NCPA Urges Key Medicaid Managed Care Rules Be Retained: In light of the fact that the Administration is currently reviewing the policies included in the final Medicaid managed care rule released last year (88 Fed. Reg. 27498, May 6, 2016), NCPA wrote the new Administrator of CMS, Seema Verma, to offer suggestions for provisions that are critical for retention and also offer one suggestion for expansion or addition. NCPA suggestions include:
- NCPA Urges Retention of Provision in Final Rule that Requires States to Develop and Enforce Network Adequacy Standards (Time and Distance Requirements) for Critical Provider Types, Including Pharmacy
- NCPA Urges Retention of Provision in Final Rule that Requires MCOs to Meet Medicaid Fee-for Service Standards Regarding Availability and Prior Authorization of Covered Outpatient Prescription Drugs
- CMS Should Advise States that MCOs Must Use Fee-for-Service Medicaid Pharmacy Provider Reimbursement Rates As a Minimum Reimbursement “Floor”
NCPA Represents Community Pharmacy Interests at FDA Compounding Listening Session: This week NCPA attended an invite-only session at FDA to discuss our compounding concerns with FDA staff responsible for all aspects of compounding. We were able to share independent community pharmacy perspectives related to office use, the MOU, inspections, essential copies and bulk drug substances, among other topics. NCPA reiterated our willingness to work with the Agency to ensure access to compounded therapies but made clear that we cannot work within the boundaries FDA has currently set in regards to office use compounding and how the MOU would be structured, especially in light of Congressional intent. We also made clear that all compounding pharmacies must be treated equally and no special exceptions be made for compounding done within a health system setting.
NCPA and NACDS Meet with PhRMA to Discuss TRICARE Pharmacy Pilot: This week, NACDS and NCPA met with PhRMA staff to discuss implementation of a pilot program included in the FY2017 National Defense Authorization Act (NDAA), to gather further support. The pilot program allows the Department of Defense (DoD) to access lower pricing for prescriptions dispensed at retail pharmacies. If authorized by the Secretary, this pilot would reduce prescription costs for the DoD, expand TRICARE beneficiary choice and access to prescription drugs at retail pharmacies, and streamline DoD administrative and prescription drug rebate processes.
NCPA Grassroots Update: NCPA sent a grassroots alert to our members that are represented by members of the House Ways and Means Committee. The alert urged independent pharmacists to contact their representative to urge them to support H.R. 1038, the Improving Transparency and Accuracy in Medicare Part D Drug Spending Act and to voice their support for a committee hearing on this vital legislation that addresses retroactive DIR fees. The Ways and Means Committee is one of the committees with jurisdiction over DIR legislation, and a committee hearing is a critical step in moving this legislation forward.
In the States:
- New Mexico: Regulations allowing trained and licensed pharmacists in New Mexico to prescribe contraception are now in effect. New Mexico will join a handful of other states including Colorado, Oregon, and California where individuals may have their birth control prescribed and filled by a pharmacist in a single visit. New Mexico physicians, nurses and community partners came together with pharmacists to develop the necessary protocol and training to ensure pharmacists can safely prescribe the medications. The rigorous approval process included review by the NM Board of Pharmacy, NM Board of Nursing and NM Medical Board.
- Nevada: In Nevada, a new bipartisan bill (SB 539) was passed that will force drug manufacturers to justify price hikes on diabetes medications, and also require PBMs to disclose rebate information. The legislation would also prohibit PBMs to punish pharmacists for “selling a less expensive alternative drug” to patients. The bill passed both the state’s Assembly and Senate and awaits the signature of Gov. Brian Sandoval (R), who reportedly has indicated his support. Both bodies had approved an earlier proposal that targeted only the diabetes drug manufacturers, but Sandoval vetoed it on grounds that it “poses serious risks of unintended and potentially detrimental consequences” for patients, according to a veto statement. He said the bill ignored the role PBMs play in drug pricing.
