In any given legislative session, PPA may be monitoring close to 100 bills that affect pharmacy. The bills listed below as PPA's Priority Issues are the pieces of legislation or related activities for which we are strongly advocating and dedicating considerable resources. Additionally, we have highlighted other pieces of interesting or related legislation, which we are tracking and closely monitoring. At the bottom of the page is our full tracking report which is updated monthly.
It is important that as a PPA member and a constituent of your local Senator and Representative that you regularly contact them regarding the issues below. Your direct contact is the most effective way in which to support PPA's efforts. Your legislator works for you! Help ensure that they are protecting your professional and business interests. Contact them today! If you are not sure who your legislator is, click here. Please feel free to contact email@example.com should you have any questions or need any assistance regarding the following issues or contacting your legislator.
For information on mail order, freedom of choice, and community access, please click here. View information on Act 207 of 2012 here.
For more information on the Pennsylvania Community Pharmacy Caucus, please click here.
2017-18 Legislative Issues
Number One Priority
Reformulation of Medicaid Reimbursement
CMS published the final Medicaid Outpatient Drug Rule (AMP-based FULs/Acquisition Cost benchmark issues) on February 1, 2016. This rule will impact Medicaid Fee-for-Service in many states, including Pennsylvania, requiring Medicaid programs to adjust their reimbursement methodologies to an acquisition cost-based benchmark.
The final rule requires states to move from traditional ingredient cost benchmarks (i.e. AWP or WAC plus a % markup) to acquisition cost-based reimbursement, namely AAC (Average Acquisition Cost) or National Average Drug Acquisition Cost (NADAC) for reimbursement by April 2017.
Currently, PPA is advocating for an appropriate professional dispensing fee to accompany the coming change in reimbursement.
Strengthen Act 207 of 2012
The intent of Act 207 is to give more patients the freedom of choice to access their local community pharmacies if they so choose. However, the act is only applicable if the retail pharmacy is willing to accept the same pricing, terms, conditions or requirements related to the cost and quality of prescriptions established for a mail order pharmacy and a pharmacy benefit manager affiliated with a mail order pharmacy.
PPA will be advocating to strengthen this Act where feasible in the 2017-18 legislative session.
For resources and information about the current enforcement procedure that the Insurance Dept is following - please click here.
We are looking at opportunities to provide for greater transparency of pharmacy benefit managers (PBMs).
Medication Synchronization & 90-Day Fill
Enable patients to synchronize their medications so that they can order and receive them on the same day each month, instead of having to make multiple visits to the pharmacy.
Addressing barriers in the market to pharmacists filling a 90 day supply of a medication that is written for a quantity of 30 with several refills.
PPA is working on legislation on these two subjects.
Expanding Pharmacist-Provided Immunization Opportunities
PPA will be advocating for nine years of age and up for all immunizations.
Because last years legislation did not include these items, we are seeking to go back and now Include medication synchronization and MTM program in the PACE program.
Public Health Emergency
PPA is looking at ways to allow Pennsylvania's Secretary of Health to declare a public emergency and allow pharmacists to participate, i.e., allow pharmacists to immunize if there is a shortage before school begins, a virus outbreak, etc.
Pharmacy Technician Registration
Pennsylvania is one of five states that currently does not register or in some way regulate pharmacy technicians. PPA is supporting legislation that would provide for a basic registration along with a criminal history background check and a few other requirements. For more information on the introduced legislation and current status, click here.
PPA is looking at ways to address any possible changes to obtaining a CLIA waiver.
Drug Pricing Transparency
Other Bills Being Monitored by PPA
For more information on other bills being monitored by PPA click here.
2015-16 Legislative Successes
MAJOR LEGISLATIVE VICTORY! Pharmacy Benefit Manager (PBM) Registration, Generic Drug Pricing Transparency, Pharmacy Audit Integrity and PACE Reimbursement - Act 169 of 2016
This bill would require pharmacy benefit managers (PBMs) to register with the Pennsylvania Department of Insurance, provide generic drug pricing transparency to pharmacies, establish uniform and fair standards in the auditing of pharmacy claims and rebalances PACE reimbursement. Read more...
Click here for more 2015-16 Legislative Successes.
View a flyer with short summaries here.
Recap of the 2013-14 Legislative Session
How did PPA make out during the 2013-14 legislative session? View a recap of issues PPA lobbied during the course of this session and more here!