Pharmacy Stakeholders ask House and Senate Leadership to Oppose Potential Pharmacy-related "Pay For": This week, seven organizations, including NCPA, wrote House and Senate leadership asking them to oppose a proposal in the Administration's FY2016 federal budget to remove authorized generics and brand name drugs from the weighted average Average Manufacturer Price (AMP) calculation for families of drug products. While the proposal is being weighed as a cost-saving to the federal government, the removal of authorized generics and brand name drugs from the weighted average AMP calculation would significantly deflate Medicaid Federal Upper Limits (FULs) and could result in inaccurate reimbursement to pharmacies and threaten Medicaid beneficiary drug access. The pharmacy stakeholder organizations who signed the letter, who also worked to ensure this provision was not included in the 21st Century Cures legislation, will continue to voice our concerns on why this policy does not make sense and could harm beneficiary access. Please see the "Documents to download" section below this article to download the letters.

Members of Congress Voice Concern with TRICARE's Compound Drug Coverage Policy: This week, Representatives Austin Scott (R-GA) and Walter Jones (R-NC) wrote to the Assistant Secretary of Defense for Health Affairs, regarding recent changes that have impacted TRICARE beneficiaries' access to compounded medications. The Congressmen support efforts to target any bad actors while still allowing community pharmacies to provide needed medications. In addition to TRICARE's important efforts to eliminate deceptive marketing practices, the Congressmen are asking TRICARE to investigate the problems surrounding access to appropriate medications.

NCPA Publishes Updated Track & Trace Fact Sheet: In anticipation of the July 1 requirement that drug dispensers maintain and store transactional information as required by the Drug Supply Chain Security Act (DSCSA), NCPA has updated a fact sheet for members. NCPA has requested that FDA delay the July 1 deadline due to ongoing readiness concerns at the wholesaler and dispenser level, but there has been no indication yet whether the date will be changed. You can access the fact sheet here: http://www.ncpa.co/pdf/tt-fact-sheet.pdf

Departments of HHS, Labor and Treasury Publish Final Rules on Summary of Benefits and Coverage: On Friday, June 12, the Departments of HHS, Labor and Treasury released final rules amending requirements that group health plans and health insurers provide a summary of benefits and coverage. The rule finalizes changes "to help plans and individuals better understand their health coverage, as well as to gain a better understanding of other coverage options for comparison." The ACA requires health plans and insurers to provide plan participants with the summary—as well as a uniform glossary to help consumers understand insurance terms.

340B Ceiling Price Regulations Should be Open for Public Comment in June: On Friday, June 5, the White House Office of Management and Budget (OMB) cleared a proposed that would use civil monetary penalties to enforce ceiling price regulations in the 340B drug discount program. The rule, proposed by the Health Resources and Services Administration (HRSA), is required by the Affordable Care Act to enforce the 340B program's requirement that drug manufacturers not charge more than the ceiling price for drugs purchased under the program. The proposed rule will likely be published and open for public comment sometime in June.

In the States:

• Oklahoma: NCPA is pleased to report that this week the State of Oklahoma finalized PBM reform regulations regarding PBM registration and MAC transparency. This process has been underway for many months and has faced considerable opposition from those representing the PBM industry. NCPA would like to congratulate all of the Oklahoma pharmacists who made this effort possible but most notably those individuals at PPOK who lead this effort. Through their tireless effort they were successful in keeping the intent and priority provisions of the legislation leading to this regulation intact through the entire regulatory process. Oklahoma represents the first state that went through this detailed of a rulemaking process regarding implementation of MAC transparency regulations.
• New York: This week NCPA State Government Affairs is happy to report that A.B.676/S.B.3346 passed both chambers on June 10th. The law will require contracts between a PBM and a pharmacy, or a pharmacy's contracting agent, to include a reasonable and defined appeals process. Under the process, the right to appeal is limited to 30 days following the initial claim submission. The PBM must provide a phone number and email for processing the appeal, and must respond to an appeal within 7 business days. If the appeal is deemed valid, the price is adjusted for the appealing pharmacy effective the date of the original claim and, if warranted, the PBM shall update the maximum allowable cost for all similarly situated pharmacies. If the appeal is denied, the PBM shall identify an equivalent drug that is available for purchase at an equal price. NCPA congratulates those in NY who made this legislation a success.
• New Jersey: NCPA will travel to Trenton, NJ on June 15th to testify before the Assembly Committee on Financial Institutions and Insurance in support of A.B.3522, which would require MAC Transparency. A.B.3522 includes provisions that will provide transparency to both the health plan and provider within the industry. A.B.3522 requires disclosure and standardization of the information utilized to determine MAC prices, defined timeframe in which figures would be updated and reported to ensure marketplace consistency, and defined appeals processes under which a pharmacist could contest a listed MAC rate.
• New Jersey: NCPA will travel to Trenton, NJ on June 15th to testify in support of A.3331. This bill would allow for Medication Synchronization. This service will be provided by licensed pharmacists and help to coordinate a patient's prescribed medications for chronic conditions to allow all of a patient's prescriptions to be refilled on the same date each month.