Latest Updates

On January 6, CMS issued a proposed rule that would reduce unpredictability for pharmacies created by PBMs and health plans taking post point of sale “clawbacks” of uncertain amounts up to several months after the pharmacy counter transactions.

CMS Administrator Brooks-LaSure committed that CMS will use its regulatory authority to address DIR post-claim-adjudication fees imposed by PBMs upon pharmacies and providers.

Join thousands of other pharmacists by contacting your senators today to urge them to include comprehensive DIR fee reform in the Build Back Better bill! Details below and available on NCPA’s website.

Republicans on the U.S. House Committee on Oversight and Reform recently held a 2.5 hour “Forum” on the role of PBMs in pharmaceutical markets in which they clearly signaled that they find political and policy advantages in pressing the issue should they take the majority in the November 2022 elections. All the Republican Representatives and 6 of the 7 witnesses were critical of the role and activities of PBMs.

On October 15th, Representatives Kurt Schrader (D-OR) and Markwayne Mullin (R-OK) introduced the LTC Pharmacy Definition Act of 2021 in the House of Representatives. This legislation complements the bipartisan Senate version, which was introduced earlier this year.