Federal Advocacy / Issues / Legislation

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NCPA’s Advocacy Report provides a weekly detailed summary of recent and breaking legislative, regulatory and state developments impacting independent community pharmacy, and NCPA efforts to effect policies to benefit its membership and the industry. The weekly report is distributed to NCPA leadership, key committees, allied organizations / stakeholders and major contributors to the NCPA LDF and PAC. 

Week Ending March 1, 2019 
NCPA discusses DIR with GOP Doctors Caucus. This week, NCPA staff met with members of the House GOP Doctors Caucus on Capitol Hill. They were also joined by staff from NACDS. Topics of discussion included PBM transparency and the CMS’s proposed rule to fix pharmacy DIR. The GOP Doctors Caucus is composed of 16 medical providers, including physicians, dentists, podiatrists, and pharmacists, in Congress who utilize their medical expertise to develop patient-centered health care policy. Members in attendance included Reps. Phil Roe (R-Tenn.), Andy Harris (R-Md.), Buddy Carter (R-Ga.), Brad Wenstrup (R-Ohio), Larry Buschon (R-Ind.), Brian Babin (R-Texas), John Joyce (R-Pa.), and Roger Marshall (R-Kan.). NCPA looks forward to continuing working with the caucus on behalf of patients and community pharmacies. See attached NCPA Legislative updated here. Read full NCPA article here.

Week Ending November 16, 2018 

NCPA Analysis: Clear Democratic tide in 2018, but no tidal wave. Previously, NCPA provided a snapshot of the 2018 midterm elections and how some of our pharmacy champions fared on Election Day. This has been supplemented with a more in depth look at the next Congress’ leadership and key committee outlook as well as a state level analysis. You can also see how NCPA PAC supported candidates fared on Nov. 6 by clicking here. Read full NCPA article click here

Week Ending November 9, 2018
Mini-telethon raises funds for NCPA PAC: This week, several NCPA members arrived at NCPA HQ to raise funds for the NCPA PAC. A special thanks to volunteers Hugh Chancy, Danny Cottrell, AJ Bhatt, Ron Fitzwater, Theresa Tolle, Nasir Mahmood, John Beckner, and Justin Wilson whose mini-telethon efforts raised more than $57,000 for the NCPA PAC from their fellow NCPA members. These are funds that will be used to elect candidates who will fight for community pharmacy owners and be their voice in Congress. If you are an NCPA member who has not invested in the PAC, click here for information on why you should consider doing so. To read full NCPA article click here

Week Ending November 2, 2018
Proposed rule on lowering drug prices is pending at OMB. Another Part D proposed rule is pending at Office of Management and Budget (OMB) as of late last week. OMB is the body responsible for reviewing whether proposed and final rules will be economically significant to the federal government. Only the name of the proposed rule ("Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out of Pocket Costs (CMS-4180-P)," not its contents, is known at this point. To read full NCPA article click hereCMS’ additional guidance on 2019 opioid edits in Medicare CMS recently released the attached guidance regarding the implementation of opioid edits that were announced in the 2019 Final Call Letter this spring. The guidance is not a formal regulation but is an explanation of CMS’ current thinking on the opioid edits. The document also outlines important information for the soft and hard edits discussed in the 2019 Call Letter. Read full attachment outline here

Week Ending October 19, 2018
NCPA leadership attends White House bill signing eliminating “gag” clauses.  On Oct 10, President Trump signed into law two pieces of legislation, S. 2553, the Know the Lowest Price Act of 2018, and S. 2554, the Patient Right to Know Drug Prices Act, which prohibit so-called pharmacist "gag clauses" in Medicare and private health plans.
NCPA to attend White House event commemorating year of historic action on opioid prevention. To read full NCPA article click here

Week Ending October 5, 2018
What’s next in the pharmacy DIR fight? Thanks in large part to the relentless advocacy efforts of NCPA and our industry allies, the unfairness of pharmacy DIRs is on the radar of policymakers. Next steps will become clearer later this fall, but here’s where things currently stand: To read full NCPA article click here

Week Ending September 21, 2018
NCPA Annual Convention approaching fast. NCPA Annual Convention is only 2 weeks away. Don’t miss out on more than 30 CE programs designed to help you increase your numbers of patients and prescriptions, increase your revenue, lower your costs and make your pharmacy more competitive. Additionally, you can take advantage of up to $14,000 in attendee only discounts offered at the trade show and expo. See the complete convention schedule for more and register here. To read full NPCA article click here

Week Ending September 7, 2018
NCPA, NACDS discuss DIR fees with HHS officials. Representatives from NCPA and NACDS recently met with staff of the Secretary of Health and Human Services focused on drug pricing to discuss community pharmacy perspectives on elimination of post point of sale pharmacy DIR fees.  
Senate acts to eliminate “gag clauses” This week, the U.S. Senate unanimously passed S. 2553, the Know the Lowest Price Act, which was endorsed by NCPA.
To read full NCPA article click here.  

