NCPA Advocacy Center Update – Week Ending April 1, 2017

Your Member of Congress is Coming Home for Two Weeks:  Consider this an opportunity to invite your member of Congress to visit your pharmacy between April 8 and April 22 and brief him or her about PBMs. Here are details:

  1. Congress takes a two-week recess starting April 8, which means your representative most likely will be back home and accessible for a few days. We’re asking you to invite your member of Congress to drop by an independent pharmacy in your area for a cup of coffee and some conversation during that recess period. Tell them all you need is 15 minutes. (It’s fine, by the way, to gather some of your competitors together for the meeting.)
  2. Talk with him or her about PBM abuses: DIR fees, copay clawbacks, and how restrictive networks are harming the patients you serve. Ask for his or her support of our DIR fee (H.R. 1038/S. 413) and MAC bills (H.R. 1316) now pending in Congress.
  3. After your visit, email and share with us any feedback and/or photos you got from your meeting.
  4. So, get going:  Call your representative’s district office today and issue the invitation.  Here are tips on how to set up a visit:

There’s never been a better time for you to reach out to your member of Congress in this way. Your meetings will help fuel our success on your behalf. They need to hear from you…in-person, both in-district and on their turf in D.C.  So please plan, too, to come to DC April 26-27 for part two of this effort: Our Congressional Pharmacy Fly-In, featuring in-person meetings with your member of Congress on his or her territory: Capitol Hill. In so doing, you’ll help assure we get a passage this session of our priority legislation now pending in Congress.

118 Health Care Groups Support Bills Banning Retroactive Pharmacy DIR Fees:  In a strong display of unity, 118 health care organizations have signed on to letters supporting companion bills in the Senate and House of Representatives – S. 413/H.R. 1038, the Improving Transparency and Accuracy in Medicare Part D Drug Spending Act – that would prohibit retroactive pharmacy direct and indirect remuneration (DIR) fees in the Medicare Part D program. The demonstration of support was assembled by NCPA, which has been at the forefront of efforts to address this issue. Signatories to the letters also included groups representing drug wholesalers, pharmacy buying groups, grocery stores, retailers and major health care systems.

NCPA delivered the letters to all original sponsors in the Senate (Sens. Shelley Moore Capito (R-Wv.), Jon Tester (D-MT), John Boozman (R-Ark.), Tom Cotton (R-Ark.), Charles Grassley (R-Iowa), Heidi Heitkamp (D-N.D.), James Lankford (R-OK), and Roger Wicker (R-Miss.) and the House of Representatives (Reps. Morgan Griffith (R-Va.), Peter Welch (D-Vt.), Bruce Babin (R-Texas), Lou Barletta (R-Pa.), Rod Blum (R-Iowa), Buddy Carter (R-Ga.), Doug Collins (R-Ga.), Rick Crawford (R-Ark.), Lloyd Doggett (D-Texas), Drew Ferguson (R-Ga.), Bob Goodlatte (R-Va.), Gregg Harper (R-Miss.), Walter Jones (R-N.C.), Thomas Massie (R-Ky.), Rep. Martha Roby (R-Al.), Cathy McMorris Rodgers (R-Wash.), Phil Roe (R-Tenn.), and Pete Sessions (R-Texas).

The Senate bill, S. 413 is up to nine cosponsors with Sens. Thad Cochran (R-Miss.) and Jerry Moran (R-KS) recently signing on.  In the House, H.R. 1038 is now up to 30 cosponsors with Reps. Rick Allen (R-Ga.), Mark Amodei (R-NV), Brendan Boyle (D-Pa.), Bradley Bryne (R-Al.), Kevin Kramer (R-N.D.), Jeff Fortenberry (R-NE), Jody Hice (R-Ga.), Dave Loebsack (D-Iowa), Roger Marshall (R-Ks.), Collin Peterson (D-Mn.), David Rouzer (R-N.C.), John Sarbanes (D-MD), and Austin Scott (R-Ga.) recently signing on.

NACDS, WSPA, NCPA Sue Washington State to Stop Unlawful Medicaid Rule That Threatens Patient CareNACDS, the Washington State Pharmacy Association (WSPA), and NCPA sued the State of Washington to stop a “substantively and procedurally flawed” rule that would pay pharmacies below the actual cost to dispense Medicaid prescriptions. The rule would jeopardize reliable patient access to medications responsible for ensuring patient health and preventing more costly forms of care that result from untreated conditions. At issue is a rule (WSR 17-07-001) by the Washington State Health Care Authority that changes the basis by which the agency determines pharmacies’ cost of acquiring pharmaceuticals, thus reducing reimbursement to pharmacies for medications dispensed to Medicaid patients.

