Community pharmacy owners rank 2018 policy priorities: A recently concluded NCPA survey of independent community pharmacy owners identified their top policy issues for this year. In order of ranking, they are: 1) Eliminate retroactive pharmacy DIR fees; 2) Ensure MAC transparency to address delays in payment rate updates and appeals processes; and virtually tied are 3) Advocate for reasonable Medicaid pharmacy reimbursement (both managed care and fee-for-service) and 4) Allow Medicare beneficiaries to access any willing pharmacy in Part D preferred networks. This valuable membership input will continue to help guide NCPA’s advocacy activity on your behalf. Mark your calendar for the NCPA Congressional Pharmacy Summit April 11-12 in Alexandria, Va. – your best opportunity of the year to advance these initiatives and push back against efforts that would harm patients and their community pharmacists.
Update on CMS’ Part D proposed rule – comment period closes soon: Hundreds of NCPA members have weighed in with CMS to back several key provisions of the proposed Part D rule, including a potential requirement to shift retroactive pharmacy DIR fees to point-of-sale instead. In addition, NCPA has engaged leading patient advocacy organizations and wrote an article for The Hill.com. As a reminder, here are some related grassroots links:
- Submit comments to CMS to encourage the agency to move forward with the proposal. You can use the NCPA developed sample comments (be sure to customize them with your personal experiences).
- Ask your Representative to sign a letter to CMS being circulated by Reps. Morgan Griffith, Peter Welch, Austin Scott, Dave Loebsack, and Buddy Carter. Click here to contact your Representative.
Proposal intends to expand health insurance options for small businesses: The Department of Labor (DOL) issued a proposed rule that it says would give small business owners and employees greater ability to obtain coverage through Small Business Health Plans (or Association Health Plans), claiming such plans could be formed “on the basis of geography or industry” or to “serve all the businesses in a particular industry nationwide.” It was immediately endorsed by the National Retail Federation and denounced by some who fear its consumer protections are inadequate, raising the possibility of a legal challenge. The announcement triggers a 60-day comment period, during which NCPA will analyze it in greater detail.
Republicans saw their majority in the Senate shrink by one this week: Sen. Doug Jones (D-AL) was sworn in after defeating Roy Moore in Alabama’s special election. Sen. Tina Smith (D-MN), who was appointed to replace former Sen. Al Franken following his resignation from sexual harassment allegations, was also sworn in bringing the Senate to a 51-49 split. This new closer dynamic should complicate Republicans’ agenda for conservative reform and will necessitate more bipartisan cooperation to ensure that deals are reached to fund the government, extend the CHIP program, and provide a fix for the so-called Dreamers when the DACA immigration program ends. While Speaker Paul Ryan (R-WI) has been adamant that entitlement reform, including Medicaid changes, would be on the table for 2018, Senate Majority Leader Mitch McConnell (R-KY) has essentially said the issue is a non-starter and that the upper chamber may look to more bipartisan legislation like an infrastructure package considering the new ratios in the Senate.
NCPA highlights to FDA pharmacy recommendations to address the opioid epidemic: “Our members have extensive knowledge and experience in caring for patients with chronic pain as well as those in their communities with substance use disorders,” NCPA said in comments to FDA outlining several recommended solutions: expanded access to Naloxone; quantity limits on initial prescriptions of controlled substances; prohibit delivery of controlled substances to patients via physician offices or the mail; expanded electronic prescribing; greater prescriber education; more access to medication assisted therapy; and pharmacists’ participation in SBIRT or Screening, Brief, Intervention and Referral to Treatment activities.
NCPA discusses PBM issues at AMA State Legislative Strategy Conference: NCPA VP Pharmacy Affairs Ronna Hauser addressed barriers to pharmaceutical care in a complex environment with other panelists from the Arthritis Foundation and the Ohio State Medical Association. She discussed the need for PBM regulation and successes at the state level and discussed ways providers and patients can best work together for improved patient access. An earlier session focused on what to expect this year regarding insurance regulation at the state level. Insurance commissioners from Iowa and Missouri outlined their perspectives and fielded several questions about the need for improved PBM oversight and regulation.
Key congressional hearings next week: On Tues., Jan. 9, the Senate Finance Committee will hold a hearing to consider the nomination of Alex Azar to be HHS Secretary. That same day, the Senate HELP Committee will hear from Sam Quinones, journalist and author of the influential book Dreamland.
NCPA Voices Concern for Restricted Pharmacy Networks in Medicaid Plans: NCPA expressed concern over the exclusion of numerous community pharmacies from pharmacy networks for Michigan Medicaid programs and provided recommendations in a letter to the Michigan Department of Health and Human Services. The letter emphasized that restrictive pharmacy networks have a negative effect on Medicaid beneficiaries’ access to pharmacy providers which could result in an increase in state expenditures on downstream medical costs. NCPA also drew attention to the fact that restrictive pharmacy networks can limit patient access to enhanced patient care services provided by many independent community pharmacies and could cause problems with meeting CMS network adequacy standards for critical provider types, including pharmacists.
HHS seeks new safe harbor recommendations under federal anti-kickback statute: The department’s annual solicitation of comments in this area was met by some stakeholders with an emphasis on advancing value-based payment reforms. NCPA will review the request for recommendations with an eye toward the Feb. 26 comment deadline.
Final rule addresses terms of sharing substance abuse patient records: HHS issued a final rule implementing changes it says “are intended to better align the regulations with advances in the U.S. health care delivery system while retaining important privacy protections for individuals seeking treatment for substance use disorders.” The final rule, effective Feb. 2, includes an option for an abbreviated notice regarding the prohibition on re-disclosure, and provides information on the use and disclosure of patient identifying information for payment, health care operations, and audits and evaluations.
FDA officials describe focus on safety of compounded drugs, particularly sterile: Top FDA officials Janet Woodcock and Julie Dohm describe in a recent New England Journal of Medicine article compounding pharmacy inspections and recalls facilitated since the 2012 meningitis outbreak. They also note FDA remains in the process of developing standards for “outsourcing facilities”, established under the 2013 DQSA, and that many stakeholders have a role to play, “including regulatory agencies such as the FDA and state boards of pharmacy, outsourcing facilities and other compounding pharmacies, and health care practitioners and systems.”
