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NCPA Advocacy Center Update Week Ending April 13, 2018

Community Pharmacists Charge the Hill

This week, nearly 300 community pharmacists from 37 states participated in NCPA’s 50th annual Congressional Pharmacy Summit. They charged Capitol Hill to advocate for NCPA’s three priority issues:  an end to retroactive pharmacy DIR fees, transparency in generic reimbursement rates in federal programs, and to open Medicare preferred pharmacy networks to all pharmacies willing to accept contractual terms and conditions. Attendees also pressed Congress to grant pharmacists provider status under Medicare Part B, fix lingering problems with compounding regulations, and offered recommendations for stemming the opioid epidemic. In all meetings were held with more than 250 congressional offices. In addition to Capitol Hill meetings, attendees were treated to discussions among expert panelists on important issues such as Medicare and Medicaid and were also provided a preview of the 2018 midterm elections.

A highlight of note from the Medicaid panel came from Vicki Cunningham, RPh, Director of Pharmacy Services for the West Virginia Bureau for Medical Services who described her efforts to educate legislators who had viewed Medicaid contracts as a business deal and wondered why pharmacies simply didn’t shop around for a better deal. She stated, “I explained that you really don’t have a choice in the contract you sign. That’s unfortunate and just seemed foreign to the people I was speaking with. But they began to understand that if you didn’t sign your Medicaid contract you would lose your private contracts. They began to understand that it really is not a free market, and it’s not a level playing field.”

For those who were unable to attend the summit this week, NCPA has a grassroots message that can be sent to legislators to voice support for community pharmacy’s top legislative priorities. NCPA’s news release on the event is also availablehere.

NCPA PAC Telethon Exceeds Expectations

Results are still being tallied and final results will be reported next week, but NCPA PAC Chairman Steve Giroux, a pharmacy owner from New York, already declared that this week’s volunteer NCPA PAC telethon was a whopping success, raising more than $88,000 in funds that will be used to elect candidates who think like you do – pharmacy champions who know what it’s like to run a small business, make a payroll, and deal with red tape. More than 20 pharmacy owners from all over the nation volunteered their time for the telethon, coming to NCPA offices in Alexandria to make calls. “It just proves again that there’s no better fundraiser for the NCPA PAC than a pharmacy owner who has invested and is willing to ask a fellow pharmacy owner to do the same,” said Giroux. “A big, big thank you to those who made calls for us this week, and to those members to rose to the challenge and invested.”

NCPA Meets with Trump Administration and HHS Officials Responsible for Drug Pricing Strategy

This week NCPA staff and leadership met with senior Administration officials to discuss independent community pharmacy’s priorities surrounding drug pricing and the need for greater transparency.  Although appreciative for CMS’ recent announcement asserting their authority to require manufacturer rebates and pharmacy price concessions be passed on to patients at point of sale, NCPA stressed the importance of a more immediate solution, as retroactive pharmacy fees are only increasing in scope.  NCPA will continue to press for actions that can be taken to stop retroactive pharmacy fees, especially in light of recent announcements by the Administration that solutions for lowering drug prices are forthcoming.

Congress Continues Opioid Focus

This week, both the Senate HELP and the House Energy & Commerce Committees held hearings examining legislation to address the opioid crisis. NCPA was active in ensuring that the legislation being considered would empower, not hamper, the ability of pharmacists to treat patients and play a role in ending the opioid epidemic. NCPA sent a letter (attached) to Senate HELP Committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) to ask questions and raise potential concerns about a mandate for pharmacists to check PDMPs. After this advocacy effort, NCPA was assured that the draft legislation, the Opioid Crisis Response Act, would not include a mandate and would defer any decision to the states. At the hearing, Chairman Alexander announced that the committee would mark-up their bill on April 24th.

