NCPA Executive Update

NCPA Executive Update delivers insights on legislative, regulatory, policy, and industry developments from NCPA CEO B. Douglas Hoey, Pharmacist, MBA, to NCPA members and pharmacy leaders every other Friday.

United, we can declare our independence from PBM abuses | NCPA Executive Update | July 5, 2019

by NCPA | Jul 03, 2019

Dear Colleague,

Doug Hoey

On Thursday, Independence Day commemorated the signing of the Declaration of Independence, which included this passage: "Governments are instituted among Men, deriving their just powers from the consent of the governed." With those words, a democracy was born that gives the people a voice. A voice to elect our government representatives, a voice to thank them for taking action, and a voice to implore them to help.

Pharmacy DIR fee reform continues to be NCPA's highest priority. As you know, NCPA expected CMS to finalize its proposed rule and eliminate retroactive pharmacy payment adjustments. When the Trump administration failed to include pharmacy DIR fee reform in its final rule, we vowed to continue the fight. The NCPA Advocacy Center staff immediately began coordinating with our congressional and industry allies on a potential legislative fix. More on that in a moment.

Numerous champions of independent pharmacy took immediate action to convey their disappointment directly to President Trump. Sens. Shelley Moore Capito (R-W.Va.) and Jon Tester (D-Mont.) circulated a sign-on letter among their Senate colleagues expressing this sentiment. Reps. Peter Welch (D-Vt.), Vicente Gonzalez (D-Texas), Buddy Carter (R-Ga.), and Morgan Griffith (R-Va.) led a similar effort in the House of Representatives.

NCPA worked with industry allies and energized our grassroots to ask lawmakers to sign onto these letters. Thank you to everyone who responded to our call to action and contacted your legislators. Due to these efforts, 28 U.S. senators and 105 members of the House of Representatives, including one-third of the majority members of the Energy and Commerce Committee, joined in expressing bipartisan disappointment to President Trump. Additionally, Sen. Sherrod Brown (D-Ohio) and Rep. Doug Collins (R-Ga.) each sent their own letters. While these letters do not solve the problem of pharmacy DIR fees, the impressive number of signatories demonstrate significant congressional support to address pharmacy DIR fees.

Did your congressional representatives sign on to the letter? Are they supporting other pro-pharmacy, pro-patient legislation? NCPA has created a spreadsheet listing every member of Congress, with separate tabs for House and Senate, and what recent priorities they have supported so you can see what your legislators have done. Kudos to Alaska, Arkansas, Maine, Montana, and North Dakota, where their entire congressional delegation has supported at least one community pharmacy priority. On the other hand, some states are conspicuously notable with insufficient legislative support for pharmacy.

Congress' annual in-district work period begins on July 26 and they won't return to D.C. until Sept. 9. Much of this time will be spent in district. Use this opportunity to engage your legislators by inviting them to visit your pharmacy or by attending a town hall meeting. NCPA can help you arrange a pharmacy visit. Contact Michael Rule at Thank your representatives for their support where warranted, or ask them why they have not supported our issues and encourage them to do so. NCPA's grassroots is a strong pillar of our advocacy efforts, and we strongly encourage your continued engagement.

The legislative fate of pharmacy DIR fees is currently in the hands of the Senate Finance Committee, which is working on a broader drug pricing bill that could move through the committee this summer. NCPA has met with both majority and minority staff of the Senate Finance Committee and is working to have pharmacy DIR fees addressed in this legislative package. Additionally, the committee's Ranking Member, Sen. Ron Wyden (D-Ore.), recently visited NCPA Chairman Michele Belcher's community pharmacy, and they had a productive discussion. We have also deployed our most important asset, our membership, to engage senators and urge their active support, including a fix to pharmacy DIR fees in this legislation. This effort included last week's "FixDIRDay" a final grassroots push before senators left town for their July 4 break. Thank you to everyone who has made calls or sent emails on this critical issue. While we remain optimistic, there is always uncertainty in the legislative process.

In addition to continuing your grassroots activity, please consider contributing to strengthen two other advocacy pillars, NCPA's Political Action Committee (PAC) and NCPA's Legislative/Legal Defense Fund (LDF). The PAC allows us to support candidates who have staked out pro-community pharmacy policy positions. We need to elect more of these candidates to Congress and state legislatures. The LDF supports NCPA's advocacy and litigation capabilities. One of the most important aspects of the LDF is that it enables us to seek counsel and research from outside experts on issues to improve our advocacy efforts and better fight on your behalf.

The common thread between our grassroots, PAC, and LDF is that they require us all to act in unity, combining our voices and pooling our resources, to successfully defend our profession in Congress, state legislatures, and, when required, the courtroom. We must stand united to achieve common goals such as reforming or eliminating onerous pharmacy DIR fees and changing the Medicaid pharmacy payment model. To quote Ben Franklin during this Fourth of July week, "We must, indeed, all hang together or, most assuredly, we shall all hang separately."


Doug Hoey