Advocacy Wins

Think NCPA's advocacy efforts don't affect you? Think again...

Getting results from Congress, federal agencies, state legislatures and the courts takes time and strategy and patience. Through that process, it's critical for you to be informed and engaged. These select examples help illustrate the benefits of NCPA advocacy efforts recently and over the past years.


  • Met with U.S. Health and Human Services Secretary Tom Price to advise him on retroactive DIR fees and combatting rising prescription drug prices.

  • Influenced introduction of ban on retroactive pharmacy DIR fees in the U.S. Senate and House of Representatives, and we're advocating hard for its passage

  • Influenced introduction of U.S. Senate and House bills assuring patients the ability to select the pharmacy of their choice under Medicare Part D.

  • Influenced introduction of federal generic pricing transparency legislation that also requires regular updates of maximum allowable cost (MAC) caps on generic prescription drug reimbursement.

  • Influenced introduction of The Pharmacy and Medically Underserved Areas Enhancement Act of 2017 in the U.S House and Senate, which would allow pharmacists to be reimbursed for patient services under Medicare in underserved areas.

  • Influenced introduction of legislation in the U.S. House to preserve patient access to compounded medications.

  • Brought Medicare on-record about harmful impact of retroactive DIR fees on patients and taxpayers. NCPA's work with the Centers for Medicare & Medicaid Services led to the publication of a groundbreaking January 2017 fact sheet.

  • Won reversal of a cumbersome DEA Registrant Renewal Policy on renewal applications that could have triggered audit implications for pharmacies and decreased patient access to controlled substances.

  • Facilitated more than 80 pharmacy visits between NCPA members and members of Congress during the 2015-2016 congressional session.

  • Grew NCPA PAC into the largest and most successful pharmacy association PAC in America. In 2015- 2016, we contributed to candidates in 160 House races, and NCPA supported candidates won in 148 of those—a 92% success rate. All 15 Senate candidates the NCPA PAC backed won their races.

  • Supported state partners in enacting MAC laws in 33 states in recent years.

  • Pressed Congress to include language clarifying congressional intent—and reining in FDA overreach—on several compounding regulations implementing the Drug Quality and Security Act (DQSA). President Trump signed H.R. 244 into law.

  • Got AMP-based FUL provision removed from 21st Century Cures legislation as an offset to help fund the legislation.

  • Won delay of implementation of USP <800> requirements on community pharmacies in several states.

  • Convinced FDA traditional compounding pharmacies can continue to repackage non-sterile drug products for use in long-term care facilities, modifying an earlier agency position.


  • Spurred the opening of more Medicare Part D "preferred pharmacy" networks to participation of independent pharmacies via bipartisan federal legislation and aggressive lobbying of Medicare officials.

  • Blocked mandatory mail order in Medicare and the health plans offered through exchanges established by the Affordable Care Act.

  • Influenced CMS to establish fair Medicaid pharmacy reimbursement benchmarks. Citing many of NCPA's arguments, CMS adopted National Average Drug Acquisition Cost (NADAC) as a pharmacy reimbursement "floor" in Medicaid (in cases where the "federal upper limit" is below acquisition cost). CMS also required states to consider both ingredient cost reimbursement and the professional dispensing fee reimbursement when proposing changes to Medicaid reimbursement.

  • Influenced Medicare to require that PBMs regularly update MAC pricing to reflect market costs. In implementing the requirement, CMS agreed that "greater transparency in maximum allowable cost prices of drugs would not only give pharmacies the ability to shop for more cost-effective versions of generic drugs, but would improve pharmacies' ability to evaluate Medicare Part D contract proposals, plan their business staffing levels and potential capital investments, and monitor claims reimbursements and appeal when it appears that there has been a reimbursement error."

  • Protected pharmacy compounding from a congressional push to effectively ban it. Initial bills proposed at the height of the meningitis crisis would have made it virtually impossible for independent community pharmacies to compound customized medication for patients.

PRIOR TO 2013:

  • Saved the average pharmacy $100,000 in 2008 alone by urging Congress to require PBMs to pay pharmacies promptly rather than holding their money. NCPA facilitated passage of "prompt payment" requirements and a delay of AMP Medicaid cuts. Pharmacies continue to benefit from prompt pay today.

  • Saved every retail pharmacy outlet in the U.S. $70,438—or $4.015 billion in total—as a result of leadership by NCPA and NACDS in a joint Medicaid AMP lawsuit, which produced a court injunction.

  • Banned proration on covered "short-cycle" prescriptions for LTC pharmacies. Thanks to NCPA's advocacy, Medicare Part D plans are banned from paying long-term care pharmacies prorated dispensing fees for short-cycle prescriptions.

  • Amended 2013 Track & Trace legislation to save independent community pharmacies $11,000 a year. The law saved pharmacies $4,000 per year on equipment, $5,000 per year labor costs, and $2,000 per year data storage and regulatory burden costs.

  • Protected community pharmacies from a cut of about $291 a day, or $105,000 a year. NCPA intervened to block a proposed settlement of the First Data Bank/Medispan antitrust case that would have required a 4% rollback of published Average Wholesale Price (AWP) figures.

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