By Michael Rule, Associate Director of Public Affairs and Grassroots Advocacy
Congress recently adjourned for its annual August recess. During this five week period, Senators and Representatives will be spending much time at home, touring the state or district and listening to constituents. For independent community pharmacists, this presents a tremendous opportunity to educate members of Congress on the role you play in the healthcare system and in your communities, and on the patient services you provide. This is also an opportunity to advocate for common sense reforms regarding abusive audits by pharmacy benefits managers (PBMs) and to seek reversal of a CMS rule regarding home delivery diabetes test supplies (DTS). You also can educate elected officials on the unintended consequences of some legislative efforts regarding pharmacy compounding.
For example, the Senate is expected to vote on a compounding bill when its members return to Washington in September. While well meaning, this bill creates regulatory burdens for independent pharmacies. For patients that rely on these individualized medications per their doctor’s orders, this could create access issues. During recess, tell your Senators and Representative that while we all share the goal of preventing another tragedy like the meningitis outbreak caused by the New England Compounding Center (NECC), legislation must preserve patient access to traditional compounding services and refrain from creating an overly burdensome regulatory atmosphere for small business independent pharmacies.
In addition to compounding, independent pharmacists should advocate for a legislative fix to the home delivery ban on DTS to Medicare Part B beneficiaries. Representative Peter Welch (D-VT) recently introduced legislation (H.R. 2845) to do this. Urge your Representative to support this important bill. Without a fix, independent community pharmacies are unable to provide home delivery service to homebound patients or those in nursing or assisted living facilities. With retail and mail order receiving identical reimbursements from Medicare for DTS, the ban on home delivery is arbitrary and unnecessary.
Finally, abusive PBM audits are still of paramount concern to independent community pharmacists. Fortunately, bipartisan Senate legislation has been introduced to set reasonable audit standards for Medicare plans. This legislation would keep audits focused on the stated intent of uncovering cases of fraud, waste and abuse, would prohibit PBMs from recouping payments unless there was intent by the pharmacy to commit fraud, and would require that any legitimate financial recoupments be passed back to Medicare and the taxpayer. Share examples of abusive audits you have endured with your elected officials. Urge your Senators to co-sponsor S. 867 and urge your Representative to support companion legislation in the House once it is introduced.
To assist you in your efforts, NCPA has compiled several resources to help member pharmacists make the most of this recess period. For example, you can find sample letters to the editor and tips on how to submit a letter here. Additionally, you can find tips on arranging a meeting with your member of Congress in their district office or on how to invite the member to tour your pharmacy here. Additionally, many members will have public events, such as a townhall, where you can raise issues of importance and tell your story. To guide you, you can access talking points on priority legislation here. (Note, an NCPA login is required to access these materials).
August recess is an ideal time to educate your elected officials on the role you play in the community, the patient services you provide, the challenges you face, and to advocate for common-sense solutions to these problems. We urge pharmacists to take advantage of the resources we have created and to make their voices heard.