Carter, Hoey Op-ed Stresses Importance
of Pharmacists During Pandemic
This week, The Hill published an op-ed by U.S. Representative Buddy Carter (R-Ga.) and NCPA CEO Doug Hoey titled “Pharmacists Play a Critical Role in Defeating COVID-19.” In the piece, Carter and Hoey stress the importance of allowing pharmacists to practice at the top of their license in addressing the COVID-19 pandemic.
COVID Related Liability Protection
Legislation Introduced in House
This week, Reps. Garret Graves (R-La.) and Henry Cuellar (D-Texas) introduced the Get America Back to Work Act, which will provide liability protection for businesses from Coronavirus-related lawsuits. The bill would be effective to cover any claims from January 1, 2020 to 18 months after the end of the emergency period. NCPA has been advocating for liability protection with a coalition of essential businesses, and it remains a priority for Republicans, as well as the White House, for the next relief package. Sen. John Cornyn (R-Texas) is also working on legislation, which is expected to be the basis for the Senate’s upcoming package.
NCPA Supports Legislation
to Simplify PPP Loan Forgiveness
This week, NCPA joined over 130 other organizations on a letter of support for S. 4117, The Paycheck Protection Program Small Business Forgiveness Act. This bipartisan legislation would forgive PPP loans of less than $150,000 upon the borrower’s completion of a simple, one-page forgiveness document. PPP loans of $150,000 and under account for 86 percent of total PPP recipients, but less than 27 percent of PPP loan dollars
President Trump Signs S. 4116 into Law
On July 4, President Trump signed S. 4116 into law. This bill extends the application period for the Paycheck Protection Program through August 8, 2020. Before this law was passed and enacted, the program was slated to close at the end of June.
NCPA Officers and Members
Attend White House Event
Three NCPA officers were among the invited guests at the 2020 Salute to America at the White House. NCPA Board Chairman Hugh Chancy and his wife, Tina Chancy; President Brian Caswell and his wife, Gretchen Caswell; and President-Elect Michelle Belcher and her husband, Ken Belcher; joined members of the military, first responders, doctors, nurses, and others fighting the coronavirus pandemic on the front lines. Also representing NCPA at the event: Cole Sandlin and his guests, NCPA Immediate Past President Bill Osborn and his wife, Jane Osborn; Danny Cottrell and his guests, NCPA Past President Steven Giroux and his wife, Carolyn Giroux. Here’s a video from the celebration.
Senate Finance Committee Chair Grassley
Reintroduces Drug Pricing Bill
Last week, Senate Finance Committee Chairman Charles Grassley (R-Iowa) reintroduced his drug pricing bill, S. 4199, the Prescription Drug Pricing Reduction Act (PDPRA). This bill contains the DIR reform provision, which is derived from the Phair Pricing Act, that Grassley and Ranking Member Ron Wyden (D-Ore.) added to their bipartisan legislation in December, which had passed the Senate Finance Committee last year. However, the newly reintroduced bill is only cosponsored by Republicans as drug pricing has become a highly partisan issue as we head towards the November election.
General Distribution Fund Reopening
According to news reports, the Administration is working to reopen the General Distribution Fund for the nearly one-third of providers who received a small General Distribution payment and who may have missed an opportunity to apply for additional funding due to confusion about the deadline and eligibility requirements. Many providers did not apply for additional General Distribution payments assuming they would be eligible for the round of funding targeted at Medicaid providers and were surprised that any amount of payment received under the General Distribution resulted in ineligibility for the Medicaid distribution. HHS has indicated to news outlet POLITICO that any provider that missed the deadline will be able to apply and be eligible to receive 2 percent of their revenue from seeing patients. More guidance will be forthcoming.
HHS Announces Over $4 billion
in Additional Provider Relief Fund Payments
HHS has announced a second phase of General Distribution from the Provider Relief Fund to be made available through the Health Resources and Services Administration (HRSA) to hospitals serving vulnerable populations on thin margins. This second phase of General Distribution will continue to expand to include other providers submitting applications for future relief funding opportunities as directed by HHS. Be sure to check the Provider Relief Fund FAQs regularly as HHS continues to update with new information. In the latest update: returned payments will be allocated by HHS to future Provider Relief Fund distributions; HHS will notify Provider Relief Fund recipients in the coming weeks with applicable audit requirements that need to be met to comply with the Terms and Conditions; and specific examples from multiple types of tax forms applicable to different organization categories are given to clarify what specific revenue information should be entered into the Enhanced Provider Relief Payment Portal.
NAIC Releases Draft PBM Model Legislation
The National Association of Insurance Commissioner’s Pharmacy Benefit Manager Regulatory Issues Subgroup has released a first draft of its PBM model legislation, available here. Although still a work in progress, the draft language would require PBMs to obtain a license from the state’s insurance commissioner, permit the commissioner to adopt PBM regulations, and prohibit certain PBM abuses (such as retroactive payment reductions, spread pricing, and self-dealing). The subgroup, which has been working on this legislation for over a year, is made up of insurance commissioners and their staff from across the country. NCPA has worked with NAIC throughout this process and had the opportunity to present to the subgroup on the impact PBMs are having on pharmacies, patients and payers/taxpayers.
