NCPA suggests any changes to ACA maintain Rx coverage and pharmacy access
ALEXANDRIA, Va. – The National Community Pharmacists Association on Wednesday reached out to Republican congressional leaders to provide the community pharmacist perspective on repeal and replacement of the Affordable Care Act and potential Medicaid changes, the association stated.
“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,” stated Douglas Hoey, NCPA CEO. “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," he said. "We believe these common-sense, bipartisan measures will improve health outcomes, reduce costs and maintain access for patients.”
NCPA sent a letter to House Majority Leader Rep. 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. 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.
Specifically, NCPA recommended any repeal and replacement of ACA include the following provisions:
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 that is used to determine Medicaid reimbursements;
Retain sections of the ACA that were dedicated to improving Medicare Part D medication therapy management programs, including an annual comprehensive medications review, and build upon it to further integrate pharmacists into the health care delivery system; and
Keep transparency provisions requiring pharmacy benefit managers 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 also made several recommendations around Medicaid, advising House and Senate leaders to consider the inclusion of “any willing pharmacy” in Medicaid pharmacy networks, the exclusion of mandatory mail order pharmacy requirements and the pursuit of more robust oversight of managed care organizations, including state inspection and audits of pharmacy benefit managers that administer the drug benefit.