NCPA Welcomes new CMS Administrator

In a welcome letter to Chiquita Brooks-LaSure, NCPA congratulated the new Administrator of the Centers for Medicare & Medicaid Services (CMS) on her recent appointment and requested a meeting to continue the dialogue begun in December, 2020 when NCPA met with Brooks-LaSure and other members of the Health and Human Services (HHS) transition team. In the letter, NCPA highlighted the essential role of independent community and LTC pharmacies and particularly the critical contributions of NCPA members during the ongoing COVID-19 pandemic, and shared the following recommendations with CMS: 1) eliminate retroactive DIR fees immediately; 2) retain pharmacist patient care authorities and flexibilities provided during the COVID-19 public health emergency; 3) require detailed Part D reporting requirements on pharmacy performance measures; and 4) develop Part D plan guidance for medical at home pharmacy services. The Administrator’s office has responded to our meeting request and is working to schedule a time to meet with NCPA to discuss these priorities.

NCPA 1-Pager Shows PBM Reform
Does Not Increase Health Premiums

Community pharmacists have long known that PBM conflicts of interest stifle patient choice and raise costs for payers. The PBM lobbying group, however, continues to spread bogus claims that legislative efforts to control those costly conflicts will actually raise costs for consumers. But a new NCPA resource shatters that myth. We’ve looked at the data and found that states that license PBMs have seen smaller increases in health insurance premiums than states that do not license PBMs. Here's the one-pager for more information. Feel free to share it with policymakers to show that it is possible to regulate PBMs and benefit patients and local business without raising costs.

Medicare Increases COVID Vaccine Reimbursements
for Certain Patients

CMS has announced, effective June 8, 2021, an additional $35 payment for pharmacists and pharmacy technicians administering the COVID-19 vaccine (per dose) in the home of Medicare patients that have difficulty leaving their homes or are hard to reach. This is in addition to the standard administration amount (approximately $40 per dose), for a total payment of approximately $75 for a single-dose vaccine or $150 for both doses of a two-dose vaccine when administered in a Medicare patient’s home. CMS will geographically adjust the additional amount and administration rate based on where the vaccine is administered. This is a key announcement for independent pharmacies because it’s mostly independents who are visiting homes. Many types of locations can qualify as a Medicare patient’s home for the additional in-home payment amount, including a unit in an assisted living facility (ALF) or group home. However, communal spaces of a multi-unit living arrangement do not qualify as a home for the additional payment amount, nor do Medicare skilled nursing facilities (SNFs) or ALFs participating in the CDC’s Pharmacy Partnership for Long-Term Care Program when their residents are vaccinated through this program. Additional information regarding eligibility and restrictions can be found here.

NCPA Victory: PCAC Votes To Include Methylcobolamin
on 503A Bulk List

By a 9 to 5 vote on June 9, 2021, the Pharmacy Compounding Advisory Committee (PCAC) recommended that FDA keep methylcobalamin on the 503A Bulk List. Prior to the meeting, NCPA submitted comments in favor of the inclusion and was represented by NCPA member and Compounding Committee member A.J. Day from PCCA during presentation and discussion. Both the written comments and Dr. Day’s presentation highlighted the importance of the availability of methylcobalamin for patients with Autism Spectrum Disorder (ASD). As a result of this vote, 503A compounding pharmacies will continue to have access to methycobalamin to treat their patients. All the substances discussed on June 9, 2021 for inclusion will go through a rulemaking process before officially becoming part of the list. FDA is not obligated to follow the advice of the PCAC, though they do consider the input.

HHS Updates Deadline to Expend
Provider Relief Fund Payments

The Department of Health and Human Services (HHS) announced revisions to the Provider Relief Fund (PRF) program, extending the deadline to expend PRF payments for recipients who received payments after June 30, 2020, and issuing revised reporting requirements applicable to providers who received one or more payments exceeding, in the aggregate, $10,000 during a single distribution period. The deadline to expend funds received between July 1 and December 31, 2020 is December 31, 2021, while funds received between January 1 and June 30, 2021 must be expended by June 30, 2022, and funds received from July 1 and December 31, 2021 must be expended by December 31, 2022. Please note that If you received a PRF payment between April 10 and June 30, 2020, the deadline to use those funds remains June 30, 2021. The revised reporting requirements can be found here. The PRF Reporting Portal will open for providers to start submitting information on July 1. More information can be found on the PRF website here.

Bipartisan Legislation Introduced
to Address Drug Shortages

On June 1, 2021, Representatives H. Morgan Griffith (R-Va.) and Henry Cuellar (D-Tex.) introduced H.R. 3662, the Patient Access to Urgent-Use Pharmacy Compounding Act of 2021. This legislation would create a permanent regulatory scheme for 503A compounding pharmacies to prepare urgent-use and shortage drugs for hospitals and physician offices when the drugs are unavailable from manufacturers or 503B outsourcing facilities. This would effectively extend the temporary guidance released by the FDA during the public health emergency to address local, regional, and national drug supply issues and shortages.

Registration Open for In-Person
2021 NCPA Annual Convention

Registration is now open for the in-person NCPA 2021 Annual Convention in Charlotte, N.C. from Oct. 9-12. Register by June 22 to get $100 off the registration rate by using the code Flash100. Don’t miss the chance to reconnect with your colleagues for four days of best-in-class business education, great networking, and a little fun in Charlotte.

Help Patients Fight Back Against PBM Steering

NCPA developed materials that you can use in your pharmacy to help your patients fight back against PBM steering. These materials direct your patients to the resources available to them on Fight4Rx. Encourage your patients to take advantage of these resources, particularly a tool that helps them customize their own letter. Contact Michael Rule with any questions.

Maine PBM Bill Passes Both Chambers

Maine LD 1450, which prohibits PBMs from utilizing misleading advertising, has passed both chambers. NCPA was proud to offer testimony in support of the bill during the committee hearing process.

New York PBM Licensure Bill Passes the Assembly

New York S3762 passed the Assembly and has been returned to the Senate. The comprehensive PBM reform bill requires PBM registration with the state, establishes reimbursement appeals processes, and contains other protections for community pharmacies and their patients.

NCPA Submits Written Testimony
Supporting Delaware PBM Reform Bill

NCPA submitted written testimony in support of Delaware HB 219. The bill would establish network adequacy standards, require ingredient costs to be reimbursed no lower than NADAC, eliminate spread pricing, and establish additional protections for community pharmacies and patients. The bill was reported out of committee.

Second Texas PBM Reform Bill Awaiting Governor’s Signature

TX HB 1919, a bill prohibiting patient steering, is the second major PBM reform bill to pass the Texas legislature this year. This important PBM reform legislation will protect Texas pharmacists and their patients by:

• Prohibiting PBMs from steering patients to their affiliated pharmacies through online or patient-specific messaging.
• Prohibiting PBMs from using patient-specific prescription information for commercial purposes.
• Requiring patient consent to transfer a prescription.
• Providing reasonable safeguards to ensure patients’ best interests are protected, and that decisions based on profits do not overrule the choices of patients and their healthcare providers.

The PBM and plans are putting vast amounts of resources towards efforts to having this bill vetoed. NCPA has joined the Texas pharmacy advocates in urging Governor Abbott to sign this patient protection legislation. Governor Abbott recently signed HB 1763, a comprehensive PBM reform bill that unanimously passed the House and Senate.

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.) 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