NCPA Comments on CMS’ Second COVID-19
Interim Final Rule
This week NCPA submitted comments to CMS on the agency’s second interim final rule related to COVID-19. NCPA urged CMS to create a direct pathway under Medicare and Medicaid for pharmacists to bill for COVID-19 testing services for patients who come to their pharmacies (currently pharmacies have to enroll as a clinical lab and are only allowed to bill for the test itself). We also urged CMS to address DIR fees, recognize medical at home LTC pharmacy services, and include pharmacists within its telehealth expansion under Medicare.
HHS Releases May and June COVID-19
Testing Plans from All States
HHS released May and June COVID-19 Testing Plans from all states, territories, and localities available at HHS.gov. The plans include details on “response to surge cases and how to reach vulnerable populations including minorities, immunocompromised individuals and older adults.” Testing plans by state and jurisdiction can be found here.
Time is Running Out to Save
on NCPA Convention Registration
If you have not yet registered for theNCPA 2020 Annual Convention, time is running out to save on your registration rate. The deadline to take advantage of the flash sale and save $100 is 11:59 ET tonight! Use code FLASH100 to claim your discount. We look forward to seeing you Oct. 17-20 in Nashville, Tenn. For more, view the preliminary convention schedule.
NCPA Remains Engaged on ESI Tricare Recoupments
As NCPA continues to learn more about the ESI/Tricare compound recoupment issue, we continue to partner with the Alliance for Pharmacy Compounding to provide the most up-to-date information for our members about the situation and steps they can take. This white paper is the third one that NCPA has provided for members.
Study Finds NADAC Plus Dispensing Fee
Does Not Increase Drug Spending in Medicaid
A paper published in the July Health Affairs Journal shows that NADAC reimbursement does not increase total drug spend in Medicaid. The author’s key finding is that switching Medicaid from list-based reimbursement to invoice based reimbursement has no statistically significant impact on total drug spend. The authors found that switching to NADAC lowered ingredient cost and therefore lowered total drug spend. And even with higher dispensing fees under NADAC based reimbursement there was no evidence of an increased overall drug spend.
NCPA, Other LTC Organizations Ask CMS
to Recognize Medical at Home Services
NCPA and almost 40 long-term care pharmacy related organizations asked CMS to formally recognize and promote medical-at-home pharmacy services to help improve value-based patient care during and beyond the COVID-19 public health emergency. According to the letter, demand for these services have been on the rise even before the pandemic, but in light of current circumstances, formal recognition is needed now to “meaningfully address the increasing aging population with long-term and complex health care needs and who require assistance with activities of daily living, especially during the COVID-19 crisis.” CMS recognition for medical-at-home services is the No. 1 priority of NCPA’s Long-Term Care Division.
CMS Delays Part D Final Rule
on Prior E-authorization
CMS has announced that it will delay finalizing the Secure Electronic Prior Authorization for Medicare Part D Final Rule in order to minimize the burden on Part D plans in light of the COVID-19 public health emergency. The Final Rule is meant to expedite access to necessary medications and ease prescriber burden by giving clinicians the ability to complete prior authorizations online (rather than over the phone or via fax) through a streamlined process in real time before the prescription is sent to a pharmacy.
Pharmacy Organizations Urge HHS Authorization
to Order and Administer COVID-19 Vaccines
In a letter with twelve other national pharmacy organizations, NCPA urged HHS to authorize pharmacists to order and administer COVID-19 vaccines, as well as provide clarification about the preemptive scope of this authority, similar to the authority provided for COVID-19 and influenza testing under the Public Readiness and Emergency Preparedness (PREP) Act.
NCPA Comments on NIOSH Hazardous Drugs List
NCPA submitted comments to the National Institute for Occupational Safety and Health (NIOSH) in response to the 2020 NIOSH List of Hazardous Drugs in Healthcare Settings and supporting documents. In the comments, NCPA asked NIOSH for clarification regarding the use of personal protective equipment (PPE) in certain situations and recommended that NIOSH include a table in the List that highlights substances that pose a risk to healthcare workers based on volatility.
DEA Proposed Rule on Controlled Substance Use in LTC
In response to prolonged advocacy by NCPA’s Long-Term Care (LTC) Division and other pharmacy stakeholders, the Drug Enforcement Administration (DEA) has announced an advance notice of proposed rulemaking to revise regulations relating to the dispensing and disposal of controlled substances in long term care facilities (LTCFs). The rule would consider a number of issues that would impact community and LTC pharmacies, including potential designation of LTCFs as DEA registrants, changes to the current prescription process in favor of chart/medication orders, and proposals to streamline the relationship between LTCFs and pharmacies. Join the NCPA LTC Division to stay up to date with LTC news, resources, and to access members-only newsletters.
NCPA Comments on Ohio Medicaid Proposed Rule
for Coverage of Pharmacist Services
NCPA submitted comments to Ohio Medicaid’s proposed rule for coverage of pharmacist services. According to the proposed rules, Ohio Medicaid would provide coverage for certain pharmacist provided care under certain stipulations. However, the rules unnecessarily limits the pharmacy services for which Medicaid will cover to those services performed on behalf of a prescriber. NCPA recommended the Department amend the language to provide coverage for any pharmacist service provided to a Medicaid recipient.
NCPA Comments on Proposed Colorado BOP
Rules and Regulations
NCPA submitted comments to CO BOP in support of the proposed pharmacy rules and regulations that would authorize pharmacists to order and administer COVID tests, and extend beyond use dates for low risk compounded sterile products. These rules will positively expand patient access to testing and medically necessary compounded medications. NCPA also recommended allowance be given for pharmacists to utilize their highly trained pharmacy interns and certified technicians in COVID-19 testing.
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