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2017-2018 Legislative Priorities

 

Main Priority

 

  • Unfair Pharmacy Reimbursement:  House Bill 2212 (bill number has been reserved for this issue.) Click here to read Rep. Doyle Heffley's co-sponsorship memo. PPA is advocating for fair reimbursement rates for community pharmacies.  Almost 90 percent of Pennsylvania Medicaid patients are served by Managed-care companies that contract with the state.  In turn, those companies contract with pharmacy benefit managers (PBM’s) for their pharmacy programs to decide which drugs will be covered and how much to reimburse the pharmacies that fill the prescriptions.  These severe pharmacy reimbursement cuts by specific PBM’s are forcing pharmacies to operate in the red.  These pharmacy reimbursement cuts make it extremely difficult for the community pharmacies in our Commonwealth to maintain inventory and serve our most vulnerable citizens.  As PPA continues to combat this problem, we ask that you contact your legislator and ask them to be a co-sponsor of this important legislation. Click here to contact your Representative.

 

  • Auditor General, Eugene DePasquale, issues press release stating that he will look into concerns that inequitable pharmacy reimbursements might be increasing prescription drug costs for consumers. Click here to read the press release.

 

  • Prohibition of Gag Clauses:  House Bill 2211 (bill number has been reserved for this issue) Click here to read Rep. Judy Ward's co-sponsorship memo.  When pharmacy benefit managers (PBM’s) contract with pharmacies, the contracts usually contain a gag clause, which prohibits pharmacists from disclosing information to their patients that could substantially reduce the patients out-of-pocket costs for their prescription medications.  For example, for many less expensive, generic medicines, co-pays can often be more expensive than if the patient simply paid out of pocket and bypassed their insurance.  PPA has worked hard to have legislation introduced (bill number coming soon)  that will allow pharmacists to disclose prescription drug information to a patient that would allow the patient to get the best price for all of their medications.  This sounds like a reasonable expectation – to pay the lowest price for your prescription medications, doesn’t it? Click here to email your Representative.

     

  • Fighting CVS/Caremark Reimbursement Cuts: Since October 2017, pharmacies have seen substantial reimbursement cuts from CVS/Caremark - the country's largest pharmacy benefit manager (PBM). Coupled with this is the astonishing fact that many independently owned pharmacies are now receiving letters and emails from CVS asking them to sell their pharmacies. As PPA continues to combat this problem we ask that you contact your legislators and raise their awareness of this issue. Click here to email your elected officials and click here for a one-page document to use when calling or meeting in-person with your legislators.

 

  • Fighting for Fair Pharmacy Reimbursement in the Medicaid Program: The Pennsylvania Department of Human Services is proposing to cut pharmacy reimbursement in the Medicaid program. PPA opposes this proposal and is fighting for fair pharmacy reimbursement. Click here for more information.

 

  • Fighting for Fair Pharmacy Reimbursement in the PACE Program: House Bill 118 passed the Pennsylvania State Senate on July 27, 2017 and the Pennsylvania House of Representatives on October 18, 2017. Subsequently, Governor Wolf signed this bill into law on October 30, 2017. This bill is now Act 40 of 2017 and, effective immediately, reduces the PACE professional dispensing fee to $10.49. Ultimately, this is the result of debate over the budget and revenue shortfall versus extensive discussions, lobbying, and efforts to contact legislators. While the $10.49 dispensing fee is not what we wanted it is much better than the original proposal of $4 or the revised proposal of $7.

 

 

Other Priorities

  • 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.

 

  • Medication Synchronization: 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.

 

  • 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.

 

  • Strengthening 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. 

 

 

  • 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.

 

  • 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.

 

  • Point-of-Care: PPA is examining ways to address possible changes to obtaining a CLIA waiver.

 

 

 

Other Bills PPA is Tracking

PPA is monitoring numerous other pieces of legislation. Click here for a full report of all the 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.

 

 

 

Recap of the 2015-2016 Legislative Session

BIG LEGISLATIVE WINS! In the 2015-2016 legislative session, PPA helped pass legislation that:

  • Requires PBMs to register in PA
  • Increases MAC and generic pricing transparency
  • Establishes uniform audit standards
  • Increases the PACE professional dispensing fee to $13
  • Expands drug take-back locations
  • Improves the PBMP for pharmacists
  • Allows for substitution of interchangeable biological products

Click here for a summary and list of resources for Act 169 of 2016.

 

Click here for a full summary of PPA's 2015-2016 legislative successes.

 

 

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