News Releases - 2017

NCPA Offers Recommendations to GOP Leaders as Congress Considers New Health Care Reforms

by NCPA | Jan 11, 2017

ALEXANDRIA, Va. (Jan. 11, 2017) The National Community Pharmacists Association (NCPA) has contacted Republican congressional leaders to provide the community pharmacist perspective on repeal and replacement of the Affordable Care Act (ACA) and potential Medicaid changes.

NCPA sent a letter to House Majority Leader Kevin McCarthy (R-Calif.) and GOP chairs of the House Ways and Means Committee, House Energy and Commerce Committee, and House Education and Workforce Committee as they consider ACA replacement package ideas. NCPA also sent a letter to Sen. Orrin Hatch (R-Utah), chair of the Senate Finance Committee, who had previously solicited ideas for Medicaid changes.

"As Congress prepares the coming wave of health care reforms, we felt the voice of America's more than 22,000 independent community pharmacies and the millions of patients they serve should be heard," said NCPA CEO B. Douglas Hoey, RPh, MBA. "These small business health care providers often reside in underserved communities, are highly accessible, and are critical to driving prescription drug access, adherence and proper utilization. We believe these common-sense, bipartisan measures will improve health outcomes, reduce costs and maintain access for patients. We look forward to working constructively throughout the legislative process to achieve those goals."

NCPA recommendations on ACA replacement include:

  • Preserve prescription drug coverage as an essential benefit to help reduce overall health costs.

  • Require a robust pharmacy network that includes meaningful access to retail pharmacies, including independent pharmacies, for patients to fill their prescriptions and promote proper adherence.

  • Maintain current definition for Average Manufacturer Price (AMP) that is used to determine Medicaid reimbursements.

  • Retain sections of the ACA that were dedicated to improving Medicare Part D medication therapy management (MTM) programs, including an annual comprehensive medications review, and build upon it to further integrate pharmacists into the health care delivery system.

  • Keep transparency provisions requiring pharmacy benefit managers (PBMs) serving exchange plans and Medicare Part D to disclose to HHS the generic dispensing rate for retail and mail order pharmacies, the amount of the rebates collected, the amount passed onto the health plan and the total difference between what the PBM charged the plan and what it paid out to pharmacies.

NCPA Medicaid recommendations include:

  • Maintain prescription drug coverage as an essential component of the Medicaid program. It should never be considered an optional benefit, because the savings that a state may realize by severing access to prescription medications are likely to be eclipsed by downstream medical interventions.

  • Allow the participation of "any willing pharmacy" in Medicaid pharmacy networks. Restrictive networks have a negative impact on beneficiary access to prescription medications and generate confusion.

  • Permit patient choice of pharmacy. Mandatory mail order pharmacy requirements eliminate the value pharmacists provide through face-to-face interaction with patients, especially those suffering with multiple chronic conditions.

  • Better integrate pharmacists into the health care delivery system in order to take advantage of their proven effectiveness in driving health outcomes and reducing costs.

  • Assure more robust oversight of managed care organizations, including state inspection and audits of pharmacy benefit managers that administer the drug benefit.

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The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 22,000 independent community pharmacies. Together they represent an $81.5 billion health care marketplace and employ more than 250,000 individuals on a full or part-time basis. To learn more, go to www.ncpanet.org, visit facebook.com/commpharmacy, or follow NCPA on Twitter @Commpharmacy.