House GOP Proposes Major Tax Overhaul: The wide-ranging plan would reduce tax rates for large corporations to 20% and small businesses to as low as 25% as well as phase out the estate tax for many Americans. However, for independent community pharmacies that are “pass-through” S corporations, the degree of tax savings is subject to a complex “blended” formula with the potential to water down savings and create disparity between large and small businesses. With that concern in mind, NCPA will continue to stay engaged in the very fluid legislative process (see earlier letter). While Republicans’ ambitious goal is to use expedited budget procedures to send final legislation to the White House before Christmas, the measure is expected to undergo significant changes and has already attracted waves of criticism, including from some fellow Republicans, and major opposition from Democrats.
Federal Commission on Opioid Epidemic Endorses NCPA-Backed Proposals: The final report of the President’s Commission on Combatting the Opioid Crisis endorsed several NCPA-supported concepts, including: more prescriber education for controlled substances; expanded access to the overdose-reversing drug naloxone; greater availability to medication-assisted therapy; enhancing the scope and functionality of prescription drug monitoring programs; and more scrutiny and restrictions on certain controlled substances delivered through the mail. Read NCPA’s complete response online. Related, HHS Office for Civil Rights recently advised health care providers how they are allowed under HIPAA to share health information with a patient’s loved ones in emergency or dangerous situations.
DIR Fees Still on Minds of Medicare Officials: A Congressional letter about DIR fees, organized by Rep. Buddy Carter (R-Ga.) and supported by NCPA, elicited a recent response from CMS Administrator Seema Verma, who indicated that the agency “is carefully reviewing the input we have received from various stakeholders, including comments related to DIR.”
Cuts in Medicaid Managed Care Reimbursement Prompt Pharmacy Response: NCPA members and state partners reported dramatic reductions in reimbursement rates in the Medicaid Managed Care (MMC) space. In response, NCPA advises pharmacists and state partners to: Contact your state Medicaid agency to protest below-cost reimbursement rates and highlight CMS’s final rule on network adequacy requirements in MMC; and re-examine any state MAC laws for their applicability to Medicaid MMC. In addition, consider 2018 legislation to require MCOs to reimburse at FFS rates and subject MCOs to state MAC laws. NCPA comments about MMC to federal Medicaid officials are a great resource.
Catch Up on Medicaid Updates: A capacity crowd tuned in to NCPA’s webinar this week on Medicaid reimbursement developments. If you missed it, an on-demand recording is on the NCPA website (CE credit only available to those who participated in the live webinar). Also, save Dec. 7 in your calendar for our NCPA Members Forum on the 2018 Community Pharmacy Checklist and what you should know on the legislative and regulatory front for next year.
NCPA Partners with PQA on Successful Team-Based Care Workshop: This week the NCPA Innovation Center and PQA co-hosted a team based care workshop in advance of the annual PQA leadership summit. The workshop focused on building scalable team based models of care and several NCPA members presented their success stories. The PQA leadership summit brought together payers, pharmacies and other key stakeholders to discuss challenges in our health system including quality measurement and opioid overprescribing. NCPA, as a member of the PQA board of directors, participated in board events including a meeting to discuss the PQA strategic plan for 2018-2020 and attribution models for Pharmacy.
Audit Threat Arises as Medicare Expands Coverage Rules for Insulin Pumps to treat them as durable medical equipment (DME) for diabetic beneficiaries who could not control their diabetes adequately with periodic insulin injections. Pharmacists should ask any Medicare beneficiaries who are purchasing insulin if they are using an insulin pump. If they are, then the insulin should be billed under the DME benefit, not to the patient or to a part D plan. More information is available online.
49 Reps. Urge TRICARE Pharmacy Pilot in DOD Bill: Reps. Buddy Carter (R-Ga.) and Dave Loebsack (D-Iowa) organized the letter which calls for re-authorization of the program for another year as Senate and House negotiators reconcile competing versions into final legislation. It was included in the House-passed NDAA, but not the Senate-passed measure.
NCPA to Address Controversial PBM Practices at Upcoming Events: Nov. 8 the FTC hosts a workshop to examine prescription drug market entry and the supply chain. NCPA will speak on a panel entitled “Understanding Intermediaries: Pharmacy Benefit Managers.” Nov. 14 NCPA CEO Doug Hoey will make remarks at a RealClear Politics forum entitled “Examining the Pharmaceutical Supply Chain from Production to Patient.”
CMS Opioid Roundtable to Feature NCPA Input: NCPA staff as well as NCPA member George Garmer, Pharmacist and Owner of Halethorpe Pharmacy in Baltimore, Md., will take part in a discussion Nov. 8 with other pharmacy stakeholders at CMS headquarters with Administrator Seema Verma, as part of our continuing efforts to educate policymakers how community pharmacists are part of the solution to the opioid epidemic.
CMS Final Rule on Quality Care Recognizes Better Pharmacist Integration: A final rule published by CMS regarding implementation of the Quality Payment Program calls for improved utilization of pharmacists on the health care team to achieve better outcomes. During the earlier comment period NCPA, along with APhA, AMCP and ASCP, provided CMS with recommendations to this effect and also expressed support for separate comments provided by the Pharmacy Health Information Technology Collaborative, of which NCPA is a member.
NCPA Key Legislation Co-Sponsorship Update: Please see key totals below and attached for more details.
DIR: S. 413: 13 / H.R. 1038: 63
MAC: H.R. 1316: 40
Pharmacy Choice: S. 1044: 5 / H.R. 1939: 22
Provider status: S. 109: 47 / H.R. 592: 229
Compounding: H.R. 2871: 40
Editor’s Note: Ronna Hauser does (and will continue to do) a great job here for NCPA members and I want to recognize and appreciate her work leading this update for some time. As I coordinate and disseminate this weekly update going forward, it will continue to reflect all the great efforts of NCPA staff for our members. If you have feedback, suggested topics, etc., please feel free to share those. Thank you.
