NCPA Staff and Members Meet with CMS Part D Team
On October 7, 2021, NCPA staff and members, Susan Rhodus RPh, SVP Contract Administration, of GeriMed, and Jeff Olson, PharmD, owner of Montross Pharmacy, met with the CMS Part D team to discuss issues effecting independent pharmacy and policies which might address those problems. Specifically, NCPA encouraged CMS to be granular in gathering performance data from PBMs under the new pharmacy performance measurement collection requirement, issue guidance on Medical at Home reimbursement which better reflects the additional services LTC pharmacies are providing patients, address auditing, enrollment, and credentialing issues with the PBMs, and finally Part D contractual issues observed during this year. NCPA will continue to advocate to CMS for policies allowing independent pharmacies to continue to serve Part D patients.
NAIC Discusses SCOTUS Rutledge Decision
The National Association of Insurance Commissioners’ ERISA Working Group held a meeting to discuss a draft summary for the NAIC ERISA Handbook analyzing the Rutledge court decision, in which the US Supreme Court held that the federal ERISA law does not preempt Arkansas’s PBM regulations. Following the meeting, the Group will accept written comments from interested parties to provide input on issues such as how much authority did the Supreme Court grant states to fully regulate PBMs-including those administering the benefit for ERISA plans.
2022 Medicare Resources for Pharmacists Now Available
The Medicare Part D Annual Election Period (AEP) starts Oct. 15, giving beneficiaries a chance to review coverage and make changes for 2022. Check out NCPA's list of helpful resources to help you answer patient questions about Part D, and don't forget to also use our Talk to Your Pharmacist First materials to get the conversation started. CMS makes changes to the program all the time, and our resource section lists important changes that community pharmacists should know. The AEP ends Dec. 7, 2021.
New DEA Form is Mandatory as of Oct. 30
As of Oct. 30, the DEA will require the mandatory use of a single sheet DEA 222 order form. This is the form that allows DEA registrants to order and transfer Schedule I and Schedule II controlled substances. After Oct. 30, the triplicate DEA order form will no longer be available or accepted. If you need to place an order for the newly implemented single sheet DEA 222 order forms, submit a request on the DEA website here.
CMMI Issues Evaluation Report
on Part D Enhanced MTM Model
Earlier this year, the CMS Center for Medicare & Medicaid Innovation (CMMI) released an evaluation report of the Enhanced Medication Therapy Management (MTM) model for the years 2017-2019. Originally implemented in 2017, the EMTM model tests whether permitting PDPs additional incentives and flexibilities improved medication management, resulting in improved outcomes for patients and reducing overall costs. However, CMMI stated in the report, the model did not have significant impact on expenditures and only modest improvements in outcomes for specific conditions – like diabetes. NCPA, as part of a coalition of organizations across the healthcare spectrum, sent a letter urging HHS Secretary Becerra to extend the EMTM model beyond the expiration date of December 31, 2021 and to apply key flexibilities developed under the model to other Part D plans to better study the benefits for patients.
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.