2021 Virtual Fly-in Registration Now Open

Registration is now open for NCPA’s 2021 Congressional Pharmacy Virtual Fly-in. Join your peers April 19-21 to participate in meetings with your federal legislators to advocate for pro-pharmacy policy priorities. This year NCPA will handle scheduling of meetings and provide the virtual platform so you can share your stories about how onerous pharmacy DIR fees and network exclusion negatively impact your pharmacy and your patients and also your personal examples of the positive impact you are making during the pandemic.

Biden Administration Increases Medicare Reimbursement
for COVID Vaccine

This week, NCPA applauded the Biden administration’s decision to nearly double the Medicare reimbursement rate for administering the COVID-19 vaccine. “The COVID-19 vaccine is only as effective as the distribution system. There are more than 21,000 small business community and long-term care pharmacies in the country. Many are administering the vaccine now, but some would lose money at the current reimbursement rate,” said NCPA CEO B. Douglas Hoey. “Increasing the Medicare rate from an average of $23 per vaccination to $40 per vaccination allows community pharmacists to recoup the additional personnel, administrative, and capital expenses associated with immunizing their patients. We would like to see it replicated for Medicaid and private plans to maximize the number of patients immunized as soon as possible.”

Biden Administration Delays Effective Dates
for Rules Affecting Community Pharmacy

In order to further study and review rules finalized in the last days of the Trump Administration, HHS has been postponing the effective dates of several rules to consider policy, factual, and legal issues:

• The Rule on “Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals” - better known as the “Rebate Rule” that would modify the safe harbor protections to pass rebates along to patients at the point of sale – has also been delayed from January 1, 2022 to January 1, 2023. NCPA submitted comments advocating for the inclusion of a DIR fix in the proposed rule.
• The Rule on the “Implementation of Executive Order on Access to Affordable Life-saving Medications” which would pass 340B pricing savings for insulin and injectable epinephrine at Federally Qualified Health Centers to patients is further delayed to July 20, 2021 from the original date of January 22, 2021. NCPA provided supportive comments during the Notice of Proposed Rulemaking.
• The SUNSET Rule, which would require the agency to evaluate and access regulations which are more than ten years old within a five-year period has been delayed from March 19, 2021 to March 22, 2022. NCPA provided comments on the negative effects such an unstable regulatory environment would have on community pharmacy. There is an ongoing legal challenge in the Northern District of California.

NCPA will continue to advocate on behalf of community pharmacy as the Biden Administration considers modifications or withdrawals of these and other regulations.

NCPA Joins Coalition Letter to Support Extension of PPP

This week, NCPA joined 93 other organizations representing small business borrowers and lenders on a letter in support of the PPP Extension Act of 2021, urging Congress to extend the Paycheck Protection Program (PPP) filing deadline by two months, to May 31, 2021 to help businesses keep their workforce employed during the current health crisis.

Senate Confirms Becerra to Lead HHS

This week, the U.S. Senate confirmed California Attorney General Xavier Becerra to serve as Secretary of Health and Human Services. Prior to his nomination to lead HHS, Becerra led a bipartisan coalition of 46 attorneys general in filing an amicus brief supporting the state of Arkansas’ position in Rutledge v. PCMA that federal law does not prevent states from regulating pharmacy benefit managers. NCPA congratulates Mr. Becerra on his confirmation and looks forward to working with him in his new position.

House Judiciary Subcommittee Continues
to Look at Antitrust Reforms

This week, the House Judiciary Antitrust subcommittee held their third hearing on strengthening competition in the United States. The witnesses ranged from Acting Federal Trade Commission (FTC) Chair to multiple state attorneys’ general. The focus of this hearing was the need for Congress to reform current outdated antitrust laws to clarify Congressional intent due to bad judicial precedents that have been handed down from the courts over the years. Many Members of the subcommittee underscored the importance of promoting competition and addressing monopolies in industries from pharmaceuticals to airlines to technology.

Credit Card Companies to Delay Fee Hike

Visa and Mastercard have announced that they’ll wait a year to implement a planned boost in fees U.S. merchants pay when consumers use credit cards online. The increase now is set for April 2022 because of the pandemic. According to Bloomberg, Mastercard said it will also delay a planned increase that would affect some brick-and-mortar stores. NCPA advocated for the delay when the pandemic began.

HHS Retracts Changes to Model Limiting Drug Coverage;
Allows MTM+ Development

This week, HHS withdrew part of the changes to the voluntary Payment Modernization Model proposed by the Trump Administration. Under the proposal, CMS would have permitted insurers to submit applications for CY2022 for plans to cover five of the six protected classes and only one drug per class. NCPA, along with other pharmacy groups, voiced concerns with HHS in a letter on the interjection of insurers and PBMs into the treatment of patients and the negative effects of this policy on underserved and minority populations. However, CMS is including MTM+ in the CY2022, which permits plans to design MTM programs with a waiver from current regulatory requirements – but CMS is not providing additional funding for the development and implementation of MTM+ programs.

Ohio Selects Single PBM for State Medicaid Program

Ohio selected Gainwell Technologies as the single PBM to administer its Medicaid prescription drug benefits. Gainwell was selected, in part, because it does not own any retail or specialty pharmacies, so there will be less patient steering and PBM conflicts of interest that increase costs for taxpayers and limit beneficiary access to community pharmacy services. Those previous conflicts of interest have led the Ohio Attorney General to sue Centene Corp. for using its PBM, Envolve Pharmacy Solutions, to “maximize company profits at the expense of the Ohio Department of Medicaid.”

NCPA Joins Effort to Oppose Washington State
Estate Tax Increase

This week, NCPA joined 37 other organizations to oppose efforts to double the top estate tax rate in Washington State. In a letter to Rep. Tina Orwall (D), the organizations noted that the proposed increase will make it harder for family owned and operated businesses, farms and ranches to pass to the next generation of ownership.

NAIC Draft PBM Model Legislation Moves Forward

The model PBM legislation being developed by the National Association of Insurance Commissioners (NAIC) has cleared another hurdle. The Regulatory Framework Task Force has voted the bill out of committee, so it will now move on to the Health Insurance and Managed Care Committee. NCPA will continue working with NAIC to ensure the commissioners understand the importance of PBM legislation in the states.

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.