Community Pharmacy State of the Union August 2017

Aug 07, 2017

ThoughtSpot 2017

Thanks to all who attended an exciting Good Neighbor Pharmacy ThoughtSpot 2017!  As part of Good Neighbor Pharmacy and AmerisourceBergen’s ongoing advocacy efforts, ThoughtSpot 2017 emphasized the importance of pharmacy advocacy via multiple channels throughout the trade show.  Former Speaker of the U.S. House of Representatives John Boehner (R-OH) reinforced the importance of community involvement in his keynote conversation with Bob Mauch, Executive Vice President and Group President, Pharmaceutical Distribution & Strategic Global Sourcing, for AmerisourceBergen.  

Bob Mauch and John Boehner at ThoughtSpot 2017

U.S. Congressman Doug Collins (R-GA) and the National Community Pharmacists Association (NCPA) CEO Doug Hoey, RPh, MBA —both steadfast champions for community pharmacists—joined our first-ever Advocacy in Action panel where they discussed critical issues impacting community pharmacy and actions to address them. Danny Cross, RPh, a Good Neighbor Pharmacy pharmacist who owns Southwest Medical Pharmacy in Carlsbad, New Mexico, was also on the Advocacy in Action panel.  Danny shared how he made a difference on PBM transparency legislation in the New Mexico state legislature and how his fellow pharmacists can also become actively involved in the legislative process to make a difference in Washington, D.C. and the states.  AmerisourceBergen’s Peter Kounelis, RPh, MBA, Vice President, Elevate Provider Network; and Beth Mitchell, Director of Government Affairs, also served as panelists.  Tim Jones, MBA, Director of Managed Care for AmerisourceBergen, led the discussion as the panel moderator.  

Advocacy in Action Panelists and Moderator at ThoughtSpot 2017

We are excited to share that nearly 1,000 letters regarding DIR fees, provider status and pharmacy visits were sent from Good Neighbor Pharmacy pharmacists to legislators during ThoughtSpot 2017.  Please share your stories with the AmerisourceBergen Government Affairs team re your responses from your outreach and advocacy!  For those who were not able to attend the Advocacy in Action panel, please be sure to watch the panel here (using this passcode: wearegnp2017), and be sure to take action and contact your federal legislators on DIR fees and provider status legislation!  Good Neighbor Pharmacy and AmerisourceBergen are here to help amplify your voices on the critical policy issues most important to you and your customers, patients.  

ACA Repeal & Replace

On May 4th, the U.S. House of Representatives passed legislation (with a vote of 217 to 213) to repeal and replace the Affordable Care Act (ACA).  Twenty Republicans did not vote for H.R. 1628, the American Health Care Act of 2017, but the House was still able to garner enough votes to push through the long-promised legislation to undo President Obama’s signature legislative achievement and replace it with a Republican led alternative.  In July, the U.S. Senate attempted to pass their own version of an ACA repeal bill to eliminate the law’s individual health insurance requirement and repeal the employer mandate for eight years, in addition to a few other measures.  The Senate’s attempt to pass this legislation failed (49-51 vote) on July 28th as Senate Majority Leadership could not gather enough votes needed (50 votes required for passage) to pass the bill.  Three Republicans and 48 Democrats voted against the Senate bill.  While the path forward to reform or repeal the ACA is still unknown, Congress is hearing from the pharmacy community regarding the importance of maintaining prescription drug coverage (especially for Medicaid patients and as a result of any changes to benefits requirements) and ensuring fair pharmacy reimbursement for patients should be included in any ACA repeal, replace and/or reform legislation.

