Help get PBM reforms passed before Congress adjourns this year

NCPA December 3, 2024

Congress returned to Washington with a sizable to-do list but few legislative days left in this lame duck session. NCPA continues to work with legislators to make sure PBM reform policies that will tremendously benefit community pharmacies' bottom line are included in any potential end-of-year package. We need your active engagement as constituents to help get these provisions across the finish line.

We're pushing Congress to improve pharmacy payments in Medicaid managed care programs by requiring PBMs to reimburse NADAC plus the state's fee-for-service dispensing fee for all Medicaid managed care prescriptions.

We're also asking them to establish requirements for CMS to clarify what "reasonable and relevant" in Medicare Part D PBM contract terms, including pharmacy reimbursements, really means. And we're asking them to create a method for pharmacies to dispute PBM contracts and allow CMS to impose resulting penalties on PBMs.

We need you to contact your representative and urge them to sign onto a bipartisan letter circulating in the House of Representatives asking leadership to ensure PBM reform is a priority as the session comes to a close. If your representative's name isn't one of the 76 this list, it's especially urgent to encourage them to sign on:

Aderholt, Robert; Allen, Rick; Auchincloss, Jake; Barragán, Nanette; Bean, Aaron; Bentz, Cliff; Bishop, Sanford; Brownley, Julia; Bucshon, Larry; Budzinski, Nikki; Burchett, Tim; Carl, Jerry; Carter, Earl; Castor, Kathy; Chavez-DeRemer, Lori; Cherfilus-McCormick, Sheila; Clarke, Yvette; Cleaver, Emanuel; Comer, James; Davids, Sharice; Davis, Donald; Dean, Madeleine; DeSaulnier, Mark; Dingell, Debbie; Duncan, Jeff; Dunn, Neal; Fleischmann, Charles; Flood, Mike; Fry, Russell; Fulcher, Russ; Gallego, Ruben; Goldman, Daniel; Gonzalez, Vicente; Graves, Garret; Grothman, Glenn; Harshbarger, Diana; Higgins, Clay; Houchin, Erin; Johnson, Henry; Kean, Thomas; Kennedy, Timothy; Krishnamoorthi, Raja; LaLota, Nick; Landsman, Greg; Langworthy, Nicholas; Letlow, Julia; Malliotakis, Nicole; Maloy, Celeste; McCormick, Richard; Miller-Meeks, Mariannette; Mrvan, Frank; Murphy, Gregory; Owens, Burgess; Peters, Scott; Rose, John; Ross, Deborah; Rutherford, John; Salinas, Andrea; Schneider, Bradley; Scott, Austin; Sherrill, Mikie; Smith, Christopher; Sorensen, Eric; Spanberger, Abigail; Sykes, Emilia; Tenney, Claudia; Thanedar, Shri; Thompson, Bennie; Trahan, Lori; Van Drew, Jefferson; Vasquez, Gabe; Veasey, Marc; Watson Coleman, Bonnie; Weber, Randy; Williams, Nikema; Wittman, Robert

You can also help us by recruiting your patients to our push for reform. The process is simple:

    1. Visit www.ncpa.org/finishthefight

    2. Scroll to campaign resources 

    3. Select a poster to print and display in your pharmacy 

    4. Ask your patients to scan the QR code and enter their name and address

    5. Have them click the submit letters link to complete their action 

If every pharmacy recruits just ten patients, we'll have inundated Congress with hundreds of thousands of patient messages. You can email Michael Rule at [email protected] with any questions. 

NCPA