In any given legislative session, PPA monitors close to 100 bills that affect pharmacy. The items listed below are the pieces of legislation and related activities for which we are strongly advocating and dedicating considerable resources. Additionally, we have highlighted other pieces of related legislation that we are tracking and closely monitoring. Near the bottom of the page is our full tracking report, updated monthly.
It is important that, as a PPA member, you regularly contact your elected officials regarding the issues below. Your direct contact is the most effective way to support our efforts. Your legislator works for you! Help ensure that they are protecting your professional and business interests.
Click here to contact your legislators today!
Feel free to contact firstname.lastname@example.org with any questions on the following issues.
2017-2018 Legislative Issues
Number One Priority - Pharmacy Reimbursement
The following two issues are closely tied together and will be our major focus during Pharmacy Legislative Day on Wednesday, April 19, 2017. This is because Governor Wolf has requested uniformity in pharmaceutical pricing and proposed merging four state agencies to create a new Pennsylvania Department of Health and Human Services.
Reformulation of Medicaid Reimbursment
The Center for Medicaid and Medicare Services (CMS) published its Final Outpatient Drug Rule on February 1, 2016 that requires state Medicaid programs to adjust their reimbursement methodologies to an acquisition cost-based benchmark by April 1, 2017. On March 23, 2017, the Pennsylvania Department of Human Services (DHS) announced the proposal it plans to submit to CMS. This proposal includes adopting an Actual Acquisition Cost (AAC) payment methodology for ingredient cost that is based on the National Average Drug Acquisition Cost (NADAC) and adopting a professional dispensing fee of $7. PPA is advocating against this proposed professional dispensing fee, which is the lowest proposed in the country.
Click here to learn more about reformulation of Medicaid reimbursement.
Governor Wolf's Proposed Cuts to PACE Pharmacy Reimbursement
Governor Wolf's 2017-2018 Executive Budget proposes slashing the PACE professional dispensing fee to pharmacies from $13 down to $4 (a 70% decrease) without changing the ingredient cost benchmark in the reimbursement formula back to what it was prior to the enactment of Act 169 of 2016. This is a stark contradiction to House Bill 946 that Governor Wolf signed on November 21, 2016 and PPA is actively opposing this proposal.
Click here to learn more about the proposed cuts to PACE pharmacy 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. 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 is advocating to strengthen this Act where feasible in the 2017-2018 legislative session.
Click here for resources and more information on Act 207 of 2012.
PPA is looking at opportunities to provide for greater transparency of pharmacy benefit managers (PBMs).
Click here for information on mail order, freedom of choice, and community access.
Pharmacy Technician Registration
Pennsylvania is one of only five states that 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.
Click here for more information on pharmacy technician registration in Pennsylvania.
Medication synchronization is when a pharmacist works with a patient to synchronize medication refills so that all of their medications can be picked up on the same day each month, instead of having to make multiple visits to the pharmacy. PPA is advocating for legislation that would permit this in Pennsylvania.
Click here for more information on medication synchronization.
Expanding Pharmacist-Provided Immunization Opportunities
PPA is advocating for a change in Pennsylvania law to permit pharmacists to provide all immunizations to patients nine years of age and older.
Click here for more information on expanding pharmacist-provided immunization opportunities.
PACE Modernization and Expansion
PPA is advocating to expand the PACE program, including instituting Medication Synchronization and Medication Therapy Management (MTM) within PACE and PACENET.
Click here for more information on PACE Modernization.
Public Health Emergency
PPA is advocating to allow pharmacists to assist (i.e. allow pharmacists to immunize if there is a shortage before school begins, a virus outbreak, etc.) when the Pennsylvania Secretary of Health declares a public health emergency.
PPA is examining ways to address possible changes to obtaining a CLIA waiver.
Telehealth / Telemedicine Initiatives
Drug Pricing Transparency
Other Bills Being Monitored by PPA
Click here for more information on other bills PPA is currently monitoring.
Pennsylvania Community Pharmacy Caucus
The Pennsylvania Community Pharmacy Caucus is a bipartisan, bicamarel alliance of legislators who advocate for and support community pharmacy throughout the Commonwealth. Working together, caucus members reinforce the important role pharmacists play as healthcare providers and as part of an interdisciplinary team of care.
Click here to learn more about the Pennsylvania Community Pharmacy Caucus.
Recap of the 2015-2016 Legislative Session
MAJOR LEGISLATIVE VICTORY! Pharmacy Benefit Manager (PBM) Registration, Generic Drug Pricing Transparency, Pharmacy Audit Integrity and PACE Reimbursement - Act 169 of 2016. This requires pharmacy benefit managers (PBMs) to register with the Pennsylvania Department of Insurance, provides generic drug pricing transparency to pharmacies, establishes uniform and fair standards in the auditing of pharmacy claims, and rebalances PACE reimbursement.
Click here for more information on Act 169 of 2016.
Click here for a full summary of PPA's 2015-2016 legislative successes.
Recap of the 2013-2014 Legislative Session
Click here for a full recap of PPA's successes in the 2013-2014 legislative session.