• Pharmacy Groups Urge Seate to Remove NADAC Provisions from Budget Reconciliation
• Court Orders CVS Caremark to Pay $95 million for Inflating Generic Prices
• Louisiana Brings Down the Hammer on CVS, Caremark, and Affiliated Entities 
• NCPA Submits Comments to CMS on Draft Guidance to Medicare Drug Price Negotiation Program
• NCPA Joins Other Pharmacy Groups in Opposing Country-of-Origin Marking Requirement
• Robert Garcia Wins Key Post on House Oversight and Accountability Committee
• Minnesota Enacts Strong Medicaid Reform Provisions
• Rhode Island Pharmacists Set to Celebrate Wins in Vaccinations and Contraceptive Authority
• Reimbursement Round Up 

Pharmacy Groups Urge Senate to Remove NADAC Provisions from Budget Reconciliation

This week, after the Senate parliamentarian struck a key provision from the proposed budget reconciliation bill banning spread pricing in Medicaid managed care programs by requiring adequate dispensing fees, NCPA joined other pharmacy groups on a letter to demand that the Senate also remove mandatory NADAC. The groups warned that the bill's passage with NADAC reporting but without the spread pricing provision would be the worst-case scenario: pharmacy deserts will grow, and many of their constituents will lose the economic impact of their local pharmacy.

Please take a moment to contact your Senators to echo the message that mandatory NADAC reporting must be removed from the bill to preserve patient access to pharmacies and that Congress should address PBM reform in a subsequent bill that includes all of the previously agreed to reforms that have not yet passed.

Court Orders CVS Caremark to Pay $95 million for Inflating Generic Prices

CVS Caremark was ordered to pay the U.S. government at least $95 million in damages after a federal court found it had overcharged Medicare for generic drugs. The ruling came in a case filed in 2014 by a whistleblower who alleged the PBM had knowingly and falsely claimed funds from the U.S. government.

The court found that the PBM had overcharged Medicare for generic drugs between 2010 and 2016 in order to benefit their bottom line.

Caremark may have to shell out even more cash than that. Next month, hearings will be held to determine the appropriate level of financial penalty imposed on the PBM. Under the False Claims Act (the law under which the lawsuit was brought), CVS may be liable for three times the damages and an added penalty adjusted for inflation.

Louisiana Brings Down the Hammer on CVS, Caremark, and Affiliated Entities 

In a press conference on Tuesday, Louisiana Gov. Jeff Landry (R) and Attorney General Liz Murrill announced the state was filing three lawsuits against CVS Healthcare Corporation, Caremark, and all their affiliated entities. The violations alleged in the lawsuit center mainly around the state's unfair trade practices act and antitrust statutes. The actions of CVS during a heated legislative battle led to allegations of misuse of patient information by CVS. In describing the lawsuits filed, Murrill stated that the lawsuits "detail in great length all of the ways that these manipulative tactics are used to drive our prices up and to drive the independent pharmacists out of business." Landry also stated that he will be looking into whether he can take action against PBMs through executive authority and would consider calling back the legislature for a special session. He pointed out that despite all their claims, PBMs are "not negotiating to lower your costs, they are negotiating to increase their profits quarter after quarter so their stock prices goes up." 

Also, Landry signed H.B. 264, sponsored by Rep. Michael Echols (R), into law. This represents the strongest and most significant PBM reform legislation passed in Louisiana, or anywhere. It provides much-needed regulations and, just as important, provides strong enforcement tools for the state.

Congratulations to the Louisiana Independent Pharmacies Association and all the pharmacy advocates down in the bayou. Well done.

NCPA Submits Comments to CMS on Draft Guidance to Medicare Drug Price Negotiation Program

NCPA submitted comments to CMS on its draft guidance to the Medicare Drug Price Negotiation Program (MDPNP). Among other things, NCPA stressed that manufacturers should pay pharmacies timely, within 14 days of the pharmacy adjudicating the claim with the plans/PBMs. NCPA argued that CMS must ensure that neither plans, PBMs, manufacturers, wholesalers, CMS nor any other entity be allowed to assess any fee on pharmacies to effectuate any aspect of the MDPNP whatsoever, and that any EFT fees should be borne by the manufacturer and not the pharmacy. 

For NCPA’s talking points on the MDPNP, click here.

