• Month of Action in Full Swing
• CMS Presentation to NCPA on MTF Enrollment, and What You Need to Know
• CMS Clarifies that Pharmacies Don't Need to Actually Dispense MDPNP Drugs 
• NCPA, APhA, TPA File Brief Supporting Tennessee PBM Regulation Law
• White House Open to FTC Enforcement of Robinson-Patman Act
• NCPA Advocates at NCSL Legislative Summit
• HRSA Proposes 340B Rebate model 
• “Pharmacy Modernization” Bill Passed First Chamber, Now Navigating Senate Committees in California
• NCPA Weighs in on Regulation for Prescription Label Requirements for Visually Impaired

Month of Action in Full Swing

NCPA’s Month of Action is in full swing as the House of Representatives is adjourned for its summer in-district work period and members will be away from Washington until September 2. If you have not yet done so, this is a great opportunity to invite members of Congress or their key staff for a visit to your pharmacy, and NCPA can assist you with resources in scheduling a visit, just complete this simple interest form.

We need to continue advocating for key PBM reforms, especially those included in the recently introduced PBM Reform Act (H.R. 4317), particularly those that enhance transparency and ban spread pricing in Medicaid managed care programs and require CMS to define and enforce reasonable and relevant contract terms, including those related to reimbursements, in Medicare Part D.

Click here for additional resources on NCPA’s Month of Action and let us know of your interest in hosting a pharmacy visit by completing this interest form or by emailing Michael Rule at mrule@ncpa.org. In addition to meeting with your legislators face-to-face, click here to contact your Representative and urge them to cosponsor the H.R. 4317. Keep the pressure on Congress to finish the job!

CMS Presentation to NCPA on MTF Enrollment, and What You Need to Know

Staff from the Centers for Medicare & Medicaid Services (CMS) delivered a highly attended webinar on enrollment in the Medicare Transaction Facilitator. A playback of the webinar and more resources and NCPA advocacy can be found on NCPA's Inflation Reduction Act: Resources and Advocacy Page.

You have probably received an email CMS on enrolling in the MTF of the Medicare Drug Price Negotiation Program. If you are going to participate in any Medicare Part D network for next year, you must enroll in the MTF-DM to receive your manufacturer refund payments. We encourage you to become familiar with the process before enrolling. Here are some things to know:

-  You can watch an intro to the MTF on CMS' dispenser homepage here.

- You can view a FAQ from CMS on the MTF here.

- You can contact CMS at MFPMedicareTransactionFacilitator@cms.hhs.gov with any questions.

- Before enrollment, you should make sure your NCPDP profile is accurate and updated.

- Before enrollment, pharmacies need to know which functions, such as central pay or reconciliation services, they want to assign to any third-party support entities such as PSAOs or reconciliation vendors.

- During enrollment, pharmacies will need to sign a legal agreement so proceed with caution and be sure to carefully review and have your legal counsel review.

- During enrollment, identify as having "material cashflow concerns," as manufacturers can provide pharmacies with a plan for mitigating their cashflow concerns.

There is no hard deadline to complete enrollment, and it will be available after January 2026. Enrollment will take approximately one hour, and you will have to provide banking information. We recommend beginning enrollment ASAP, since you will have to be enrolled to review the individual manufacturer effectuation plans in September.

CMS Clarifies that Pharmacies Don't Need to Actually Dispense MDPNP Drugs 

The Centers for Medicare & Medicaid Services (CMS) updated its FAQ clarifying that pharmacies do not need to actually dispense drugs under the Medicare Drug Price Negotiation Program (MDPNP). Specifically, CMS stated that “Enrolling in and using the MTF DM is free for pharmacies and the act of enrolling itself does not place any requirement on pharmacies to engage in the Part D program or to dispense any drugs under the Medicare Part D program; that is, pharmacies that enroll in the MTF DM retain the ability to make future decisions related to their Part D participation.” This follows an earlier letter that CMS Administrator Mehmet Oz sent to Rep. Buddy Carter (R-Ga.) making the same clarification.

Additionally, CMS' Medicare Part D final rule from April 2025 says PBMs must put contractual language in place obligating pharmacies to participate in the MDPNP if they participate in any Part D network. Based on the letter from Oz, it appears that the rule requires pharmacies to enroll in the MTF but does not require them to actually dispense drugs covered by the MDPNP.

Here is the regulatory requirement:

"§ 423.505 Contract provisions. * * * * * (q) Enrollment in the Medicare Transaction Facilitator Data Module for the Medicare Drug Price Negotiation Program. For contract year 2026 and all subsequent years, any contract between the sponsor and a pharmacy, or between a first tier, downstream, or related entity and a pharmacy on the sponsor's behalf, for participation in one or more of the Part D sponsor's networks must include a provision requiring the pharmacy to be enrolled in the Medicare Transaction Facilitator Data Module (MTF DM) (or any successor to the MTF DM) in a form and manner determined by CMS. Such provision must also require the pharmacy to maintain and certify up-to-date, complete, and accurate enrollment information with the MTF DM, in accordance with applicable terms and conditions of participation with the MTF DM, including but not limited to contact, third-party support entity or entities, and banking information, in a form and manner determined by CMS."

While CMS may not require pharmacies to dispense MFP drugs, PBM network agreements might, so read your contracts carefully.

