By Michael Rule
The 114th Congress convened just over a month ago, yet it has been an eventful time for independent community pharmacies as legislation has been introduced to address all three of our top priorities as identified by a recent NCPA member survey.
Survey responses identified the lag by PBMs in updating MAC reimbursements as members’ top priority. We are happy to report, H.R. 244, the MAC Transparency Act, was introduced by Representatives Collins (R-Ga.) and Loebsack (D-Ia.). The bill would apply to Medicare, TRICARE and the Federal Employee Health Benefit Program. It would require PBMs to update their MAC pricing lists at least once every seven days and make certain disclosures to pharmacies including the source(s) used to set the MAC price.
Addressing preferred networks in Medicare was the second top priority. As such, Representatives Morgan Griffith (R-Va.) and Peter Welch (D-Vt.) reintroduced the Ensuring Seniors Access to Local Pharmacies Act (H.R. 793). The bill is identical to H.R. 4577 from the last Congress and would allow any pharmacy located in a medically underserved area the opportunity to choose whether to participate as preferred pharmacies under Medicare.
Finally, legislation has been introduced in both the House and Senate to recognize pharmacists as providers under Medicare. H.R. 592/S. 314 recognizes Pharmacists are capable of playing a greater role in the delivery of health care services and would allow pharmacists practicing in medically underserved areas to bill Medicare for services they are allowed to provide under state law
NCPA has created grassroots materials for each of these key issues, and it is vital that you and your patients take advantage of them to make your voice heard in support of these measures. Sample emails to Congress for each of these priorities are available on the Legislative Action Center. You can also find additional resources on H.R. 793 on NCPA’s Pharmacy Choice webpage and on H.R. 244 on the Pharmacy Access page.