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Louisiana pharmacist to Congress: Independents need to stay in the DME business

BY Michael Johnsen

ALEXANDRIA, Va. — Louisiana pharmacist Randy Mire testified before Congress Tuesday that efforts to combat the diabetes epidemic in his home state and elsewhere would be significantly undermined if independent community pharmacies like his are forced to stop offering diabetes testing supplies as a result of Medicare’s competitive bidding program for durable medical equipment, according to a National Community Pharmacists Association release.

Mire appeared on behalf of NCPA before the U.S. House Small Business Subcommittee on Healthcare and Technology.

“My pharmacy is one of the very few pharmacies still in the area that provides these essential DME supplies to patients,” testified Mire, owner of Gem Drugs, located in Reserve and Gramercy, La. “To me, these patients are more than just a prescription. I provide DME supplies in order to make certain that the beneficiaries have access to the supplies that they need. If I were to decide not to offer these DME supplies because the burden of offering such supplies has become too high and the cost too much, then these beneficiaries would have nowhere else to turn to receive the face-to-face consultations and quality supplies that I provide to them and that they deserve.”

The Bayou State has among the highest diabetes rates in the nation, he noted, and his patients have complained that mail-order deliveries lack adequate patient consultations and are unreliable — a fact driven home by the recent impact of Hurricane Isaac on his community.  

Mire urged lawmakers to support H.R. 1936, The Medicare Access to Diabetes Supplies Act. The bipartisan legislation would allow small pharmacies — defined as 10 locations or fewer — to continue to furnish patients with diabetes testing supplies and personalized counseling on their proper use, as competitive bidding is implemented. 

NCPA noted that a recently conducted survey of more than 400 community pharmacists found:

  • About 92% of independent community pharmacies would be forced to leave the Medicare diabetes test supply program if presented with a sharp reduction in payments;

  • More than 50% of community pharmacies said that the average Medicare diabetic patient comes to their pharmacy at least three times per month for diabetic supplies and/or counseling;

  • 83% of community pharmacists said that the impact on patients if they had to obtain diabetes supplies from mail order would be significant; and

  • 45% of community pharmacies deliver diabetes testing supplies to assisted living facilities. CMS’ current competitive bidding proposal would prohibit these pharmacies from doing so.

In addition to Mire’s testimony (available in its entirety here), NCPA submitted written comments to the subcommittee (available here).


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NPA bolsters membership services with veteran appointment

BY Michael Johnsen

WASHINGTON — The Natural Products Association on Tuesday announced that membership marketing expert Gabrielle Alahouzos will be the new VP membership services. Alahouzos most recently served as the director of membership marketing for the National Association of Home Builders, which has more than 160,000 members.  

“We’re excited to have Gabrielle on our team, leading NPA on a path to stronger membership growth and retention,” stated John Shaw, NPA executive director and CEO. “Her expertise will be of great benefit to NPA as we work toward improving our membership recruitment efforts.”

For nearly 15 years, Alahouzos has focused on building and maintaining a quality membership experience. In her role at NAHB, she developed an ROI framework to measure their marketing strategy and led the launch of a Net Promoter Score program to improve member feedback and analyze member satisfaction.

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NRF seeks to block swipe fee suit settlement

BY Allison Cerra

WASHINGTON — The National Retail Federation is set to go to court in order to block the proposed $7.25 billion settlement of a federal antitrust lawsuit over Visa and MasterCard credit card swipe fees.

NRF said a resolution, which has been approved by its board of directors, authorizes NRF to take steps, including "intervention in pending actions" in order to reach a solution "equitable to the broad merchant community." NRF is exploring what form the legal action might take. NRF noted it is not a party to the lawsuit, and U.S. District Court judge John Gleeson has not yet fully outlined how outside groups will be allowed to intervene, or if the case qualifies as a class action.

NRF is concerned by a number of provisions of the proposed settlement:

  • The $7.25 billion amounts to pennies on the dollar. If the case went to trial, a verdict in favor of retailers could result in a judgment totaling hundreds of billions of dollars given the eight-year time period of the case and rules allowing for antitrust damages to be tripled;

  • Nothing is done to block future increases in swipe fees. Without competitive restrictions, the card industry would quickly recoup the cost of the settlement from the very retailers who have been harmed, and increases that have averaged 16 percent a year over the past decade could continue indefinitely;

  • Nothing is done to reform the anticompetitive, cartel-like system by which Visa and MasterCard each set fee schedules that all banks issuing their respective cards agree to follow. NRF has testified before Congress that the system is a violation of federal antitrust law;

  • Nothing is done to require the card industry to disclose the fees on the cards or otherwise create the transparency needed to bring about competition to lower fees;

  • A highly publicized provision allowing merchants to surcharge customers who pay by credit card is pointless because merchants are seeking to reduce prices for customers, not increase them. It also includes myriad restrictions that would make it difficult to surcharge even if someone wanted to;

  • Visa and MasterCard have promised to recognize merchant bargaining groups, but no requirement is made for the card companies to negotiate in good faith; and

  • NRF is particularly concerned by a provision barring all merchants — including those that do not yet exist — from ever again suing Visa and MasterCard over swipe fees.

"The National Retail Federation categorically opposes the proposed settlement," NRF president and CEO Matthew Shay said. "It does nothing to curb the anticompetitive behavior of Visa and MasterCard, and instead ensures that swipe fees paid by retailers and their customers will continue to rise while barring any future legal challenges. The proposal is a lose-lose-lose for merchants, consumers and competition. NRF will take any and all steps necessary to oppose the settlement as it is currently proposed and will work toward real reform of the swipe fee system."

Credit card swipe averages about 2% of each transaction and amounts to about $30 billion a year, or $250 per household, NRF said, adding that swipe fees are the second- or third-highest expense for most retailers, behind employee salaries and healthcare benefits.

"We represent the nation’s retailers and that means not just today’s retailers but tomorrow’s as well," Shay said. "It is our duty to foster an environment that is supportive of young, new entrepreneurs who will create the Walmarts and Amazons and Main Street shops of the future. We can’t stand by and allow their rights to be stripped away before they’ve even had a chance to start their businesses."

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