What HR 9 Means for Your Pharmacy Business and How You Can Get Involved

by Dirk White, RPh, EVP of Legislative Affairs & Regional Leader for Alaska

“Get out and talk with your State and Federal legislative delegations. Invite them to come visit you at your pharmacy to see what you do and how you impact many people’s lives.”
’Tis the season, or so it seems in retail, always a season or holiday. Which season is this you ask? Well, legislative season, when almost every state legislative body gavels back into session, and we take up old legislation left intact or start anew. Check the our Legislative Resources page for links to your legislature and legislators.

On the Federal level, in response to the opiate abuse issues we all are facing, Congress passed, and President Trump signed into law, HR 9: The Every Prescription Conveyed Securely (EPCS) Act.

Below are some of the provisions that will affect the practice of pharmacy:

  • All Schedule 2-5 prescriptions covered under Medicare Part D plans must be transmitted electronically. There are exemptions to this rule, but too many to cover in a short article. HHS will publish rule-making, specifying the circumstances under which e-prescribing may be waived, as well as enforcement and noncompliance penalties. This applies to medications prescribed on or after January 1, 2021.
  • Other sections will impose a mandatory “lock in” program for all Part D plans starting in 2022. If you have more than one location and each pharmacy is able to share real-time electronic data, then all locations are treated as one pharmacy.
  • If the FDA Secretary determines that a controlled substance has a reasonable probability of causing adverse health consequences or death, the Secretary may order the distribution of that controlled substance stopped. There is an appeal/review process to this action.
  • By January 1, 2021, Medicare programs must allow electronic transmission of PA data to the plan and back to the prescriber.
  • By October 1, 2021, it is required that the PDMP be checked before prescribing and before dispensing by both participants. By that date, all state Medicaid programs will be allowed access to PDMP data electronically. There is a recommendation that all prescription data be submitted to PDMPs within a 24-hour period, as well as all PDMDs to share data across state lines.
  • Many states are working on expanded scope of practice and provider status legislation. An interesting bill that I think will draw quite a bit of attention is legislation to prohibit the “steering” of patients to a plan/payor owned dispensary, i.e. mail order or a brick and mortar facility.

There is lots of interesting legislation going around, so if you want to continue in your business, you may want to get out and talk with your State and Federal legislative delegations. Invite them to come visit you at your pharmacy to see what you do and how you impact many people’s lives.

If you don’t know who your House Representative is or how to contact them, you can go to house.gov. If you know their name, you can always search for their contact information on the internet through your favorite browser.

If you don’t know how to contact your Senators, you can find them at senate.gov. If you know their names, you can search for their contact info online through your browser of choice.

When contacting your Senators and House Representatives, be sure to start your communication with your name and family members’ names and that you are a pharmacist or pharmacy owner. Remind them that you are their constituent and that you employ X number of employees in their district with an annual payroll into your community of $X every year. Tell them that you provide your employees all of these X benefits from your ongoing operation.

If you live in a rural location, then tell them how far the nearest independent and chain pharmacies are to your community and how large a patient base you serve, the local population, and in some cases square miles. Include anything that you do in or outside your pharmacy that helps improve your community health and wellbeing, such as increasing access to critical health care like immunizations, diabetic training, and counseling. By providing this information, you will help persuade them to take your input with the seriousness it deserves.