NCPA Advocacy Center Update – Week Ending March 30, 2018

Online Registration Deadline Fast Approaching for NCPA Congressional Pharmacy Summit

The deadline to register online for the NCPA Congressional Pharmacy Summit is Wednesday April 4.  Any registrations after that date must be done on site. Don’t miss the opportunity to take advantage of several CE opportunities as we provide you with a legislative briefing and the latest Medicare and Medicaid updates. Then you will have an opportunity advocate for your pharmacy, your patients and your profession in meetings with legislators to encourage them to support common sense legislative reforms.  If you need additional inspiration, view this invitation from pharmacy champion, Congressman Doug Collins (R-Ga.) expressing the importance of pharmacist attendance. See the attached agenda for more information.

Lending support to Texas independent pharmacies
NCPA Vice President of Government Affairs Karry La Violette was among those attending a recent meeting of Rio Grande Valley community pharmacy owners and the Alliance of Independent Pharmacists of Texas in McAllen, Texas. The meeting was also attended by Rep. Vicente Gonzalez, who represents the state’s 15th Congressional district and his staff. Rep. Gonzalez is a co-sponsor of H.R. 1038 to address retroactive DIR fees.

Provider Status Legislation Offered as Part of Solution to Opioid Crisis
Progress continues to be made on provider status legislation, the “Pharmacy and Medically Underserved Areas Enhancement Act.” The Patient Access to Pharmacists’ Care Coalition, which NCPA is a member of, has been working on refining the language of the bill in the hopes of lowering a potential Congressional Budget Office score by narrowing the scope of the bill to focus on health tests and screenings, as well as the management of chronic conditions with a 50% or higher prevalence rate in the Medicare population. In an attempt to address the opioid epidemic, language has also been added to clarify that pharmacists could provide interventions to prevent prescription drug abuse by providing reimbursable services for beneficiaries enrolled in an opioid overutilization plan. The coalition is seeking to have H.R. 592 included in a hearing scheduled for the week of April 9th in the House Energy and Commerce Subcommittee on Health addressing the opioid epidemic. 

Ohio to Examine Deceptive PBM Practices
Ohio will be taking a closer look into deceptive PBM practices and their effects on the state’s Medicaid program. Amid increasing pressure from local newspapers demanding that action be taken, Ohio lawmakers and the state auditor recently held a press conference discussing the need to address the “PBM oligopoly” and the tax dollars it pockets for itself. The Ohio Pharmacists Association has been instrumental in shedding light on this issue. The press conference can be viewed here and newspaper coverage can be read here.

NCPA Favors Rescinding “Conscience Clause” Rule
This week, NCPA weighed in on the U.S. Department of Health and Human Services’ Office of Civil Rights’ (“OCR”),  Proposed Rule which expanded the definition of health care professionals and employees who can  decline providing certain services under federal law (known as the “Conscience Clause”) to include pharmacists. The Proposed Rule also contained provisions to ensure compliance with Federal discrimination laws. In its comments, NCPA urged OCR to rescind the proposed rule. Absent rescinding the rule entirely, NCPA urged OCR to ensure that the Proposed Rule was in proper posture with Congressional intent in the statutes cited for its authority to issue the Proposed Rule. NCPA also urged OCR to consider exemptions from the Proposed Rule if the cost of compliance was too burdensome for small businesses.N 

In the states …

  • Kansas SB 351, which prohibits copayments that exceed the total submitted charges by a network pharmacy and prohibits PBMs from proscribing a pharmacist or pharmacy from sharing information related to the patient’s cost share, was approved by the governor.
  • Kentucky HB 463, which prevents a PBM from requiring a patient to pay a cost share amount greater than the amount paid without coverage and ensures pharmacists have the right to provide information to a patient regarding the patient’s cost share, passed both chambers and was delivered to the governor.
  • Louisiana HB 436, which prohibits limitations on certain disclosures by pharmacists, provides for reimbursements to pharmacies not affiliated with a PBM, requires disclosures by PBMs, and provides for certain maximum allowable cost provisions, passed the House and was sent to the Senate.
  • Maryland SB 1079, which provides for certain maximum allowable cost provisions and allows the Insurance Commissioner to adopt certain regulations related to PBMs, passed the Senate and is in the House.
  • New Hampshire SB 354, which prohibits limitations on pharmacists’ disclosures to patients, prohibits PBMs from charging copayments greater than the cost of the medication, and prohibits PBMs from charging retroactive fees not apparent at the time of claim processing, passed the Senate and is in the House.