NCPA Advocacy Update – Week Ending October 1, 2016

Widespread Support for Ban on Part D Retroactive DIRs:  NCPA and nearly 100 other pharmacy stakeholder organizations have expressed their support to the key lawmakers behind legislation that would prohibit retroactive DIR pharmacy fees on Medicare Part D clean claims. The group includes 40 state pharmacy associations, wholesalers, grocery stores, buying groups, regional chain pharmacies, along with independent community pharmacies and franchisees. NCPA appreciates all the organizations that joined the letter and voiced their strong support for S. 3308/H.R. 5951. Click here for the Senate version and here for the House version of the letter, both of which list the 99 signatories.

NCPA Requests PBM Oversight Hearing on Heels of EpiPen Hearing:  As a follow up and to keep building  momentum from last week’s hearing in the House Oversight and Government Reform Committee focused on the pricing of EpiPens, NCPA sent a request this week to the Committee Chairman and Ranking member requesting a PBM oversight hearing this year. In addition, Committee Member Rep. Buddy Carter penned an excellent article articulating the key points that must be the future focus of the Committee. Click here for Carter’s article:

Congress Leaves Washington for Another Extended Recess:  Before leaving town Congress passed a continuing resolution (CR) which was signed by the President and funds the government through December 9, 2016. Both Houses of Congress are scheduled to return the week of November 14 to continue work on a longer term government funding package. While the schedule remains in flux, the Speaker and Senate Majority Leader have expressed their desire that a version of the 21st Century Cures Act will possibly be considered. Also, the conference report on the NDAA is expected, and we are hopeful that the TRICARE acquisition cost parity pilot will be included, notwithstanding the fact the White House veto threat hangs over the measure.

With Congress in recess until after the election, this is another opportunity to invite your legislators to visit your pharmacy or to schedule a meeting with them at their congressional district office to discuss pressing pharmacy issues such as new DIR legislation (S. 3308/H.R. 5951), MAC transparency, and any willing pharmacy. NCPA members participated in numerous such events in August (click here  to read some highlights) and now it’s important to keep the momentum going. Click here for more information on how to schedule a visit with your legislators.  You can also visit the NCPA Legislative Action Center to send messages to your legislators to urge their support for important legislative priorities.

What Do Clinton and Trump Think About Community Pharmacy?NCPA has written to the two major political party presidential candidates, outlining the important role independent community pharmacy plays in the nation’s health care system, and asking the Democratic and Republican campaigns for feedback relative to their views in several critically important areas. Questions included:

  • Do you support seniors having the right to have a choice of which pharmacy they patronize?
  • What is your position on the expectation that pricing and payment transparency is available to consumers and pharmacies, respectively, at the pharmacy counter?
  • Do you support pharmacist provider status in the Medicare program?

TRICARE Pharmacy Network Changes Beginning December 1, 2016:  Express Scripts will add Walgreens to the TRICARE retail pharmacy networking beginning December 1. At the same time, CVS pharmacies, including those located within Target stores, will no longer be in the network.  Beneficiaries can start transferring their prescriptions now from CVS.  To find a TRICARE network pharmacy, visit and select Tools and then Find a Pharmacy.

NIOSH Publishes 2016 Hazardous Drug List: The National Institute for Occupational Safety and Health (NIOSH) has published its 2016 Hazardous Drug List.  Of importance to community pharmacy, this is the list that is referenced in USP General Chapter <800> Hazardous Drugs—Handling in Healthcare Settings. More drugs were added to the list, which is of concern.  Pharmacists, in order to comply with the Chapter,  will need to budget and plan for the significant operational and structural changes needed.  As previously reported,  NCPA, along with six other national pharmacy orgs recently sent letters to all state boards of pharmacy requesting a five year delay in enforcement of USP General Chapter  <800> until July 1, 2021 (the official implementation date is July 1, 2018). Please find the updated NIOSH list here:

CMS Finalizes Rule On Care, Safety, and Consumer Protections for Long-Term Care Facility Residents:  On September 28, CMS issued a final rule to make major changes to improve the care and safety of the nearly 1.5 million residents in the more than 15,000 long-term care facilities that participate in the Medicare and Medicaid programs.  The final rule, first proposed in 2015 is targeted at reducing unnecessary hospital readmissions and infections, improving the quality of care, and strengthening safety measures for residents in LTC facilities. The rule, which becomes effective Nov. 28, 2016, brings the first major overhaul to U.S. nursing home regulations since 1991. The new regulations will be implemented in phases, with the first “phase-in” period completed by November 28, followed by additional phases ending on November 28, 2017 and November 28, 2019.The final rule also mandates nursing home operators 1) provide “nourishing, palatable” dietary options that meet residents’ nutritional needs and preferences, 2) create an infection prevention and control program and 3) develop a comprehensive, person-centered care plan for each resident within 48 hours of admission. A nurse aide and a member of the dietary staff must contribute to that care plan, the rule reads. The rule also includes new and updated regulations on elder abuse, staff competency and discharge planning. NCPA staff is continuing to review the final rule and will provide additional compliance information.

New Government Report Confirms Drastic Price Increases for Many Generic Drugs:  Many in Congress routinely express outrage when the cost of certain medications increase drastically. A recent report issued by the U.S. Government Accountability Office (GAO) examined prices of generic medications in Medicare Part D and revealed that more than 20% of the drugs studied (315 out of 1,441) experienced a price hike of at least 100% over the course of a year between 2010 and 2015. During this time frame, 35 drugs experienced multiple price hikes of 100% or more. While GAO stated in most cases prices increased between 100-200%, it discovered that in 63 instances they rose more than 500%, with 15 of these rising more than 1000%. The study further found that these price increases generally persisted for more than a year, and most experienced no price decrease after the initial price spike. While the report also shows on average generic drugs do help lower prices, the aforementioned findings independently corroborates data collected by NCPA over the past several years. NCPA was interviewed for this report.

Combat DIR Fees! New Session at NCPA Annual Convention:  The magnitude and unpredictability of DIR fees are wreaking havoc on independent community pharmacies. Learn what you can do to help offset the impact of DIR fees on the bottom line and what NCPA and its allies are doing. Join 3,000+ community pharmacists at the 2016 NCPA Annual Convention in New Orleans from Oct. 15-19, 2016. Also, find out more about the newly introduced DIR legislation in Congress that would effectively prohibit retroactive DIRs for pharmacies in Medicare Part D. Plus, peer-led programs feature pharmacy owners describing strategies they have successfully used to increase pharmacy revenue, attract new patients with unique niches and reduce overhead costs. Learn more + Register at