In my top 10 Yogi Berra of "Yogi-isms", "When you come to a fork in the road, take it," is near the top. We're facing that fork. Just last month, the Senate Finance Committee advanced the Modernizing and Ensuring PBM Accountability Act to the full Senate by a 26-1 vote. This package contains several NCPA priorities including a cost-plus reimbursement floor in all state Medicaid managed care programs and standardized quality metrics and mandated claim-level reporting for all Medicare Part D plans. (While there is no Part D reimbursement provision today, one is being considered that would require, at a minimum, reimbursements to cover the cost to acquire and to dispense prescriptions.)
So, let's not "wait and see" if the full Senate approves it after they get back from recess in September. This month, let's take the fork—and be proactive by hosting your legislator at your pharmacy by participating in NCPA's 2023 Month of Action. Even if it's just 30 minutes, meet them, greet them, and remind them that it's great that legislation has been introduced but you need their vote to get the legislation passed into law. Make sure your legislators understands the important role you play in the community and the challenges you face—including PBMs. Consider having one of your patients by your side so they can share what your pharmacy means to them and the rest of the community.
Not sure how to do that? It's easy. Just complete this simple form and NCPA team member Michael Rule will follow up with you.
As promising as NCPA legislative priorities have been, PBMs have nearly unlimited financial resources at their disposal and, in recent months, we have witnessed the effectiveness of those resources in misleading policymakers. But, the PBMs don't have you. They do not have your voice. They do not have your relationships and your credibility. Your advocacy efforts on behalf of your pharmacy and the patients you serve is a great equalizer to the PBM's bottomless pockets.
Last year, NCPA held its initial Month of Action to turn up the heat on legislators in the midst of the midterm elections. Community pharmacies just like yours hosted 63 visits with members or their key staff during this campaign—that's more than 12 percent of all of the members of Congress who were behind the counter in a pharmacy to see where the magic happens!
This has proven effective as in the first seven months of the new Congress, strong legislation has passed key committees in the House and Senate. Additionally, the House Energy and Commerce Committee unanimously passed the PATIENT Act which also includes the ban on spread pricing in Medicaid Managed Care programs along with other NCPA Priorities. You can read more about these priorities in NCPA's House and Senate legislative checklists. The point is: last year's NCPA Month of Action helped make the 12 months that followed action-packed on the Hill for community pharmacy and it was a huge success that we want to build upon.
After years of fighting, we are in a good position to strike a major legislative victory for greater transparency and fairness to community pharmacies and your patients.
And, as Yogi also said, "It ain't over, 'til it's over." Ask your legislators to finish the job!
B. Douglas Hoey, Pharmacist, MBA
P.S. If you are attending ABC's ThoughtSpot Conference today, be on the lookout to hear more about NCPA's Month of Action!