Week Ending August 3, 2018
83 Members of the House urge Sec. Azar to address pharmacy DIR fees. This week, 83 members of the House of Representatives wrote to HHS Secretary Alex Azar and urged him to move forward with a proposal that would effectively eliminate retroactive pharmacy DIR fees by requiring that all pharmacy price concessions be accounted for at the pharmacy counter.  The letter was led by community pharmacy champions R eps. Morgan Griffith (R-Va.) and Peter Welch (D-Vt.) and signatories included seven committee chairmen, two committee ranking members, and eleven members of the Energy and Commerce Committee. To read full NCPA  updates click here. Read the Community Pharmacy Recommendations for Measuring Quality at the Pharmacy Level in the Medicare Part D Program letter here.

Week Ending July 27, 2018
Energy and Commerce Committee Leaders Request FTC Review PBM Mergers. This week, House Energy and Commerce Committee leaders, Chairman Greg Walden (R-Ore.), Oversight and Investigations subcommittee Chairman Gregg Harper (R-Miss.), and Health subcommittee Chairman Michael C. Burgess, M.D. (R-Texas), sent a letter to the Federal Trade Commission requesting they conduct a retrospective review of pharmacy benefit manager (PBM) mergers, and how they have affected prescription drug prices for consumers. Read full NCPA update here

Week Ending July 20, 2018
NCPA, pharmacy stakeholders and pharmacists weigh in on drug pricing RFI. This week, NCPA submitted comments regarding the Trump Administration’s blue print and request for information (RFI) on reducing prescription drug prices and patient out of pocket costs.  NCPA's letter asked that CMS consider eliminating pharmacy price concessions – known as DIR fees – altogether. 
NCPA’s comments on DIR echo those expressed by pharmacy stakeholders in a multi-signatory letter in which 153 organizations expressed support for this approach. Additionally, nearly 2,000 comments were submitted on the RFI by community pharmacists urging the administration to address pharmacy DIR. Read full NCPA updates here

Week Ending July 13, 2018
Monday deadline for submitting comments on drug pricing RFI. Monday is the deadline to submit comments on the Trump administration’s blueprint for lowering prescription drug costs. NCPA has a template available that can be personalized for pharmacists who would still like to submit comments.
NCPA sponsors informational congressional staff briefing on RFI and other pharmacy issues. This week, NCPA sponsored an informational briefing on Capitol Hill to educate congressional staff on issues impacting community pharmacies, including the President’s drug pricing blueprint. To read full NCPA updates click here.  Read the Health Choices Coalition Letter here

Week Ending June 29, 2018
Bipartisan senate effort encourages Sec. Azar to address pharmacy DIR: Sens. Shelley Moore Capito (R-W.Va.) and Jon Tester (D-Mont.) are leading a letter to HHS Secretary Alex Azar, urging him to address retroactive pharmacy direct and indirect remuneration fees in Medicare Part D as part of any attempts to lower drug prices. Senators have until July 9 to sign on, so please take a few moments to encourage them to do so through NCPA’s Legislative Action Center.
NCPA also has created sample comments that individuals can personalize and submit to the docket regarding the administration’s RFI and blueprint for lowering prescription drug costs.
NCPA and others file legal brief in Washington State Medicaid lawsuit: NCPA, along with the National Association of Chain Drug Stores and the Washington State Pharmacy Association, filed a brief with the Washington State Court of Appeals on Wednesday challenging the state's refusal to reimburse community pharmacies for the costs of providing care and services to disadvantaged Medicaid patients. Read full NCPA update click here

Week Ending June 22, 2018
NCPA member RFI comment template now available:
NCPA has developed template comments that individual pharmacists can personalize and submit to the docket pertaining to the Trump administration’s proposed blueprint/RFI for lowering drug prices and out of pocket costs. Click here to access. The comments track closely to NCPA’s asks on the RFI, which can be viewed here, and request the final plan that emerges: To read full NCPA update click here

