NCPA Advocacy Update

Week ending August 13

Author: APCI Staff/Monday, August 16, 2021/Categories: Legislative Affairs

NCPA Statement on Biden Drug Pricing Plan

NCPA CEO B. Douglas Hoey issued a statement in response to President Biden’s drug pricing remarks (video recording of remarks are available here, and a fact sheet on the President’s plan can be found here), noting that the “President’s plan takes a swing at lowering drug prices and whiffs by ignoring the most glaring cause of high drug costs,” “Pharmacy benefit managers and their insurer-partner/owners continue to manipulate drug costs so consumers pay more, steer patients to their own pharmacies, and squeeze small-business neighborhood pharmacies with backdoor fees.” Read the full statement here.


NCPA Documents Highlight State Legislative Victories

NCPA has published two documents highlighting pro-pharmacy legislation that has been enacted in the states. The first highlights all PBM reform and scope of practice bills passed in 2021, as well as the state government reports showing PBMs’ mismanagement of publicly funded pharmacy benefit programs. The second highlights the state legislation from the 2021 session that was directly impacted by the U.S. Supreme Court’s unanimous decision in Rutledge v. PCMA.


Immunocompromised People with Medicare
to Receive Additional COVID-19 Dose At No Cost

The Food and Drug Administration (FDA) recently amended the emergency use authorizations (EUAs) for both mRNA vaccines from Pfizer-BioNTech and Moderna to allow for the use of an additional dose in certain immunocompromised individuals—specifically solid organ transplants recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise. Based on the revised EUA, the Advisory Committee on Immunization Practices (ACIP) has recommended an additional dose of an mRNA vaccine for moderately to severely immunocompromised individuals previously vaccinated with mRNA vaccines. Mixing and matching between the two mRNA vaccines is acceptable if the vaccine of the primary series a patient received is not available. It should be noted that these recommended additional doses are not considered “booster doses”. At this time, the EUA for the Janssen COVID-19 vaccine has not been amended for an additional dose and there is no recommendation for an additional dose in individuals previously vaccinated with the Janssen vaccine.

Further, the Centers for Medicare & Medicaid Services (CMS) has announcedthat people with Medicare who qualify for an additional dose can receive it with no cost sharing. Medicare will pay $40 for administering an additional dose of COVID-19 vaccines—the same amount as paid for other doses of the COVID-19 vaccine administered on or after March 15, 2021. For additional vaccine billing and reimbursement guidance, check out this NCPA resource.


FTC Seeks Comments on Anticompetitive Contracts

The Federal Trade Commission (FTC) is requesting public comments on contract terms that may be harmful to fair competition. If you have not done so, please take a few moments to send a comment letter to the FTC urging them to investigate unfair terms in PBM contracts and inform them of your own experiences of how these terms harm patient choice and competition. Be sure to add your comment to the more than 1,600 that have been submitted through this link.


Senate Passes Bipartisan Infrastructure Bill
then Adopts Budget on Party Line Vote

On Tuesday, the Senate passed its bipartisan infrastructure bill, a $550 billion package with money set aside for roads, bridges, transit, Amtrak and more. The 69-30 vote comes after months of negotiations between Congress and the White House, and while it marks a major milestone toward signing the measure into law, many more hurdles remain. In particular, Democrats have insisted that the bill be paired with a $3.5 trillion budget reconciliation bill that will cover other “social infrastructure” along with clean energy. The Senate passed their budget on a party line vote early Thursday morning, which is the first step towards a reconciliation bill that could include drug pricing priorities. House Speaker Nancy Pelosi has said she will not move the bipartisan infrastructure package until the Senate has completed its reconciliation bill, which will push any final passage into fall at the earliest. The House will come back from their August recess on the 23rd to consider the budget. After the budget has passed both chambers, key House and Senate committees have a tentative goal of September 15th to develop the actual $3.5 trillion reconciliation package.


NCPA Urges Fed to Enforce Routing Law
and Reduce Debit Rate Interchange Fees

NCPA submitted comments to the Board of Governors of the Federal Reserve System (Fed) in response to a proposed rule. The proposed rule would clarify that each debit card transaction must be able to be processed on at least two unaffiliated payment card networks, including in card-not-present transactions. The proposed clarification would protect a patient's ability to obtain prescriptions online and in a safe manner during the ongoing COVID-19 pandemic as well as bring immediate relief to independent pharmacies committed to keeping access to prescriptions available to their patients who guard their health by limiting trips inside stores. Staff at the Federal Trade Commission (FTC) submitted comments to the Fed similarly supporting the proposed clarification on card-not-present transactions as well as the two unaffiliated payment card network requirement, alleviating some of the burden that networks place on merchants and consumers.


CMS Proposes to Rescind Most Favored Nation Model
Interim Final Rule

CMS issued a proposed rule to rescind the Most Favored Nation (MFN) Model interim final rule for Medicare Part B Drugs and Biologicals (summary of the MFN Model here). NCPA had previously submitted comments urging the agency to rescind the rule and to work with NCPA and other stakeholders to identify more appropriate models to curb the cost of prescription drugs. NCPA comments had highlighted concerns related to patient access, specifically the creation of a situation where pharmacists are unable to acquire MFN Model drugs at prices commensurate with MFN Model reimbursement. The comments also raised several legal concerns, which had led federal courts to block implementation of the MFN rule in three separate cases, each order effectively blocking the MFN rule from taking effect.


NCPA Backs Rutledge’s Bid for Arkansas Governor

Arkansas Attorney General Leslie Rutledge has announced her candidacy to be the Republican nominee for governor in the 2022 election. Rutledge was the plaintiff in the landmark Supreme Court decision, Rutledge v. PCMA, which determined in a unanimous decision that states could regulate PBMs. NCPA PAC is supporting Rutledge in her race to be Arkansas’s top executive. The NCPA PAC supports many pharmacy champions. Please consider contributing to NCPA PAC. To learn more about Rutledge, visit her website.


Invite Your Legislator to Visit Your Pharmacy
During the August Recess

This week Rep. Michelle Fischbach (R-Minn.) visited a Thrifty White location in her district to discuss pharmacy priorities while Rep. Ron Estes (R-Kan.) visited Graves Drugs and heard about DIR fees. If you have not yet done so, this is an ideal time to invite your member of Congress to visit 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. The House and Senate are both in recess, with the House now expected to return the week of August 23 to consider the budget resolution passed by the Senate. Click here for tips on scheduling a pharmacy visit or contact Michael Rule at mrule@ncpa.org for assistance.


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 reformscope 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.

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