During the House Energy and Commerce hearing, NCPA weighed in with a letter to the committee (attached) urging inclusion of provider status legislation, H.R. 592, as a solution to address the opioid crisis and was instrumental in getting Rep. Cathy McMorris Rodgers (R-Wash.) to bring the bill up at the hearing asking for its inclusion in the opioid package. NCPA also wrote a letter of support (attached) for H.R. 3528, which would require electronic prescribing for controlled substances, after securing key changes to the bill to exempt long-term care patients and to ensure that patients’ choice of pharmacy is respected. Additionally, pharmacy champions, Reps. Morgan Griffith (R-Va.) and Buddy Carter (R-Ga.), raised concerns with legislation that would mandate pharmacists check PDMPs and would enact mandatory lock-ins for patients at risk for opioid abuse in Medicare and Medicaid without taking into account a patient’s choice of pharmacy. NCPA is working with the committee to address these concerns.

Finally, NCPA wrote a letter of support (attached) for S. 2645, the Access to Increased Drug Disposal Act, which was introduced by Sen. Joni Ernst (R-Iowa) to provide grants to help pharmacists and other providers implement controlled substances take-back and disposal programs. Next week, the Senate Finance Committee will hold a hearing reviewing opioid legislation on April 19th.

House E&C Subcommittee on Oversight Calls on Drug Wholesalers to Testify

This week the House Energy & Commerce Subcommittee on Oversight and Investigations announced that it will be holding a hearing on May 8, 2018 related to the committee’s ongoing investigation into alleged pill dumping in West Virginia. The following witnesses have been called to testify:

  • Mr. John Hammergren, Chairman, President and CEO, McKesson Corporation;
  • Mr. George Barrett, Executive Chairman of the Board, Cardinal Health Inc.;
  • Mr. Steven Collis, Chairman, President and CEO, AmerisourceBergen Corporation;
  • Dr. Joseph Mastandrea, Chairman of the Board, Miami-Luken, Inc.; and
  • Mr. J. Christopher Smith, former President and CEO, H.D. Smith Wholesale Drug Company.

The committee has spent the past year investigating the sale of pills in West Virginia by wholesale drug distributors and has sent letters to all of the distributors asking for information about steps they took to keep drugs off the black market and to report suspicious orders of pills. Also, last month committee members aggressively questioned DEA’s Acting Administrator, Robert Patterson, about his agency’s role in combating the opioid crisis, particularly during the time of the alleged pill dumping in West Virginia.

NCPA Presents Before ERISA Industry Committee

On Wednesday, Matt Magner, NCPA’s Director of State Government Affairs, participated in panel discussion before the ERISA Industry Committee, which represents large plan sponsors with 10,000 or more employees. The panel focused on federal and state legislative efforts to reign in prescription drug costs. Boehringer Ingelheim Pharmaceuticals and Patients for Affordable Drugs also participated in the discussion. Magner focused his comments primarily on expanded scope of practice, such as the Idaho regulations addressing prescriptive authority, and efforts to increase PBM transparency in MMC, and how that has benefited those plan sponsors. At the request of the moderator, he also discussed gag clauses and copay clawbacks. The panelist from Patients for Affordable Drugs focused their comments on federal issues, like the CREATES Act and REMS, but he also touched on PBMs.

In the states …

Several states have completed their legislative sessions or will be wrapping up soon. The following are key pieces of PBM legislation that have been signed into law this year:

  • Alabama and New York enacted fair pharmacy audit legislation.
  • Arkansas enacted comprehensive PBM reform legislation.
  • Florida and New Jersey enacted legislation requiring PBM registration in the state.
  • Florida enacted legislation strengthening their maximum allowable cost provisions.
  • Mississippi enacted legislation related to medication synchronization services.
  • Arizona, Florida, Indiana, Kansas, Kentucky, Mississippi, New York, South Dakota, Utah, Virginia, and West Virginia enacted legislation ensuring pharmacists can communicate information on equivalent, cheaper alternatives to patients.
  • Arizona, Florida, Indiana, Kansas, Kentucky, New York, and Virginia enacted legislation prohibiting copay clawbacks.
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