NCPA DIR Lawsuit Webinar
We invite you to join NCPA for a webinar, NCPA v. Azar: The Fight to End DIR on Thursday, Jan. 28 at 8:00 p.m. ET, that will review our strong legal case against pharmacy DIR fees. This webinar is an opportunity to hear from NCPA leadership and our legal counsel about this case, which is the next step in NCPA’s ongoing battle against pharmacy DIR fees, which started in 2014. Please consider supporting NCPA’s fight on your behalf with a contribution to NCPA's Legislative/Legal Defense Fund. You can give online or text LDF to (703) 783-9397 to donate.
NCPA Applauds Biden Administration COVID-19 Strategy
In a statement, NCPA CEO B. Douglas Hoey applauded the Biden Administration National Strategy for the COVID-19 Response and Pandemic Preparedness. Hoey noted that small business independent pharmacies have been engaged in the fight against the Coronavirus from the beginning. Moreover, independent community pharmacies have played an integral role in the successful vaccine rollout strategies in places like West Virginia, Arkansas and Alaska, and NCPA is eager to work with the administration on these, and other, important initiatives.
Additionally, an August 2020 survey of NCPA members found that 86 percent of community pharmacists say they plan to offer the COVID-19 vaccines when they hit the marketplace
DIR Coalition Submits Letter on DIR to Biden Transition Team
This week, NCPA joined the other members of the DIR Coalition in a letter to encourage the incoming transition team to address DIR reform. Unfortunately, the Trump Administration did not finalize any of the proposals they initiated. DIR reform is necessary to provide clarity on the true price of the cost of Part D drugs and to initiate reforms to benefit patients. NCPA has filed a lawsuit against HHS for the lack of action on behalf of the agency to address DIR fees and will continue to vigorously advocate for DIR reform before the Administration and Congress.
SBA Now Accepting Second Draw PPP Loan Applications
The application portal for second draw Paycheck Protection Program (PPP) loan is now open until the March 31, 2021 deadline. Please note that there are now three different application forms for PPP loan forgiveness—the standard Form 3508 for all borrowers, the Form 3508EZ for borrowers who did not reduce employee levels, wages, or hours, and the Form 3508S for borrowers who took out loans of $50,000 or less. In addition, the Small Business Administration (SBA) and the Department of the Treasury has released guidance that implements changes required by the Economic Aid Act, part of the larger Consolidated Appropriations Act of 2021, related to the forgiveness and review of PPP loans. Please be sure to consult with your legal counsel and/or tax advisors before applying for a second draw PPP loan or any federal program for which you might be eligible.
Pennsylvania Increases Medicaid Reimbursement
for COVID-19 Vaccines
This week Pennsylvania announced it would be increasing the Medicaid payment rate for COVID-19 vaccines to the Medicare rate of $16.94 (1st dose) and $28.39 (2nd dose). This new rate is an increase from the $10 (for each dose) that Pennsylvania previously adopted as the payment rate. NCPA joined the Pennsylvania Pharmacists Association, the Philadelphia Association of Retail Druggists, the Pennsylvania Association of Chain Drug Stores, Value Drug Company and the National Association of Chain Drug Stores on a letter urging Pennsylvania Medicaid to increase payments to a rate no less than rates paid under Medicare. Additionally, NCPA has been in regular communication with CMS so they are aware of states with Medicaid payments less than current Medicare rates.
CMS Reverses Itself and Approves Washington States’
Flawed Medicaid Reimbursement Plan
In a surprising reversal, CMS approved a Washington State Medicaid reimbursement plan which includes a Medicaid dispensing fee well below neighboring states and the national average. In March 2019, CMS disapprovedthe state’s Medicaid reimbursement, and Washington filed an appeal. In November of last year, an administrative law judge also ruled that Washington State’s Medicaid reimbursement plan violates Medicaid rules. NCPA joined NACDS and the Washington State Pharmacy Association (WSPA) in a letter to CMS asking that CMS adopt this decision so Washington State is required to resubmit a state plan amendment that includes an appropriate dispensing fee. In the waning moments of the Trump Administration, CMS reversed their original decision, and with little explanation, approved this flawed Medicaid reimbursement that could potentially reimburse pharmacies well below their costs. NCPA, NACDS and WSPA are determining next steps to address this unfair and nonsensical decision by CMS.
Energy and Commerce Subcommittee
Assignments Announced
Democrats and Republicans on the House Energy and Commerce Committee have announced their subcommittee assignments. Rep. Anna Eshoo (D-Calif) will chair the health subcommittee and Rep. Brett Guthrie (R-Ky.) will serve as the ranking member. The health subcommittee is the starting point for most of community pharmacy’s legislative priorities. A full list of Democrat subcommittee assignments is available here and the list of Republican assignments is available here.