NCPA Joins Other Pharmacy Groups in Opposing Country‑of‑Origin Marking Requirement

NCPA joined the American Pharmacists Association, American Society of Health-System Pharmacists, Healthcare Distribution Alliance, National Association of Boards of Pharmacy, National Association of Chain Drug Stores, National Association of Specialty Pharmacy, and the Retail Industry Leaders Association in signing onto a letter to the Department of Homeland Security opposing a ruling announced by the U.S. Customs and Border Protection (CBP) that would, for the first time, require that country-of-origin marking be included on prescription drug labels that are dispensed by pharmacies and provided directly to patients. 

NCPA joined letters in October 2024 and March 2025 to CBP urging it to reconsider its ruling. CBP has not answered our request but has instead recently announced an intention to begin enforcing its requirements. The organizations argue in the current letter that, if implemented, CBP’s ruling would interfere with other federal and state statutory and regulatory requirements governing the dispensing of prescription drugs, unduly burden pharmacies, and ultimately place patient safety at risk. 

Rep. Robert Garcia Wins Key Post on House Oversight and Accountability Committee

Rep. Robert Garcia (D-Calif.) handily won his party's internal vote to succeed the late Rep. Gerry Connolly (D-Va.) as Ranking Member of the House Committee on Oversight and Accountability, besting fellow Rep. Stephen Lynch (D-Mass.) by a vote of 150 to 63. Lynch had been serving as the interim top Democrat on the Committee after Connolly stepped away from the post amid his battle with cancer.

The Oversight Committee holds significant investigatory authority over PBM abuses; the committee held a scathing hearing in July 2024 in which members of both sides of the aisle excoriated the CEOs of the big three PBMs over their practices. Garcia is the Democratic Caucus Leadership Representative and also serves on the committees on Homeland Security and Transportation and Infrastructure. NCPA congratulates Garcia and we look forward to continuing to work with all members of the Oversight Committee as Congress keeps up the pressure on PBMs. 

Minnesota Enacts Strong Medicaid Reform Provisions

Gov. Tim Walz (DFL) signed into law HF 2, an omnibus health and human services budget bill, with strong Medicaid reform provisions.  The new law requires the state Medicaid program to utilize a single PBM to administer the pharmacy benefit starting January 1, 2027.  Among its requirements, the PBM will have to reimburse pharmacies with the lesser of NADAC or actual acquisition cost plus the professional dispensing fee used in the state’s fee-for-service program, currently $11.55.  In the meantime, HF 2 also creates a “directed pharmacy dispensing payment” of $4.50 per prescription for Minnesota independent pharmacies with less than 13 locations and those serving rural and/or underserved areas as defined by the Health Resources and Services Administration (HRSA), taking effect July 1, 2025, and expiring on December 31, 2026.  Congratulations to all stakeholders for this big win! 

Rhode Island Pharmacists Set to Celebrate Wins in Vaccinations and Contraceptive Authority

Rhode Island is set to become at least the 16th state to align their vaccination laws with the permissions granted through the PREP ACT which allows pharmacists to independently administer COVID and flu vaccines to patients three (3) years and older. Senate Bill 166 was passed by the Rhode Island House of Representatives and is now headed to the Governor’s desk for their expected signature. Also headed to the Governor’s desk is Senate Bill 476, legislation that changes current law that pharmacist initiated contraceptive prescriptions will not be limited to a three (3) month supply. NCPA sent a letter of support for both bills when they were heard in their committees. We congratulate the Rhode Island Pharmacists Association on their success in more scope expansion becoming law! 

Reimbursement Round Up

Amendments are expected to California SB 41, but NCPA is drafting comments in anticipation of the bill’s initial Assembly hearing in early July.  NCPA continues to collaborate in Ohio on budget bill HB 96, advocating for the re-inclusion of pharmacy reimbursement provisions.  Minnesota HF 2 was signed into law (see above) creating a single PBM required to use fee-for-service methodology as a floor.  NCPA eyes are on the conference committee process for North Carolina SB 479, having advised stakeholders at various junctures on both SB 479 and HB 163.  Eyes are also on recently signed Maine HP 1038/LD 1580, prohibiting spread pricing.  Alaska firmed up its PBM licensure laws with the signing of SB 132, which includes a $20,000 fee for both new and renewed licenses. 

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.