ALEXANDRIA, Va. (April 24, 2017) This week, hundreds of community pharmacists will convene in Washington, D.C. to advocate for their patients and their businesses during the National Community Pharmacists Association's (NCPA) 2017 Congressional Pharmacy Fly-In. On April 26 and 27, community pharmacists will meet with members of Congress to generate support for legislative priorities that improve patient access to prescription drug services. Those efforts will be supported by a week-long advertising campaign in leading Washington, D.C. news outlets.
"Community pharmacists see firsthand every day the importance of assuring patient access to their prescription drug therapy. There's an important national discussion about prescription drug coverage and affordability that continues today. Independent community pharmacists are part of the solution both through greater transparency and achieving better health outcomes through proper medication use," said NCPA CEO B. Douglas Hoey, MBA, RPh. "Community pharmacists will also educate members of Congress this week about their experiences with pharmacy benefit managers' (PBMs) pricing games and offer legislative solutions to make drug middlemen more transparent and accountable, which in turn will improve health outcomes for patients overall and bend the cost curve."
The legislative priorities independent community pharmacies will advocate for include:
- Improving Transparency and Accuracy in Medicare Part D Spending (S. 413 / H.R. 1038): Retroactive pharmacy DIR fees have exploded in Medicare Part D. These bills would prohibit retroactively reducing payment on claims submitted by pharmacies under Medicare Part D. This would increase transparency in Medicare, lower cost-sharing levels for seniors, reduce the program's catastrophic costs, and support patient access to independent community pharmacies.
- Creating Prescription Drug Price Transparency (H.R. 1316): Generic prescription drugs account for over 80 percent of medications dispensed by community pharmacies, yet how they are priced by PBMs is a black box. This bill would codify Medicare transparency provisions concerning 'maximum allowable costs' (MACs) for generics and apply them to TRICARE and FEHBP. It would also establish a MAC appeals process and prohibit PBM requirements to use a PBM-owned pharmacy—a clear conflict of interest.
- Ensuring Seniors Access to Local Pharmacies (H.R. 1939): This bill would give seniors more access to discounted copays for prescription drugs at their pharmacy of choice. It would allow pharmacies in medically underserved areas to participate in Medicare preferred pharmacy networks if they accept the drug plan's terms and conditions.
- Obtaining Pharmacist Provider Status (S. 109 / H.R. 592): These companion bills would recognize pharmacists as providers under the Medicare Part B program. If enacted, pharmacists would be able to perform services for patients consistent with their state's scope of practice if their pharmacy is located in a medically underserved area, health professional shortage area, or medically underserved population.
- Standing Up for Our Health Care Reform Principles in Overall Health Care Reform Efforts: Any legislation replacing the Affordable Care Act should retain provisions that enhance patient access to prescription medications, including: preserving prescription drug coverage as an essential health benefit; maintaining meaningful access to retail pharmacies for patients to fill their prescriptions; preserving Part D improvements to medication therapy management (MTM) services; and keeping the current average manufacturer price (AMP) definition used for Medicaid fee-for-service reimbursements.