HHS Office of Civil Rights Will Not Impose Penalties
for COVID Vaccine HIPAA Violations
This week, the HHS OCR announced it will not impose penalties on healthcare providers for good faith violations of the HIPAA Rules in connection with online or web-based scheduling applications for individual appointments for the COVID-19 vaccine during the ongoing nationwide public health emergency. While this policy was announced this year and effective immediately, it retroactively applies to December 11th, 2020.
President Biden Pauses Unpublished Regulations,
Seeks Regulatory Reform
On his first day in office, President Joe Biden, in a memo from his Chief of Staff, paused any regulatory actions which have not been published in the Federal Register or delaying rules which have not yet been implemented for 60 days. Additionally, the President issued a memo requiring the Director of OMB, in conjunction with the agency heads, to review the current regulatory process and produce a set of recommendations on how to modernize and improve the process. NCPA will monitor the actions of the new Administration for any potential changes or revocations on guidance, rules, and regulations which impact community pharmacy.
CMS Finalizes Rule on the Prior Authorization Process
On January 15th, 2021, CMS issued a final rule on the prior authorization process for fee for service programs, Medicaid managed care programs, CHIP managed care entities, and Qualified Health Plans (QHP) on the federal exchanges. The rule requires those cited programs and plans to build, implement, and maintain APIs using a standard to promote automation of the prior authorization process. Additionally, the rule places deadlines on decisions for prior authorizations – 72 hours for urgent requests and 7 calendar days for non-urgent requests – and any denial must be accompanied by a reason. These changes will take effect on January 1st, 2024. Under rules promulgated by CMS under authority of the SUPPORT Act, electronic prior authorization for Part D plans is required by January 1st, 2022.
HHS Releases Vaccines National Strategic Plan 2021-2025
HHS has released its Vaccines National Strategic Plan 2021-2025 (Vaccine Plan), which provides a common vision for the immunization system of government agencies and offices, vaccine researchers and experts, healthcare providers—including pharmacists—and systems, public health, health communicators, vaccine manufacturers, and health plans to better protect the public from vaccine-preventable illnesses. The Vaccine Plan recognizes that policy changes at the state and federal levels over the past two decades to expand pharmacist scope of practice has greatly expanded access to vaccines, and that addressing challenges and removing barriers associated with payments for vaccination services are crucial to not only continue increasing access, but reducing vaccination disparities by socioeconomic status, race, and ethnicity. The Vaccine Plan does not address issues related to COVID-19.
Update: HHS Emphasizes Community Pharmacists’ Role
in HIV Plan After NCPA Feedback
HHS’ recently released HIV National Strategic Plan, A Roadmap to End the Epidemic, 2021-2025, (Box 6, Pg. 30) emphasizes pharmacists and community pharmacies’ key role in HIV prevention and care after NCPA submitted comments to the Office of Infectious Disease and HIV/AIDS Policy (OIDP) on the draft HIV National Strategic Plan (HIV Plan) for 2021-2025. The plan highlights the opportunity to leverage pharmacists’ knowledge, accessibility, and relationship with patients and providers towards a comprehensive HIV prevention and care strategy to expand access to care and improve population health.
DQSA Coalition Submits Letter to Incoming Administration
on Compounding
NCPA, along with over 30 organizations, offered a letter to the incoming Biden Administration to serve as a resource on compounding issues. The letter highlights several issues which have arisen during the Trump Administration: reimbursement issues, the ongoing MOU on interstate compounded drug shipments, and the NASEM report on compounded bioidentical hormone therapy. The Coalition requests the Biden Administration revisit these policies and resolve the issues surrounding those policies.
NCPA Submits Comments Supporting Washington PBM Reforms
NCPA submitted comments supporting two bills in Washington state: SB 5075and SB 5076. The bills would protect patient choice by requiring PBMs to contract with any pharmacy willing to meet its terms and conditions for network participation, allow patients to use the in-network pharmacy of their choice, and inform patients about their right to refuse to use mail-order pharmacy. Both bills are currently being considered by the Senate Health & Long Term Care Committee.
NCPA Opposes Potential California Board of Pharmacy Ban
on 503A Pharmacies Compounding Methylcobalamin
In coordination with the California Pharmacists Association, NCPA submitted comments to the California Board of Pharmacy emphasizing the need to maintain appropriate patient specific compounded Methylcobalamin (MeCbl) medications through 503A pharmacies licensed in the state. The Board expressed its desire to ensure safety through cGMP requirements via 503B pharmacies, but upon pushback from patients, physicians, and pharmacists, the Board will not be taking any action at this time.
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. The weekly update is intended exclusively for the recipient and is not for external distribution.