DIR Fees

The impact of DIR fees on community pharmacies, Medicare Part D and Medicare beneficiaries is a serious and growing priority for all dispensing pharmacies (including not only community, but also retail, specialty, long-term care, hospital and physician office pharmacies) and for AmerisourceBergen. AmerisourceBergen and several pharmacy organizations in Washington continue to advocate for greater transparency on DIR fees and the need to have fees assessed at point of sale rather than retroactively in addition to fair and timely reimbursement for pharmacies.  Specialty pharmacies, manufacturers, and physician groups are also increasingly concerned about and vocal on this issue in Washington. AmerisourceBergen Government Affairs is coordinating advocacy with our pharmacy and physician customers, internal experts, and pharmacy trade associations to seek legislative and/or administrative relief on this issue.  Representatives from AmerisourceBergen recently met with the U.S. Office of Management and Budget Director Mick Mulvaney regarding drug pricing, and we expressed the need for greater transparency related to DIR fees in the context of efforts to ensure continued patient access to prescription medicines. DIR fees are being considered a driving factor behind higher out-of-pocket drug costs for patients. Key legislative and regulatory activity so far this year includes:

U.S. Senators Shelley Moore Capito (R-WV) and Jon Tester (D-MT) and U.S. Representatives Morgan Griffith (R-VA) and Peter Welch’s (D-VT) bipartisan legislation (S. 413/H.R. 1038) to ban all retroactive DIR fees on pharmacy claims has increasing support in Congress with 12 bipartisan Senate/49 bipartisan House cosponsors. Good Neighbor Pharmacy and over 100 pharmacy organizations support this legislation.

On June 2, Good Neighbor Pharmacy submitted a comment letter from Brian Nightengale, President of Good Neighbor Pharmacy, to CMS regarding the CMS Proposed Medicare Part D DIR Reporting Requirements for 2016. Several other organizations, including NCPA, the National Association of Chain Drug Stores (NACDS), and the National Association of Specialty Pharmacies (NASP), also submitted comments to CMS.

AmerisourceBergen supports the Congressional letters to HHS Secretary Tom Price urging administrative action to address retroactive DIR fees charged by PBMs and health plans. The Congressional letters were led by U.S. Reps. Tom Marino (R-PA) and Dave Loebsack (D-IA) and U.S. Sens. Grassley (R-IA), Capito (R-WV), Tester (D-MT), and Heitkamp (D-ND).

Pharmacy Provider Status

AmerisourceBergen supports and seeks Congressional co-sponsorship for legislation, S. 109/H.R. 592 - introduced by U.S. Senators Chuck Grassley (R-IA) and Bob Casey (D-PA) and U.S. Representatives Brett Guthrie (R-KY) and G.K. Butterfield (D-NC), to ensure pharmacists are recognized as providers and reimbursed by Medicare Part B for providing health care services (e.g. immunizations, flu tests, etc.) in medically underserved areas.  As of August 1, 2017, pharmacy provider status legislation has 43 bipartisan Senate/203 bipartisan House cosponsors in Congress and has the support of several pharmacy and patient groups. The Patient Access to Pharmacists’ Care Coalition (PAPCC), of which AmerisourceBergen is a member, is working to coordinate advocacy for bill passage and propose options to reduce the cost of the bill with the goal of including the legislation in the Children’s Health Insurance Program Reauthorization this year. Representatives from the PAPCC met with CMS Administrator Seema Verma and expressed the need to recognize pharmacists as providers under Medicare to ensure patient access to care. The coalition is working to send over 1,000 letters from constituent pharmacists to Members of Congress asking for cosponsorship and passage of the bill this year. 

Drug Pricing and Transparency

While ACA repeal and replace remains the current health care priority of Congress, drug pricing is another critical issue many Members of Congress are hearing concerns and complaints about directly from constituents in their states and districts.  On May 29th, the New York Times published an article related to rising drug prices and pointed out the role of independent pharmacists in health care.  In June, the Senate HELP Committee held a hearing on prescription drug pricing, and they are expected to hold additional hearings this fall.  The Trump Administration is also rumored to be planning to release an Executive Order on Drug Pricing this year.  NCPA recently sent a letter to the U.S. Office of Management and Budget (OMB) Director Mick Mulvaney to request a meeting and offer recommendations, such as addressing retroactive DIR fees that impact cost of medication for Medicare patients and the Medicare Part D program. 

We appreciate your ongoing advocacy efforts in your own communities and we can see they’re making a difference. We look forward to working together to amplify “OurIndependentVoice!”