NCPA Urges Greater Enforcement Against
Anticompetitive PBM Practices
This week, NCPA submitted a statement for the record at a hearing held by the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights hearing to examine competition within the pharmaceutical marketplace. NCPA pushed the subcommittee to scrutinize the role of vertically integrated for-profit companies that have affiliated with pharmacy benefit managers and engage in business practices that put small-business community pharmacies and consumers at an economic disadvantage.
Among senators speaking at the hearing, Sens. Chuck Grassley (R-Iowa) highlighted how PBMs operate with little transparency, making it difficult for patients and others to understand drug pricing. Josh Hawley (R-Mo.) discussed the need to stop the retroactive collection of pharmacy DIR fees which drive independent pharmacies towards insolvency; and Marsha Blackburn (R-Tenn.) said that Congress should regulate PBMs to protect patients, community pharmacies, and taxpayers from anticompetitive PBM behaviors like audits, patient steering, and clawbacks. Read NCPA’s news release on the hearing here.
Rep. Fred Keller Makes a Pitch for DIR Legislation
at Committee Meeting
This week, the House Committee on Energy and Commerce held its "Member Day" hearing, offering House members a chance to testify on legislation or issues of importance to them, their constituents, and districts. Rep. Fred Keller (R-Pa.) testified in support of H.R. 3554, the Pharmacy DIR Reform to Reduce Senior Drug Costs Act, reiterating the shocking 91,500 percent growth in pharmacy DIR fees from 2010-2019 and the threat skyrocketing fees pose to small-business community pharmacies. He urged the committee to take up the bipartisan legislation that would save seniors $9 billion in their out-of-pocket drug costs and ensure that it is included in any drug pricing package. Ranking Member Cathy McMorris Rodgers (R-Wash.) chimed in with her support for getting a solution to the DIR fee problem across the finish line this Congress. You can hear Keller’s remarks at 47:50 on the recording.
NCPA Leaders Engage with White House Staff
Regarding Anticompetitive PBM Practices
This week NCPA was invited to participate in a private briefing with the White House National Economic Council & Special Assistant to the President for Technology and Competition Policy. NCPA President Brian Caswell was able to ask about potential corrective actions that can be taken to PBM mergers already approved and to share the plight of independent pharmacy owners related to the big 3 PBMs' monopolization of the prescription drug benefit market. NCPA will continue to engage with White House staff as well as the FTC as work is done to implement President Biden’s Executive Order on Promoting Competition in the American Economy that NCPA reported on last week.
Legal Win: Federal Judge Remands Washington State Case
Back to CMS
This week, in a win for NCPA, the U.S. District Court for the Western District of Washington approved a motion filed last week by the U.S. Department of Justice to remand back to CMS an unlawful, below-cost Medicaid pharmacy reimbursement plan in Washington state. NCPA, along with the Washington State Pharmacists Association and the National Association of Chain Drug Stores, had filed a lawsuit challenging the plan. The Trump administration’s acting CMS administrator had approved this flawed scheme on Jan. 19, the last day of the previous administration. If CMS disapproves the plan, Washington state should be required to submit a new Medicaid state plan amendment, reflecting the true cost of dispensing in the state and creating a reimbursement rate consistent with federal Medicaid rules. For more, read the joint press release issued by NCPA, WSPA and NACDS.
Legislators Visit Community Pharmacies
Over July 4 Recess Period
Several NCPA members hosted members of Congress for pharmacy visits during the July 4 congressional recess period. Rep. Michael Burgess (R-Texas), a member of the House Energy and Commerce Health Subcommittee visited Community Pharmacy in Denton, Texas owned by NCPA member Kelly Selby. Additionally, Rep. Darin LaHood (R-Ill.) visited Alwan Pharmacy and Compounding Center in West Peoria, Ill. owned by NCPA member Mike Minesinger and Rep. Michelle Fischbach (R-Minn.) visited a Thrifty White location in her district. The next Congressional recess period is scheduled for July 31-September 8. This is an ideal time to invite your member of Congress to tour your pharmacy and urge their support for pro-pharmacy and pro-patient legislation such as for S. 1909/H.R. 3554, the Pharmacy DIR Reform to Reduce Senior Drug Costs Act. Click here for tips on scheduling a pharmacy visit or contact Michael Rule at mrule@ncpa.org for assistance.
CDC: Federal PREP Act Authority Preempts State Law
Recently, the CDC issued a letter regarding the expiration of certain state, local, and tribal declarations of a public health emergency. While the expiration of these declarations might impact certain state and local regulations and requirements, they do not affect any authorities regarding COVID-19 testing or vaccination granted under the PREP Act. The federal declaration expressly preempts state law. Liability protections will continue to be extended to qualified persons, such as pharmacists, pharmacy interns, and technicians, through 2024 – regardless of actions a state or local entity might take. The federal PHE, which was extended effective April 21 for 90 days, will likely be extended for the remainder of 2021. NCPA anticipates an extension to be filed soon. The PHE affects telemedicine and other waived requirements for federal health care programs, including Medicare Part D flexibilities related to refill-too-soon edits, extended day’s supply, home or mail delivery, prior authorization, signature log requirements, and in-person audits. For more information, visit the CMS website. NCPA will continue to advocate for the permanent adoption of greater flexibilities to permit pharmacists to practice to the full extent of their license.
Advocacy Center Staff Directory
Click here to access NCPA's Advocacy Center staff directory for a listing of NCPA advocacy staff, their areas of responsibility and their contact information. NCPA advocacy staff members are available to assist with your questions and welcome hearing from our members. Don’t hesitate to contact us for assistance.
AIDS Healthcare Foundation Launches Campaign
Targeting CVS
The AIDS Healthcare Foundation recently launched a campaign focused on CVS and the harm the company is causing patients, community pharmacies and the health care system. As part of the campaign, interested advocates can send emails to their legislators alerting them to concerns with the company. Click here for more on the campaign.
States Enact Provider Status Legislation
NCPA is excited to see more states pass provider status legislation that mirrors the language under the U.S. Department of Health and Human Services guidance that grants authority for licensed pharmacists and pharmacy interns to administer the COVID-19 vaccines through 2024. Below is a list of bills that have become law to make this authority permanent and extended to other vaccines:
Illinois SB 2017 – allows pharmacists to administer all vaccines recommended on CDC schedules and travel vaccines for those 7 and older, requires reimbursement at the physician rate. Signed into law June 17, 2021.
Florida SB768 – authorize pharmacists who are certified to administer vaccines to adults and to also administer influenza vaccines to children seven years of age or older. Signed into law June 21, 2021.
Maryland SB736 – authorizes pharmacists to administer FDA approved vaccines to individuals 3-17 years old from July 1, 2021, to June 30, 2022. Enacted May 30, 2021.
Join Us in Charlotte, N.C. for the NCPA 2021 Annual Convention
If you have not yet done so, register for the in-person NCPA 2021 Annual Convention in Charlotte, N.C. from Oct. 9-12. Don’t miss the chance to reconnect with your colleagues for four days of best-in-class business education, networking opportunities, and a little fun in Charlotte. We look forward to seeing you there.
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.