Contrary to a federal rule by CMS, the Washington State rule does not make required adjustments to account for another aspect of pharmacies’ costs—the “professional dispensing fee.” The professional dispensing fee must cover actual costs to safely fill the prescription such as the pharmacist’s professional services. The current dispensing fee in Washington State is significantly lower than the cost of dispensing identified in studies conducted by other states and experts. For example, an independent study commissioned by NACDS and NCPA found that the cost of dispensing in Washington State is more than double the proposed professional dispensing fee for Medicaid prescriptions in Washington State’s new rule.

The following documents are available:

Senate HELP Hearing on FDA Nomination:  The Senate HELP Committee will hold a hearing on April 5th to consider the nomination of Dr. Scott Gottlieb to lead the FDA.  Gottlieb, a conservative drug industry insider and former FDA and CMS official has talked extensively about how to lower the cost of prescription drugs by modernizing the agency’s approval process and speeding cheaper generic competitors to market.  Since leaving the FDA, Gottlieb has worked as an adviser to investment firms and as a fellow at the conservative-leaning American Enterprise Institute, a Washington think tank. He has been the drug industry’s preferred choice for the FDA job and has worked as a consultant to some of its companies. NCPA is working to ensure that questions are posed during the hearing  addressing compounding.

NCPA Participates in PCCA ACT Legislative Conference:  This week NCPA participated in PCCA’s fly in by accompanying members to Hill visits to educate lawmakers on the importance of compounding.  Issues discussed included office use, memorandum of understanding, USP monograph problem, and the Pharmacy Compounding Advisory Committee. We are pleased to report that several Members of Congress agreed to sign onto a letter to FDA led by Reps. Stewart (R-UT) and Carter (R-GA) asking the agency to withdraw office use guidance as a result of the fly in, bringing the current total to 46.

GAO Issues Supplement to Compounding Report:  the Government Accountability Office (GAO) issued an e-supplement this week, which is a companion product to the Drug Compounding report that was issued in November 2016: Drug Compounding: FDA Has Taken Steps to Implement Compounding Law, but Some States and Stakeholders Reported Challenges (GAO-17-64). The e-supplement is an Internet-only product that provides selected results from GAO’s survey of state regulatory bodies on drug compounding, including additional data that are not included in the report. The e-supplement is titled: Drug Compounding: Survey of State Pharmacy Regulatory Bodies (GAO-17-363SP, March 2017), an E-supplement to GAO-17-64. You can access the e-supplement at the following link:

Trump Issues Executive Order on Drug Addiction and Opioid Crisis Commission:  This week President Donald Trump established the President’s Commission on Combating Drug Addiction and the Opioid Crisis.  The mission of the Commission is “to study the scope and effectiveness of the Federal response to drug addiction and the opioid crisis” and issue recommendations to improve the response.  Interim recommendations are due within 90 days and a final report is due by October 1, 2017.  The Commission is chaired by New Jersey Governor Chris Christie (R) and includes representatives of Federal agencies, including the Departments of Justice, Education, Veterans Affairs, Health and Human Services, the Drug Enforcement Administration, the Office of National Drug Control Policy, and experts and private citizens affected by drug addiction and the opioid crisis. NCPA will be recommending that a pharmacist be included on the Commission.

DEA ALERT: Faxed-based Phishing Scams Targeting Pharmacies:  The DEA has received several notifications of faxed-based phishing scams that ask registered pharmacies for personal identifying information (PII) or request for additional collection of fees. Linked are example fax requests of PII and collection of additional fees. Pharmacies that have already provided this information should contact their local field office. Registrants who receive information that seems suspicious should forward them to: Also, DEA does not send unsolicited faxes or emails requesting sensitive data.

In the States: 

  • Connecticut: S.B. 445 was introduced and would ensure that a PBM does not prohibit a pharmacist from disclosing any relevant information to an individual purchasing prescription medication, including, but not limited to, the cost of the prescription medication, actual reimbursement to the pharmacist for the sale of the prescription medication, efficacy of the prescription medication and the availability of any alternative medications that are less expensive than the prescription medication.
  • Florida: H.B. 557 was introduced and would limit the initial prescription of opioids for treatment or alleviation of acute pain. The prescription may not exceed 5 days and the dispenser must report through the system when a controlled substance is dispensed.
  • North Dakota: NCPA State Government Affairs submitted a letter urging Gov. Burgum to sign both S.B. 2258 and S.B. 2301. These bills attempt to address a range of issues including requiring the PBMs to disclose “spread pricing” to the plan sponsor and prohibiting DIR fees and claw-backs.
  • NCPA Attends Missouri Pharmacy Association Legislative Day:  NCPA Government Affairs staff presented on NCPA priorities, new Agency Administration leadership, and the health care debate surrounding the ACA in Jefferson City.  Nearly 400 members and students were present and the state association was thankful for NCPA’s participation.
Posted in Legislation

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