-19 tests. 
Also in Virginia, the Board of Pharmacy released guidance for COVID-19 testing by pharmacies. Pharmacies who have obtained a CLIA-waiver may order and administer EUA, CLIA-waived COVID-19 tests. The guidance includes an FAQ addressing topics on how to obtain a CLIA-waiver, reporting requiring, among other points.

Opportunity to Contract With HRSA-funded Health Centers
Through 340B Program

This week, HHS awarded $583 million from the Paycheck Protection Program and Health Care Enhancement Act to HRSA-funded health centers to expand COVID-19 testing. Health centers may use these awards to support efforts to prepare for, prevent, and respond to COVID-19, and there may be an opportunity for community pharmacists to contract with health centers through the 340B Program. You are encouraged to reach out to health centers in your community (a full list of health centers that have received these awards can be found here) to inquire about 340B contract pharmacy services.

NCPA Win: USP Finalizes Compounding Resolution

This week, the United States Pharmacopeia (USP) held its 2020 virtual convention (occurs every 5 years), during which NCPA’s USP delegate Ronna Hauser participated. NCPA submitted comments prior to the virtual convention, successfully urging USP to align their compounding resolution with the specificities we offered in our original resolution comments, i.e. the need for more consistency with USP’s development of beyond- use dates. USP’s final compounding resolution did align with NCPA’s ask, stating that standards for BUDs will be developed using data, scientific evidence, and input from recognized healthcare professionals and state and federal regulators.

NCPA Member Summary on Compounding During COVID-19

NCPA created a member summary for pharmacy compounders to aid in keeping up to date on various guidances and notices that have come out from the Food and Drug Administration and USP, including direction on hand sanitizer compounding, 503A compounding flexibilities, and USP resources that apply during the COVID-19 public health emergency.

Medicare Special Enrollment Period

This week, CMS issued guidance for Medicare Advantage Organizations, Medicare Part D plan sponsors, and Medicare-Medicaid plans to clarify that certain individuals who were eligible, but unable to make an election to enroll in a Medicare Advantage or Part D plan due to COVID-19, qualify for a Special Enrollment Period, that is available effective from March 1, 2020 and extending four months.

Louisiana House Committee Considers
Pharmacy Reimbursement for Healthcare Services

The Louisiana House Committee on Insurance held a hearing on HB 459. This legislation will provide reimbursement for healthcare services and procedures performed by pharmacists within the scope of the pharmacist’s license pursuant to the Louisiana Pharmacy Practice Act, if such benefits would be ordinarily paid if the service was performed by another healthcare provider. NCPA submitted a letter of supporting the reimbursement provision.

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