• Amplify the Need for PBM Reform on Social Media
• NCPA Podcast Breaks Down Budget Reconciliation Bill
• WARNING: GoodRx Direct Contracting Webinar
• NCPA Joins Project PAUSE In Promoting Access to Medication for Nursing Home Residents
• NCPA Submits comments on Draft MTF 835 Companion Guide
• Colorado Targets Rural Independents
• Iowa General Assembly Passes PBM Reform
• California PBM Legislation Through the Senate
• NCPA State Legislative Activity Update

Amplify the Need for PBM Reform on Social Media

In December, it became crystal clear to the entire world that X/Twitter is where important advocacy-focused discussions take place on social media. If you're not yet part of the conversation there, it's time to get involved. With the House of Representatives having passed a budget reconciliation bill that includes legislation to eliminate spread pricing and require transparent and fair reimbursement (Medicaid fee-for-service rate) in all state Medicaid managed care programs, the ball is now in the senators' court. Together, we can make it loud and clear to them on X that PBM/Medicaid managed care reform must stay in the bill. Click here for NCPA’s instructions on how to engage and sample tweets you can modify to engage your Senators. Let’s turn up the heat and ensure a community pharmacy priority is addressed. 

NCPA Podcast Breaks Down Budget Reconciliation Bill

We know there are questions about what was in the "big, beautiful bill" that now awaits consideration by the U.S. Senate. Which NCPA priorities are in it? What happened leading up to House passage, and what does its future look like in the upper chamber? NCPA's Jack Mozloom and Kaite Krell break it all down for you in the latest episode of the "Independent Rx Forum" podcast. You can tune in here or wherever you get your podcasts. The "Independent Rx Forum" podcast is sponsored by Wellgistics Health and powered by RxConnexion.

WARNING: GoodRx Direct Contracting Webinar

It has come to our attention that GoodRx has reached out to a number of pharmacies regarding its new "Community Link" program and invited them to register for a webinar promoting this new program. BEFORE SIGNING UP for this webinar, it is very important that you consider the following:

- You could be forfeiting important legal rights merely by registering for the GoodRx webinar.

- GoodRx is requiring webinar attendees to agree to their Terms of Use as part of the registration process.

- These terms may prevent you from participating in, or benefiting from, ongoing or future class action litigation against GoodRx. This may include NCPA's pending lawsuit against GoodRx and PBMs, where we seek to represent a class of pharmacies harmed by alleged price fixing.

We strongly advise you to carefully consider the potential consequences of registering for the webinar or any other program and agreeing to these Terms of Use. NCPA will keep you informed as we receive updates. NCPA is working with counsel for GoodRx to bring a resolution to this issue, but until you hear from NCPA (and not GoodRx’s social media posts), please consider using caution or consulting your own counsel

NCPA Joins Project PAUSE In Promoting Access to Medication for Nursing Home Residents

NCPA joined with various other groups in Project PAUSE to sign onto letters to the House and Senate Appropriations Committee on Labor, Health and Human Services, Education and Related Agencies (Labor-HHS), letters to the House and SenateAppropriations Committee on Agriculture, Rural Development, Food and Drug Administration (FDA-AG), and related testimony in the House and Senate. 

The letters promote the inclusion of language in the report accompanying the fiscal year (FY) 2026 L-HHS appropriations bill regarding steps that the Centers for Medicare and Medicaid Services (CMS) should take to eliminate an unnecessary barrier to nursing home residents receiving access to appropriate neuropsychiatric medication, and the fiscal year (FY) 2026 FDA-AG appropriations bill to advance access to necessary care for Medicare beneficiaries living with Alzheimer’s and other neurocognitive impairment. The language of the L-HHS letter asks that Congress and CMS should develop and implement effective policies to curb the inappropriate use of antipsychotics and ensure access and appropriate use of these medications by patients who need them. The letter specifically asks to retire the measure and modifying the Medicare Data Set (MDS) to ensure sufficient documentation by the patient’s physician and independent facility pharmacist. 

Project PAUSE (Psychoactive Appropriate Use for Safety and Effectiveness) is a coalition of national patient and professional organizations, including NCPA, collectively advocating on clinical regulatory and legislative issues in long-term care.

NCPA Submits comments on Draft MTF 835 Companion Guide

NCPA submitted comments to CMS on the draft Medicare Transaction Facilitator (MTF) 835 Companion Guide. The draft guide addresses how electronic remittance advice (also “835 eRA”) is created and transmitted from the MTF to pharmacies and other dispensers for refunds owned to the pharmacy from a drug manufacturer for dispensing a prescription eligible for the Maximum Fair Price (MFP) negotiated in the Medicare Drug Price Negotiation Program. CMS had a dedicated page for pharmacies who want more information. NCPA has raised on numerous occasions pharmacy owners concerns’ with this program, including these MDPN program talking points.

Colorado Targets Rural Independents

Gov. Jared Polis (D) signed into law HB 25-1222, PBM reform legislation that among its provisions creates a reimbursement floor in the commercial market for rural independent pharmacies.  Effective January 1, 2026, the floor will be NADAC plus the state’s Medicaid dispensing fee for rural independent pharmacies (currently $14.14) plus a 1% increase annually.  The legislation also contains audit protections and ensures that rural independent pharmacies can deliver drugs to underserved communities.  NCPA was pleased to support the legislation in its committee process.  Congratulations to all the stakeholders who worked on the bill.

Iowa General Assembly Passes PBM Reform

S.F. 383, a bill regulating pharmacy benefit managers, passed through the Iowa General Assembly and now sits on Gov. Kim Reynolds (R)'s desk awaiting her signature.

The bill will help ensure the future of independent pharmacies in Iowa by requiring PBMs to treat them equally with respect to participation, referral, reimbursement of a covered service, or indemnification if a pharmacist is acting within the scope of the pharmacist's license, if the pharmacy is compliant with all applicable laws and rules. It's critical that Reynolds signs it. You can learn more about S.F. 383 here.

California PBM Legislation Through the Senate

NCPA is pleased to continue its partnership with the California Pharmacists Association in support of PBM reform legislation.  The Senate passed SB 41, PBM reform legislation with wide ranging provisions such as NADAC + a professional dispensing fee based on the state’s Medicaid program and a requirement that PBMs use passthrough pricing models.  NCPA has engaged SB 41 with comment letters during its Senate committee process and has engaged its grassroots at the direction of CPhA.  This happens amidst the May budget revision in which Gov. Gavin Newsom (D), who has vetoed similar legislation in the previous two years, was vocal about the need to reform PBMs.  How the Governor’s repositioning on PBM reform affects the previously introduced legislation remains to be seen.  The bill now moves to the Assembly. 

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.