NCPA's state government affairs team tirelessly tracks and engages with state legislation and regulation across the country, with our priorities including comprehensive PBM reform, PBM regulation enforcement, and Medicaid managed care reform. Here's a breakdown of our recent state government affairs activity relating to pharmacy reimbursement.
- NCPA wrote in support of MAC pricing and appeals legislation SB 2047 in Hawaii, which was amended and passed by the House Committee on Health. The Department of Commerce and Consumer Affairs testified it would need $1.5 million and five full-time employees to facilitate these requirements.
- Meanwhile, Utah sent HB 527 to the governor, also with MAC pricing and appeals process provisions but no appreciative fiscal note. The bill was just signed into law.
- Also heading to the governor's desk is Ohio HB 229, legislation establishing clear PBM oversight and enforcement authority for the Department of Insurance.
- NCPA eyes are on Florida HB 697, a bill that after considerable changes is now headed to the governor with provisions enabling pharmacists to decline to dispense prescriptions that would be reimbursed below cost and requiring equal reimbursement for pharmacies not owned or affiliated with a PBM.
- NCPA continues to support Tennessee legislation that would prohibit PBMs from owning pharmacies, reaching out to committee members as companion bills are heard in both House and Senate committees.
- NCPA continues its support of South Carolina S. 342, legislation that was introduced with a commercial market reimbursement floor of 104 percent of NADAC plus the Medicaid professional dispensing fee. Stakeholders are working to overcome unfriendly amendments that removed the reimbursement floor.
- Louisiana HB 919 was reported favorably from the House Health and Welfare Committee with amendments including a required professional dispensing fee floor of $12 for independent pharmacies with a physical location.
- NCPA is communicating with California stakeholders about a burdensome requirement to include ICD-10 codes on all prescriptions starting later this year.
- NCPA also assisted a legislator in New Hampshire to address onerous provisions for pharmacies pertaining to patient out of pocket smoothing proposed in SB 478. The bill has stalled for now.
Please check out the NCPA state legislative tracking webpage, where you can see all the bills we are following and connect to our Advocacy page.
NCPA
