DOJ Seeks to Block UnitedHealth Group
from Acquiring Change Healthcare

After meeting directly with DOJ attorneys reviewing the proposed acquisition of Change Healthcare by UnitedHealth Group, and publicly calling for DOJ to block the acquisition, NCPA applauded the DOJ’s action on Thursday against United and Change. The Antitrust Division of the Department of Justice, along with the States of Minnesota and New York filed a complaint against United and Change asking the court to find that the proposed acquisition violated antitrust law and to permanently stop United and Change from completing the deal.

FTC Seeks Public Comment on PBM Abuses

This week the FTC invited public comments about the practices of Pharmacy Benefit Managers (PBMs) and their impact on patients, physicians, employers, independent and chain pharmacies, and other businesses across the pharmaceutical distribution system. FTC staff is studying a wide array of PBM business practices and issues. The request for information is available here and comments can be submitted here.

Survey Shows Patients Tired of PBM Abuses

A recent NCPA-commissioned survey of 716 registered voters, conducted Feb. 14-15 by Public Policy Polling, showed that 84 percent of registered voters say health insurance plans and their PBMs shouldn’t tell patients which pharmacies to use, a practice known as “patient steering.” Specifically, 78 percent said insurance plans and PBMs shouldn’t require patients to use pharmacies owned by insurance plans and PBMs or be allowed to require patients get their medicines through the insurance company’s mail-order pharmacy. When asked if insurance plans and PBMs should require patients to use more expensive medicines when there is a less expensive alternative, 83 percent said no. If your patients are also tired of PBM abuses, direct them to Fight4Rx and encourage them to utilize the resources available to fight back against the PBMs. Read more about the survey here. NCPA’s press release on the survey is available here.

Only 10 Days Left to Support CMS’ Effort
to Address Pharmacy DIR Fees

Over the past three weeks, pharmacists submitted over 2,100 comments on CMS’ proposed part D rule using NCPA’s comment template. If you have not yet done so, there are only 10 days left to submit your own comment. Template comments should be personalized and submitted through NCPA’s grassroots portal.

Effectively personalize your comments by:

• Adding background on pharmacy including personal anecdotes about how long your pharmacy has been serving Part D patients and what percentage of reimbursement Part D represents
• Discussing the harm that will come to their patients, pharmacy, and employees if pharmacy DIR fees are not addressed (examples: have reduced pharmacy hours, stopped providing free home delivery of medications to seniors, closed your pharmacy)
• Providing examples of how pharmacy DIR fees have increased and how they have impacted their business (examples: reduce staff, reduce charitable/community donations)

Additionally, NCPA has created a patient template available through the Fight4Rx platform. Please share this link with your patients and encourage them to take a few moments to submit comments as well.

NCPA’s Karry La Violette Discusses Pharmacy DIR Fees
on IPA Podcast

Karry La Violette, senior vice president of government affairs at NCPA, discussed retroactive pharmacy DIR fees on the latest edition of the Independent Pharmacy Alliance podcast. Tune into the podcast to hear about the proposed rule addressing retroactive pharmacy DIR fees that appears to move nearly all pharmacy price concessions to the point of sale starting Jan. 1 and hear Karry explain how comments from pharmacy owners can make a difference. You’ll find the Independent Pharmacy Alliance podcast on Apple podcasts or listen here. Don’t forget to also listen to NCPA’s Independent Rx Forum podcast, available on Spotify, Apple, and most podcast forums.

Gov. Whitmer Signs Michigan PBM Bill into Law

This week. Gov. Gretchen Whitmer (D) signed HB 4348 into law. Among other things, it:

• Requires a PBM to be licensed in the state;
• Eliminates transaction fees and clawbacks;
• Eliminates spread pricing;
• Prohibits discriminatory treatment of non-affiliate pharmacies by PBMs; and
• Requires pharmacy audit protections

NCPA Victory: FDA Concedes the MOU
and Goes Back to Drawing Board

This week, the FDA voluntarily conceded the matter in Wellness Pharmacy v. Azar before the U.S. District Court of D.C. over implementation of the Memorandum of Understanding (MOU) as required under Section 503A. Originally released in October 2020, the MOU is an agreement that is intended to address interstate distribution of inordinate amounts of compounded drugs and complaint investigation by a state regulator relating to compounded drugs distributed outside the state. NCPA and other stakeholders had already successfully delayed enforcement until October 2022, but now the FDA is engaging in a notice and comment rulemaking process and will be extending enforcement discretion until that is completed. NCPA has provided a brief summary of the ruling and the next steps for the MOU here.

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.