NCPA Advocacy Update

Week ending June 5

Author: APCI Staff/Monday, June 8, 2020/Categories: Legislative Affairs

NCPA Officer Participates in Listening Session
with Vice President Pence

This week, NCPA Officer Michael Kim, PharmD participated in a listening session at a Maryland church hosted by Vice President Mike Pence with political and business leaders from the Washington metro area about the protests around the nation to address racial injustice. Kim shared his stories of the damaged caused to his four Washington, DC pharmacies due to the unrest and also took the opportunity to address independent pharmacy concerns with PBMs.


PPP Flexibility Changes Clear Senate,
Await President Trump’s Signature

This week, President Trump signed the Paycheck Protection Program Flexibility Act. This bill extends the term for the forgiveness of PPP loans (24 weeks or until the end of the calendar year), allows for five years to repay any money owed, extends the rehiring deadline for loan forgiveness from 8 to 24 weeks, and reduces the 75/25 rule to 60/40 so that at least 60% of PPP loan funds must be used for payroll. NCPA’s summary of the bill is available here. NCPA has been advocating for these revisions to the PPP, including signing onto a letter to Congressional leadership, Treasury Secretary Mnuchin and Small Business Administrator Carranza. NCPA’s news release on the enactment of this bill is available here.


NCPA Joins Voices with Other Pharmacy Organizations
to Oppose Racial Injustice

This week, NCPA joined with other national pharmacy organizations on a statement opposing racial injustice. The statement noted that “people of color and other marginalized groups experience a continuum of systemic racism, discrimination, and injustices that result in ongoing health inequities created by numerous factors.” It further highlighted specific actions the pharmacy community plans to take to combat racial injustice and ensure the care provided by pharmacists and within pharmacies upholds the highest standards.


Disaster Relief Available for Those Affected by Civil Unrest

The NCPA Foundation has been notified of several pharmacies that were vandalized and/or looted during the civil unrest in the past week. If your pharmacy has been affected contact NCPAF@ncpa.org. Donations for the Disaster Relief Fund can be made via the NCPA Foundation's Charity GoFundMe page.


NCPA Asks CMS for Pharmacy Relief as COVID-19 Continues

This week, NCPA submitted comments to the Centers for Medicare & Medicaid Services’ Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency Interim Final Rule. NCPA asked for acknowledgement of the leniencies they are issuing for plan sponsors may not be afforded to pharmacies or provider groups in contracts with plan sponsors (for provisions such as Star Ratings), and that CMS should indicate relief for pharmacies and provider groups as well. NCPA also highlighted the continuous and heightened impact of DIR fees on our members that are especially problematic during the PHE.


COVID-19 Pandemic Response, Laboratory Data
Reporting Requirements

HHS released guidance reminding laboratories and providers that perform or analyze COVID-19 tests that Section 18115 of the CARES Act requires them to report the results from each such test to the Secretary of HHS. All data must be reported through existing public health data reporting methods. All laboratories – including laboratories, testing locations operating as temporary overflow or remote locations, and other facilities performing testing at point of care or with at-home specimen collection related to COVID-19 – shall report data for all testing completed, for each individual tested, within 24 hours of results being known or determined, on a daily basis to the appropriate state or local public health department based on the individual’s residence. Any entity ordering a diagnostic or serologic test, collecting a specimen, or performing a test should make reasonable effort to collect demographic information and should include such data when ordering a laboratory test to enable the entities performing the test to report these data to state and local public health departments. Therefore, pharmacies who enroll as clinical labs should be aware of these reporting requirements as well. This information should be made available in all reporting to state and local public health departments and subsequently the CDC as soon as possible, but no later than August 1, 2020.


