Dear Colleague,
As you may have read yesterday in the NCPA member alert and on our social media feeds, the totally byzantine legislative process in the U.S. Senate has suddenly jeopardized independent pharmacies. One of our top priorities—the Medicaid managed care spread pricing provision (the "cost plus" provision with the "plus" determined by your state)—was stripped out of the enormous budget reconciliation bill by the Senate parliamentarian. According to her, the provision violates the so-called Byrd rule, which is intended to eliminate extraneous items from the budget process. In other words, the pharmacy part of the "Big Beautiful Bill" is now butt-ugly.
That's a long-winded way of saying we need your help, and we need it now. Ironically, the main threat is another pharmacy provision that remains in the bill. It imposes mandatory NADAC reporting. Without the spread pricing "cost-plus" provision, which seeks to ensure adequate compensation for pharmacies, mandatory NADAC reporting is highly likely to REDUCE YOUR REIMBURSEMENTS! That would be a disaster. It would hand PBMs another tool with which to manipulate drug pricing and rub out their competition, and we cannot let that happen.
Yesterday we joined other pharmacy groups to demand that the Senate remove mandatory NADAC reporting from the bill (Click here to read the letter). We warned that the bill's passage with NADAC reporting but without the spread pricing (cost plus) provision would be the worst-case scenario: pharmacy deserts will grow, and many of their constituents will lose the economic impact of their local pharmacy. Separately, our advocacy team is on Capitol Hill now, loudly ringing the alarm bell.
I know we've asked you to advocate for both of these provisions before. And you've done so very effectively (that's how they ended up in the legislation!). But they only benefit independent pharmacies and patients if they are kept together. If Congress passes mandatory NADAC reporting without spread pricing (cost plus) reform, it will be worse than if they had done nothing at all. So, we need you to amplify that message by contacting your senators immediately. Click this link to our grassroots portal and let them know they absolutely must remove mandatory NADAC reporting from reconciliation bill. You should also let them know that the spread pricing provision and other important PBM reforms must be passed this year in a separate package.
There's no time to lose. Congressional leaders are still shooting for July 4 as a deadline to pass this bill. If it passes in its current form, the consequences for independent pharmacies and their patients will be grave.
Best,
B. Douglas Hoey, Pharmacist, MBA
NCPA CEO
