Federal and State Pharmacy Bills Proposed; Some Become Law

dirkEarly in my pharmacy practice, Sal D’Angelo, RPh from New Orleans, told me something that has stuck with me ever since.

“Get into politics, or get out of pharmacy!” That statement rings stronger every year I have been in practice. More and more we have local, state, and federal government as our business partner whether we want them as such or not.

What can YOU do?

The summer 2015 Congressional break is approaching, and our legislators are generally available locally for meetings. Contact the Senate and House of Representative offices in your area and invite your elected officials and/or their staffers to visit you and your pharmacy. Discuss the federal bills described below, and request that legislators co-sponsor part or all of the un-passed legislation. If you don’t know your legislators, find out who they are and offer to be a volunteer healthcare expert and resource for their office. Legislators may be contacted by telephone, facsimile, and email. Paper mail is accepted but takes longer to be read and acted upon due to federal security screening processes. To learn the legislators for your state, go to www.thomas.gov, www.senate.gov, and www.house.gov.

In conclusion, as pharmacists, we are excellent grass roots politicians. We hear what patients are asking and our answers and opinions are highly regarded. When we provide information to our legislators and their staff they realize that we interact daily with their constituencies. With legislators and staffers, I always conclude conversations with an offer to help strategize how proposed legislation may impact healthcare. I want, and we want, to be healthcare resources senators and representatives trust, rather than the rhetoric of paid lobbyists.

Proposed Federal Legislation

Many bills introduced in every state die in committee and/or languish there. Each state has its own system. Depending on the state’s system, these bills may be dead-on-arrival at the close of the 2015 session or be reintroduced next session.

Ensuring Seniors Access to Local Pharmacies Act S. 1190 and H.R. 793 (bipartisan authors, both bodies)

These companion bills are “Any Willing Provider” (AWP) legislation. The bills allows community pharmacies in medically underserved areas or health professional shortage areas to participate in Medicare Part D preferred pharmacy networks, as long as independent pharmacies comply with the terms and conditions offered to “in-network pharmacies.”

Provider Status Bills S. 314 and H.R. (bipartisan authors, both bodies)

These companion bills will recognize pharmacists as providers under Medicare Part B. This bill will allow Pharmacists practicing in a medically underserved area or a health profession shortage area to provide and be reimbursed under Medicare Part B for services allowed under their state’s scope of practice.

Ensuring Patient Access and Effective Drug Enforcement Acts S.483 and H.R. 471

If enacted, the bills allows pharmacies to submit corrective action plans prior to having DEA licenses suspended or revoked. The bill seeks to build a more collaborative environment than currently exists between the Drug Enforcement Administration (DEA), other federal enforcement groups, and regulatory agencies, wholesalers, and community pharmacies. Note: I’ve heard it said that these bills are to remind the DEA that they are a regulatory agency and not an enforcement agency.

Mac Transparency Act H.R. 244 (bipartisan authors)

This bill, reintroduced in January of this year, will require PBMs to disclose the contract reimbursement rate and update that rate at least once every seven days to reflect market fluctuations.

Proposed and Passed Western States Legislation

ALASKA:

Senate Bill 71

This bill was introduced, moved through the legislature, and has been signed. SB71 will allow pharmacists to independently vaccinate patients without a collaborative practice agreement. Note: Alaska Board of Pharmacy has started a regulation project to make the necessary changes to our practice act.

ARIZONA:

Senate Bill 1288

A Medication Synchronization bill has passed the legislature. This allows pharmacists to do short-fills synchronizing multiple prescriptions for a patent with two or more chronic conditions. It requires insures to pro-rate co-pays as well as pay additional dispensing fees to pharmacies.

CALIFORNIA:

Assembly Bill AB 627

On June 25, 2015 the California Assembly passed AB 627, a Bill by Assembly member Jimmy Gomez and sponsored by CPhA. The Bill is the “MAC Transparency Bill” and was introduced to establish fair standards for MAC-based pharmacy reimbursement. AB 627 requires PBMs to update their Maximum Allowable Cost (MAC) lists weekly; requires PBMs to provide in-network pharmacies with the current MAC list upon request and disclose the sources used in establishing MAC lists; and establishes much-needed standards for appeals filed by pharmacies for MAC list prices that appear to be out of date.

AB 627 has been sent to Governor Jerry Brown and is awaiting his action.

IDAHO:

Effective as of April 11, 2015, final rules on interchangeable biologics. No notification necessary.

MONTANA:

Senate Bill 8

Electronic prescription of controlled substances II-V have been signed into law.

OREGON:

House Bill 2028

Clinical pharmacy testing passed the legislature and has been signed by the Governor. This bill allows pharmacists to provide medical testing.

Senate Bill 520

This bill passed legislature and has been signed by the Governor, allows pharmacists to vaccinate patients as young as seven years.

UTAH:

House Bill 279

Biologics has passed. This bill requires the pharmacist or designee to enter into an electronic database what specific product was dispensed within five days of dispensing. This entry will be presumed to be notice to the prescriber.

WASHINGTON:

Senate Bill 5441

Patient Medication Coordination (Med Synch) has been signed into law. This bill requires patient co-pays be pro-rated but no additional dispensing fees for the pharmacy.

Senate Bill 5557

Pharmacist Services has been signed into law. This bill acknowledges pharmacists as providers within the scope of their practice. The bill requires insurers to pay pharmacists for those services, if the service is a covered service.

Senate Bill 5857

PBM (MAC pricing enforcement) is in the Senate budget and may still pass during the current special session.

Senate Bill 5935

Biological Products has been signed into law. This bill requires prescriber notification in the event of an interchangeable biologic substitution until 2020. The bill requires mandatory substitution, if an interchangeable biologic is available.

Thanks to Lis Houchen Regional Director, NACDS State Government Affairs, and Matt DiLoreto NCPA Senior Director, State Government Affairs, for their assistance on this article.

For more WSPC or legislative information, email questions or comments to [email protected]