NCPA Advocacy Update

Week ending March 18

Author: APCI Staff/Monday, March 21, 2022/Categories: Legislative Affairs

House Letter Expresses Bipartisan Support
for CMS’ DIR Efforts

This week, 85 members of the House of Representatives sent a letter to HHS Secretary Xavier Beccera in support of CMS’s proposed rule that reforms pharmacy DIR fees. The letter urges CMS to ensure that all price concessions are included at the point of sale, including those assessed in the coverage gap, and that pharmacy reimbursement is reasonable. The letter was led by Reps. Peter Welch (D-Vt.), Morgan Griffith (R-Va.), Vicente Gonzalez (D-Texas), Buddy Carter (R-Ga.), Raja Krishnamoorthi (D-Ill.) John Rose (R-Tenn.), Abigail Spanberger (D-Va.), and Diana Harshbarger (R-Tenn.). Additionally, Rep. Lisa Blunt Rochester (D-Del.) sent her own letter echoing support for the proposed rule.


Column Urges FTC to Reconsider PBM Vote

In a column published in The Hill this week, NCPA CEO Douglas Hoey and Rep. John Rose (R-Tenn.) explain how decades of vertical integration have damaged community pharmacy and patients. The column implores the FTC to reconsider its recent decision not to investigate PBM practices.


Senate Finance Committee Holds Drug Pricing Hearing

This week, the Senate Committee on Finance held a hearing titled “Prescription Drug Price Inflation: An Urgent Need to Lower Drug Prices in Medicare”. Witnesses included Dr. Rena M. Conti of Boston University, Douglas Holtz-Eakin of the American Action Forum, Stephen Ezell of the Information Technology and Innovation Foundation, and Steffany Stern of the National Multiple Sclerosis Society. The hearing highlighted strong disagreement along party lines with Democrats advocating for giving the HHS Secretary authority to negotiate drug prices for the Medicare program and Republicans opposing the concept. Some Senators highlighted the need to address PBMs to lower drug prices, including Sen. Maria Cantwell (D-Wash.) who discussed the need for the FTC to review PBM practices and Sen. James Lankford (R-Okla.) who highlighted the way PBMs impact patients through formularies, rebates, and pharmacy price concessions. NCPA submitted a statement for the recordhighlighting the Biden administration’s proposed rule to end retroactive pharmacy DIR fees and needed tweaks to the proposal, as well as advocating for the end of spread pricing in Medicaid Managed Care.


NCPA Submits Comments to USP on Proposed Changes
to <795> and <797>

On March 17, 2022, NCPA submitted comments to USP on their proposed changes of chapters <795> and <797>. In the comments, NCPA highlighted several issues, including establishing default Beyond Use Dates for nonsterile and sterile compounded drugs, limitations on batch sizes for <797>, and a general lack of an evidentiary record to support these changes for safety reasons. NCPA expressed concern that implementing these changes would negatively affect patient access to compounded drugs. USP first proposed changes to the chapters back in 2019 and continue to move forward with the process despite the concerns and issues raised by NCPA and other impacted stakeholders. NCPA will continue to advocate for the adoption of standards which promote the practice of compounding and meaningful safety measures.


Pharmacist Chris Schiller Jumps into Open
Oklahoma Congressional Race

Pharmacist Chris Schiller, owner of Economy Pharmacy in Tulsa, Okla. is running to replace Rep. Markwayne Mullin (R) in Oklahoma’s second Congressional District. Mullin is seeking the Senate seat being vacated by Sen. James Inhofe (R). Schiller is one of four announced candidates running in the Republican primary. The others are former State Rep. John Bennett, current State Sen. Marty Quinn and Erick Wyatt, who ran unsuccessfully in the 2014 primary against Sen. Inhofe. The primary will be held on June 28.

Schiller is the second pharmacist to announce a run for Congress in 2022. Rich Moon, owner of Pharmacy Innovations in Jamestown, NY is running for a Congressional seat in New York. He will face Rep. Claudia Tenney in the primary, which will also be held on June 28.


Important Updates on the HRSA COVID-19 Uninsured
and Coverage Assistance Programs

HRSA announced March 16th, that they will no longer accept claims for testing and treatment under the COVID-19 Uninsured Program on March 22, 2022 at 11:59 p.m. ET due to lack of sufficient funds. FAQ for the COVID-19 Uninsured program can be found here.

In addition, the COVID-19 Uninsured program and the COVID-19 Coverage Assistance Funds will stop accepting vaccination claims on April 5, 2022 at 11:59 p.m. ET due to lack of sufficient funds. Claims submitted by these deadlines will be paid subject to eligibility and availability of funds. FAQs for the COVID-19 Coverage Assistance Fund can be found here.

For additional questions on the HRSA COVID-19 Uninsured Program on testing and treatment claims or vaccination claims:

For additional questions on the HRSA COVID-19 Coverage Assistance Fund on vaccination claims:


NAIC continues digging into PBM practices

The National Association of Insurance Commissioners continues its efforts to address PBM practices and their impacts on patients, payers, and pharmacies. NAIC’s PBM Issues Subgroup is in the process of creating a white paper on PBMs and is currently in the fact-finding stage to inform their investigation. The Subgroup met this week to discuss state efforts to control PBM abuses and the methods used to accept complaints of violations of PBM laws. Another committee, the ERISA Working Group, is currently analyzing the U.S. Supreme Court’s Rutledge decision to help states determine how the decision allows them to regulate PBMs. The ERISA Working Group plans to release a draft of its analysis next week and open it up to public comment. NCPA continues to actively engage with both committees throughout the process.


NCPA weighs in on Maryland PSAO regulation reforms

NCPA submitted comments on Maryland HB 973, which would address issues in existing regulations of pharmacy services administrative organizations (PSAOs). The bill was favorably reported by the House Health and Government Operations Committee.


NCPA urges West Virginia Governor to sign
patient choice bill into law

NCPA submitted a letter urging West Virginia Gov. Jim Justice (R) to sign HB 4112 into law. The bill would give patients greater authority to choose which in-network pharmacy to fill their prescriptions and would address the arbitrary “specialty” designation that PBMs use to steer patients to PBM-owned pharmacies.


Vermont committees favorably reports PBM bill

The Health Care Committee and Ways and Means Committee both favorably reported Vermont HB 353. The PBM reform bill protects patient choice, strengthens existing MAC appeals language, adds pharmacy audit protections, and addresses PBM conflicts of interest.


Nebraska Governor signs PBM licensure bill into law

Nebraska Gov. Pete Ricketts (R) signed LB 767 into law. The newly enacted law required PBMs to obtain a license to operate in the state and provides the state with regulatory oversight over PBMs.


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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