WASHINGTON — The National Community Pharmacists Association is expecting its highest turnout in two years for the association's 2013 Legislative and Government Affairs conference being held Tuesday and Wednesday. NCPA intends to address many key issues impacting community pharmacy with legislators during the two-day conference.
The issues are paramount to keeping independent pharmacy owners in business. "[I am] concerned about the pushing out of smaller [healthcare] providers," Rep. Austin Scott, R-Ga., told journalists during a conference call Tuesday morning. "Without positive cash flow, the doors don't stay open," he said, emphasizing the need to stop what most in the independent pharmacy community see as abusive audit practices by pharmacy benefit managers.
Establishing greater transparency in the operations of PBM was a recurring theme across NCPA's legislative agenda over the next two days. "Small providers are being held hostage by a system that most people don't understand," Scott added.
One of the many key issues for NCPA includes legislation that enables smaller pharmacies to compete across PBM pharmacy networks by instituting PBM audit reforms that prohibit abusive audits without eliminating altogether a tool to identify waste and fraud. Today, PBMs are so large and community pharmacy so small that the balance of power skews heavily in favor of PBMs, noted Doug Hoey, NCPA CEO. That's not representative of a traditional business relationship, Hoey said. "We're looking for balance."
As many as 24 states have instituted some form of audit reform legislation, Hoey noted. "Now it's time for a uniform federal law."
Another critical issue for NCPA is MAC pricing for generics. MAC pricing is not updated frequently enough to accommodate generic cost spikes, Hoey said. "There's no reason why, in this day and age, [MAC] prices cannot be updated instantaneously," Hoey suggested.
Other important issues NCPA members will address with leaders in Congress include creating an opportunity for community pharmacists to participate in PBM preferred networks, expand the role of the pharmacist to incorporate more medication therapy management reimbursement opportunities and compounding legislation.