The NCPA wants Congress to pass legislation that would increase the competitiveness of community pharmacies.
Hundreds of community pharmacists from across the country have gathered in Washington, DC, this week for the National Community Pharmacists Association’s 2012 Legislative and Government Affairs Conference. The conference attendees are receiving briefings about the NCPA’s public policy goals and will meet with their federal representatives to urge them to support a number of bills designed to give community pharmacists more leverage in their dealings with insurance plans and pharmacy benefit managers (PBMs).
“Community pharmacists are on the front lines, and all across America it’s community pharmacists that are helping patients achieve better health and lower costs through the proper use of prescription medications,” said Rep. Cathy McMorris-Rodgers (R-WA), co-chair of the Community Pharmacy Caucus, in a conference call held to lay out the NCPA’s public policy goals.
McMorris-Rodgers discussed 2 bills that she has introduced in the House of Representatives: HR 4215
, the Medicare Pharmacy Transparency and Fair Audit Act, and HR 1971
, the Pharmacy Competition and Consumer Choice Act of 2011. HR 4215, introduced earlier this year, would require sponsors of a Medicare Part D prescription drug plan to inform pharmacies about how the plan’s “maximum allowable cost” (MAC) reimbursement limits are set, to update pricing information weekly, and ensure that pharmacies are notified promptly of pricing changes. In addition, it would limit audits of pharmacies carried out by Part D plan sponsors or their designees such that prescription claims could not be overturned unless intent to commit fraud and a resulting increase in cost to the plan were established.
HR 1971, introduced last year, included all the provisions in HR 4215, as well as a number of others. It would protect patients from being financially penalized for having prescriptions filled at a pharmacy of their choice rather than one owned by their insurance plan or its PBM. It would also require private insurance plans to disclose what the NCPA has called “profit-padding practices” such as encouraging patients to take higher-priced drugs. (Similar disclosure requirements are already in place for Medicare Part D plans and forthcoming state health insurance exchanges.)
“The reason this legislation is important is because community pharmacists are the small businesses that are dealing with the goliaths of PBMs, and this legislation will allow them to compete and to stay open in many examples,” said McMorris-Rodgers, adding that she hopes at least to have a hearing on 1 of the bills before this November's election.
McMorris-Rodgers and others on the conference call noted that passing legislation to protect the interests of community pharmacists was all the more important given the recent approval of the merger
of 2 of the country’s 3 largest PBMs, Express Scripts and Medco. A federal lawsuit
to block the merger filed by the NCPA along with the National Association of Chain Drug Stores and a number of community pharmacies is still pending.