NCPA will keep its members posted on any developments. For resources on the MDPNP, click here.

NCPA, APhA, TPA File Brief Supporting Tennessee PBM Regulation Law

This week, NCPA, the American Pharmacists Association, and the Tennessee Pharmacists Association filed a joint amicus brief in a federal court in support of a 2021 Tennessee law regulating PBMs after a federal court enjoined the law. The brief argues that without regulation, PBMs have engaged in harmful practices and urges the court to uphold Tennessee’s right to regulate PBMs.

Tennessee is defending a law that banned PBMs from engaging in patient steering and excluding pharmacies from preferred networks. A federal court issued an injunction against the law after McKee Foods, which makes baked goods like Little Debbie snacks, challenged it, arguing that the Tennessee law was preempted by the federal Employee Retirement Income Security Act of 1974. The case is now before the federal Sixth District Court of Appeals, where NCPA, the APhA, and TPA filed the brief.

For more information read our press release here.

White House Open to FTC Enforcement of Robinson‑Patman Act

On Tuesday, NCPA and other members of the Main Street Competition Coalition met with Ryan Bosch of the White House's National Economic Council to discuss the administration's support for the enforcement of the Robinson-Patman Act (RPA). RPA is a law prohibiting price discrimination when buyers purchase goods in similar quantities or volumes. NCPA is happy to report that there is conceptual buy-in from the NEC and the White House to enforce the law through the Federal Trade Commission.

NCPA sees several instances where the once dormant law can be enforced to level the playing field on the buy-side and sell-side of the pharmacy industry. Between spread pricing and class of trade designations, there are several opportunities for the FTC to use the RPA when looking into the pharmacy industry that will ultimately help patients with access issues and save taxpayers money.

NCPA Advocates at NCSL Legislative Summit

This week NCPA attended the National Conference of State Legislature’s (NCSL) annual Legislative Summit in Boston, Massachusetts.  The Summit is the largest gathering of state legislators and staff in the country.  State Representative Steve Elkins (D-Minnesota) brought two PBM-related resolutions to the NCSL Standing Committee on Health.  One resolution sought NCSL to urge Congress to adopt bipartisan legislation to clarify that ERISA (Employee Retirement Income Security Act of 1974) does not pre-empt states from regulating PBMs as commercial health insurance companies under applicable state law.  Rep. Elkins’ second resolution sought NCSL to urge Congress to adopt bipartisan legislation to clarify that ERISA does not preempt states from requiring employer sponsors of ERISA health plans and their plan administrators to contribute healthcare claims data to state All Payer Claims Databases.  At the bottom of a packed agenda of policy resolutions, the Committee did not reach these two resolutions.  NCPA is reaching out to Rep. Elkins to offer assistance with advocating for these resolutions moving forward.  Among its many legislator meetings, NCPA focused on connecting with pharmacists and pharmacy owners serving in state legislatures, including Representative Tracy Marra (R-Ct.), Representative Michelle McGraw (D-R.I.), Assemblyman John McDonald (D-N.Y.), and Senator Ferrell Haile (R-Tenn.).

HRSA Proposes 340B Rebate model 

The Health Resources and Services Administration has proposed a 340B rebate model, with comments due on Sept. 2. NCPA will be submitting comments.

The rebate pertains to the transaction between the manufacturer and the covered entity (CE). Basically, the rebate would be a reimbursement made from the manufacturer to the CE in the amount of the acquisition cost less the 340B ceiling price.

HRSA’s Office of Pharmacy Affairs (OPA) is inviting drug manufacturers to apply for participation in a voluntary 340B rebate model pilot program for a minimum of one year. The OPA is introducing this pilot program to test the rebate model on the NDC–11s included on the CMS Medicare Drug Price Negotiation Selected Drug List, regardless of payer.

NCPA’s comments on the rebate model will address timely reimbursement to pharmacies and stipulate that no additional administrative costs of running the rebate model should be imposed on pharmacies.

“Pharmacy Modernization” Bill Passed First Chamber, Now Navigating Senate Committees in California

The California Pharmacy Association is rallying around Assembly Bill 1503 which makes broad changes to state pharmacy laws and creates a standard-of-care model through changes in prescription refill rules, and medication error along with the creation of a new pharmacy technician advisory committee. The standard-of-care model. The bill promotes physician involvement with greater pharmacist coordination and improved communication to ensure patients receive safe and optimal care. NCPA submitted a letter of support to the Senate Business, Professions and Economic Development Committee, and has since been voted out of that committee. The next committee hearing will be in Senate Appropriations in mid-August.

NCPA Weighs in on Regulation for Prescription Label Requirements for Visually Impaired Patients 

The Maryland Department of Health held open public comment for proposed regulation COMAR 10.34.43 Prescription Labeling for Blind, Visually Impaired, and Print Disabled Individuals. The regulation implements SB 940 passed in 2023 which requires the State Board of Pharmacy to adopt regulations necessary to ensure that patients who are blind, visually impaired or otherwise print disabled have access to prescription labels, tags and medical guides. NCPA sent comments before the July 28th deadline concerning the increased financial burden on community pharmacies to meet the labeling requirements. The Board of Pharmacy has estimated that the additional cost of leasing labeling equipment could be at least $2,600 per year, and costs associated with maintenance will increase over time.

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.