NCPA Advocates on Behalf of Tricare Pharmacies
Facing Recoupments for Compounds
NCPA continues to advocate on behalf of our members who have received a recoupment notice from Express Scripts Inc. advising them that recoupment actions have been initiated on compounded prescriptions for Tricare/CHAMPUS beneficiaries at the request of the Defense Health Agency's Office of Program Integrity. NCPA is working with APC on member resources to help in their appeals and today released this white paper prepared by Jeffrey Baird, Esq. and Bradley Howard, Esq. of Brown & Fortunato P.C. Health Care Group, as a member resource. NCPA is also coordinating with PAAS. We also are in active discussion on the matter with Tricare leadership, ESI, and members of Congress. DHA has indicated to us they are working on a formal response and will discuss with us when final.
NCPA Signs onto Letter Supporting Enhancements
of Employee Retention Credit
This week, NCPA joined over 100 other organizations on a letter to Congressional leadership supporting H.R 6776, the Jobs Credit Act, and asked that it be included in a future legislative package addressing COVID-19. This bipartisan bill would make several enhancements to the Employee Retention Credit, which was included in the CARES Act, including allowing businesses that received PPP loans to qualify for the credit.
2020 NCPA Convention Registration Now Open
Registration is now open for the NCPA 2020 Annual Convention It's time to embrace new opportunities, energize your business, and take your service model to new heights. We've got a one-time deal for owner/managers and staff pharmacists ONLY, a flash sale to take $100 off the registration rate. Use code FLASH100 to claim your discount. Register today and mark your calendar for Oct. 17-20 in Nashville, Tenn. For more, view the preliminary convention schedule.
NCPA Signs Joint Letter to DC BOP on Emergency Rules
for COVID-19 by Pharmacists
This week, NCPA, NACDS, NGA, and FMI submitted a joint letter of recommendations to the Washington, DC Board of Pharmacy highlighting the restrictive nature of the Board’s recently released emergency ruling for COVID-19 testing by pharmacists. The letter asks for a broad standards of care approach. As D.C. works to ensure the safety of patients, pharmacists, and pharmacy staff during testing, the goal is to positively impact patient access while maintaining the highest standard of care.
NCPA Seeking Clarity from HHS Regarding
Provider Relief Fund Distributions
CMS will be hosting a call the week of June 22 that will include details on the Provider Relief Fund distribution for Medicaid/CHIP providers (NCPA summary here). Register for the CMS June 23 webcast here, or the June 25 webcast here. NCPA will also participate and report on the results of that discussion.
CMS Proposes Rule to Expand and Modernize
Value-Based Purchasing Agreements in States
This week CMS proposed a rule which they purport would allow more flexibility for payers and manufacturers to enter into value-based agreements while still ensuring that Medicaid will get the best prices. CMS is touting this move as a way to lower drug prices by “modernizing regulations, encouraging innovation and empowering states, private payers, and manufacturers to pay for prescription drugs based on clinical outcomes.” NCPA is reviewing the proposal and will submit comments to address concerns about the possible impact of this proposal on reimbursements.
MedPAC Releases Annual Report to Congress
On Monday, the Medicare Payment Advisory Commission (MedPAC) released its June 2020 Report to Congress: Medicare and the Health Care Delivery System. MedPAC recommends a redesign with two major changes: (1) for spending below the catastrophic threshold, MedPAC recommends eliminating the manufacturers’ coverage gap discount that currently applies to enrollees without the low-income subsidy (LIS) and removing the coverage gap for LIS enrollees, and (2) for spending above the catastrophic threshold, MedPAC recommends imposing a manufacturer discount on high-cost drugs to reduce incentives to raise prices, and recommends adding an annual cap on enrollees’ out-of-pocket costs.
Ohio Medicaid to Start Paying Pharmacists
for COVID-19 Testing
Ohio Medicaid joined the growing list of state Medicaid agencies (Alaska., Idaho, Md., and N.Y.) paying pharmacists for administering COVID-19 tests and/or collecting specimens for tests. Pharmacist-performed nasal swabs will be paid at a rate of $23.46. Click here for NCPA updates on state guidance and payment for tests.
NCPA Asks for LTC Exemption on Insulin Pen Packaging
This week, NCPA joined the American Society of Consultant Pharmacists and the Senior Care Pharmacy Coalition in a letter to the FDA expressing concern with the unintended patient consequences resulting from the FDA’s November 2019 requirement that insulin pen manufacturers state in their package inserts that boxes of insulin pens must be dispensed unopened. As stated in our letter, “[I]f a box of insulin pens cannot be opened by the dispensing pharmacy, the pharmacy cannot individually label or affix an expiration reminder label to each pen.” Therefore, our groups asked the FDA to exempt LTC pharmacies from the requirement that boxes must be dispensed unopened.
NCPA Comments to CDC on Pain Management
This week, NCPA submitted comments to CDC providing a pharmacist perspective on prescribing opioid and non-opioid pain medications for acute and chronic pain, and recommendations on addressing barriers to pharmacist integration into pain management teams and service.
Mississippi Legislature Passes PBM Reform Legislation
The Mississippi Legislature passed HB 708, which would prohibit PBMs from implementing retroactive claim reductions, arbitrary pharmacy accreditation/certification requirements, and other abusive PBM practices. The bill is now headed to Gov. Tate Reeves’s (R) desk for his signature.
Appeals Court Blocks Requirement that Drug Prices
Must be Included in Ads
This week, a federal appeals court ruled the Trump administration could not require pharmaceutical companies to include drug prices in their advertisements, upholding a previous ruling that blocked the requirement. A three-judge panel of the District of Columbia Court of Appeals unanimously asserted that the list price "bears little resemblance" to what government programs like Medicare and Medicaid pay. HHS previously finalized a rule mandating the disclosure of list prices in May 2019 as an effort to lower drug prices, but it was challenged in court by pharmaceutical companies.
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