Week Ending June 15, 2018
NCPA endorsed legislation to address opioid abuse moving through congress: As part of Congress’ ongoing efforts to combat the opioid epidemic, there was movement on two pieces of legislation that have been endorsed by NCPA (see attached NCPA support letter here and EPCC Act letter of support here).
Sec. Azar testifies on drug pricing: In a hearing before the Senate Health, Education, Labor and Pensions (HELP) Committee on Tuesday, HHS Secretary Alex Azar said several drug companies "are looking at substantial, material decreases in drug prices," but he indicated it could take time for the cuts to happen. Watch video here

Week Ending June 1, 2018
NCPA Board Chairman and CEO Discuss Drug Pricing Proposals in New Video: This week NCPA board chairman Brian Caswell, CEO Doug Hoey, and regulatory affairs director Kala Shankle released a short video discussing the Trump administration's recently announced drug pricing proposals. Discussion topics included providing relief for pharmacists on pharmacy DIR fees, fiduciary status for PBMs, and the President’s strong language on his efforts to lower drug prices. Watch video here.  Read the full NCPA report here.

Week Ending May 25, 2018
NCPA promotes Karry La Violette to lead Advocacy Center: 
NCPA announced this week that Karry La Violette has been promoted to senior vice president of government affairs and director of the Advocacy Center. In this role, La Violette will oversee all of NCPA’s policy, advocacy, grassroots, and communications endeavors. Read the full NCPA report here.  Final 2019 Call Letter: Utilization Review Controls (read letter here)

Week Ending May 4, 2018
NCPA Urges CMS to Pursue Rulemaking Addressing Retroactive DIR Fees: 
This week, NCPA sent a letter (read full letter here) to CMS urging the agency to move forward with proper rulemaking to require pharmacy DIRs to be accounted for at point-of-sale. Read the full NCPA report here.  Attachments reference in the report: Advocacy Center Staff Directory.

Week Ending April 27, 2018
NCPA Efforts Result in Key Pharmacy Protections in Senate and House Opioid Bills: 
This week, both chambers of Congress took the first steps in advancing legislation to address the opioid crisis. Read the full report Attachments referenced in the report: Senate Tricare Retail Pharmacy  House Tricare Retail Pharmacy

Week Ending April 20, 2018
NCPA Introduces MedPAC Nominee to Key Hill Staff:  This week NCPA government affairs staff accompanied NCPA’s Medicare Payment Advisory Commission (MedPAC) nominee Troy Trygstad to meetings with staff from key Congressional committees that have jurisdiction over Medicare.  Read the full report.  Attachments referenced in the report:  HR 4275 Letter of Support;   NIOSH Comments

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.  Read the full report.  Attachments that are referenced in the report.  Opioid HearingOpioid ResponseEPCS LetterAIDD Letter

Week Ending April 6, 2018
Congressional Committees Continue Work on Opioids: Next week, both chambers of Congress will hold hearings on the opioid crisis.  Read the full report.

Special Report of April 4, 2018
On April 2, 2018 The Centers for Medicare & Medicaid Services released their final Part D Rule and final Call Letter for 2019 Medicare Part D and Medicare Advantage plans.   Read the full report.

Week Ending March 30, 2018
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.”  Read the full report.  Attachments referenced in the report:  Congressional Summit AgendaGrassley Letter

Week Ending March 23, 2018
NCPA Responds to Senate Drug Pricing Transparency Request:  On Friday, NCPA responded (see attached) to a request from six Senators, led by Sen. Bill Cassidy (R-La.) and including Sen. Michael Bennet (D-Colo.), Sen. Charles Grassley (R-Iowa), Sen. Tom Carper (D-Del.),Sen. Todd Young (R-Ind.) and Sen. Claire McCaskill (D-Mo.), for comments regarding the ongoing effort to improve health care price and information transparency.  Read the full report.  Attachments to this report:  NCPA Senate Drug Pricing Transparency Request; 2018 Congressional Summit Agenda;  White House Fact Sheet Opioid.

Week Ending March 16, 2018
NCPA Offers Opioid Recommendations to Key Committee:  In a letter to the chairman and ranking member of the House Ways and Means Subcommittee on Health this week, NCPA offered several suggestions on how to combat the ongoing opioid crisis.  Read the full report.

Community Pharmacist Advises Congress on Opioid Epidemic: At a Feb. 28 hearing of the House Energy & Commerce Subcommittee on Health NCPA member Richard Logan, Jr., Pharm.D. who owns two pharmacies in Missouri and is a recently retired drug diversion investigator with the Mississippi County, MO Sheriff’s Department, testified on behalf of NCPA.  Read the full report.