Medicaid Moves to Reimburse for COVID-19 Testing

States are starting to issue regulations for Medicaid coverage of COVID-19 testing, which currently contemplate pharmacies as specimen collection sites (aka swab and send). In late May, New York launched a COVID-19 testing pilot program which will allow participating pharmacies to get paid through the state's Medicaid program. Maryland's Medicaid agency has released guidance allowing for pharmacists to be reimbursed for specimen collection. Additionally, Ohio Gov. Mike DeWine (R) recently announced that he was instructing Ohio Medicaid to reimburse pharmacists for COVID-19 testing. Governor DeWine specifically mentioned that he had been working with the Ohio Pharmacists Association to make sure that tests are readily available. DeWine said community pharmacies are vitally important to our communities since they are among the frontline healthcare providers. Maryland and New York advisory documents contain more details on their respective programs.


Ohio Lawmakers Urge Medicaid to Cover Testing

Ohio State Reps. Allison Russo (D) and Thomas West (D) sent a letter to the Medicaid director urging the agency to create billing codes for COVID-19 specimen collection and testing so that pharmacists can provide much needed COVID-19 tests. Just last week, Governor Mike DeWine (R) announced that he was directing the Medicaid agency to allow pharmacists to be covered. More on this can be found in the Columbus Dispatch.


COVID Has Changed the Pharmacy Landscape

Community pharmacists anticipate lasting changes as a result of COVID-19, according to a survey released by NCPA this week. According to the survey, 61 percent of community pharmacists anticipate that more pharmacies will be offering point-of-care testing for various illnesses, including COVID-19 when that becomes available.


NCPA Joins Compounding Pharmacy Groups
in Asking OMB to Review MOU

This week, NCPA joined the Alliance for Pharmacy Compounding, American Pharmacists Association, and National Alliance of State Pharmacy Associations on a letter to the Office of Management and Budget asking for a careful review of the FDA’s Final Memorandum of Understanding on the distribution of compounded products across state lines. We expressed continued concern with FDA’s decision to not separate the definitions of “distribution” and “dispensing.” We also alerted OMB to FDA’s underestimations of the burden this Final MOU would have on States who choose to sign it, which we asserted would not be a high number due to the restrictions and added requirements on States.


Hoey: Medicaid Must Recognize Medical-at-Home
Pharmacy Services

In a column for Pharmacy Times this week, NCPA CEO Douglas Hoey asserted that pharmacy benefit managers will not change their payment structures for medical-at-home pharmacy services for Medicare Part D beneficiaries until CMS recognizes these services. CMS’ formal recognition of these services will help promote value-based patient care and increased savings to the health care system. This is imperative because a recent survey shows that more than 80 percent of Americans over 50 want to remain in their homes as they age.


NCPA Comments to CMS Regarding Maternal
and Infant Health Care in Rural Communities

In a joint comment letter to CMS with NASPA, AACP, APhA, and ASHP, NCPA emphasized the importance of pharmacist-provided maternal health services in improving health care access, quality, and outcomes for women and infants in rural communities, and provided answers to questions outlined in CMS’ request for information, including how pharmacists can address barriers to access, high pre-term birthrates and maternal death-rates, and how CMS can support pharmacy efforts to address rural disparities.


NJ Bill Granting Pharmacist Testing Authority
and Requiring Health Coverage Passes Senate

New Jersey Senate Bill S 2436 passed the senate and currently awaits a hearing in the Assembly Committee on Health. This bill would authorize pharmacists to order and administer tests for COVID-19 and requires health benefits plans and Medicaid to provide coverage for the tests, alleviating a barrier for patients looking to get tested.


Idaho Medicaid Grants Provider Status to Pharmacists

Idaho Medicaid announced it will allow registered pharmacists to enroll as ordering, referring or prescribing providers (ORP). This came after Idaho Medicaid rules passed the legislature and were approved by Governor Brad Little (R), recognizing pharmacists as non-physician practitioners. Pharmacists will be able to bill Medicaid for services authorized under the Idaho Pharmacy Act. Pharmacists with an NPI have automatically been enrolled; others who do not have an NPI must obtain one and then apply to Idaho Medicaid.


NCPA State Legislative Activity Update

NCPA tracks state legislation related to our top three state priorities: Medicaid reformscope 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.

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