DIR reform, supply chain security, and more

Regardless of where you live, the action in Washington, DC, affects you, your patients, and practice. Get up to speed on latest news from federal agencies, Congress, White House. A bipartisan group legislators has introduced U.S. House Senate APhA-supported legislation reform direct indirect remuneration (DIR) fees. The Pharmacy DIR Reform Reduce Senior Drug Costs Act (H.R. 3554/S. 1909) would close a Department Health Human Services (HHS) loophole that pharmacy benefit managers (PBMs) exploit charge pharmacies retroactive Critics practice argue fees inflate Medicare patients’ out-of-pocket prescription drug costs jeopardize viability pharmacies. require PBMs treat same way they do other price concessions by moving them point sale. Notably, bill not end altogether; however, assessing at sale provide with payment transparency need determine their financial stability sustainability. Although independent bear brunt damage unpredictable inflict, all dispense medications Part D beneficiaries feel its effect. Pharmacies sizes communities—urban rural—have increasingly been forced shutter due least part PBM clawbacks. closures deprive patients easy access life-changing care pharmacist as pandemic made clear, have serious public health consequences: important sites COVID-19 testing vaccinations. Furthermore, offer no corresponding advantage for beneficiaries. plans never use claw back reimburse or otherwise reduce beneficiary cost sharing. That drives costs, which negative effect adherence medication regimens can lead poorer outcomes costly hospital stays. Making it easier youAPhA created resource guides pursue reimbursement under two HRSA programs. Access apha.us/HRSA_APhAguide. APhA doubled between 2017 2019A CMS budget report agency submitted Congress contained bombshell revelation: grew 91,500% 2010 2019.HHS—which opened door runaway but done nothing it—had previously reported rose 45,000% 2017.That means just 2 years. 2019. HHS—which 2017. will also replace quality measures extract fees, groups characterize arbitrary opaque. Instead, instruct standardize performance measures. Last, mandate include suitable claim-level detail electronic remittance advices accompany payment. bills’ primary sponsors are Reps. Peter Welch (D-VT) Morgan Griffith (R-VA); Sens. Jon Tester (D-MT) Shelley Moore Capito (R-WV). On May 25, HHS announced pharmacists submit claims Resources Administration (HRSA) receive incurred while providing services uninsured patients. This applies including vaccine administration, testing, treatment delivered after February 4, 2020. Uninsured Program rates most cases; depends how much funding is available program. program allocated $4.8 billion eligible claims. must enroll be generally work medical intermediary provided functions like rather than benefit. To learn more about requirements specifics Program, visit apha.us/HRSAclaims. In addition, HRSA’s new Coverage Assistance Fund allows collect vaccinations individuals who insurance, whose insurance does cover imposes patient Claims should administration copays, deductibles, coinsurance, within 365 days service delivered. claims, providers create an account Portal. find details register, apha.us/HRSAcoverage. June 8, 2021, President Joe Biden his take immediate actions address vulnerabilities pharmaceutical supply chain enhance safety nation’s supply. supported administration’s efforts protect mitigate shortages both finished products active ingredients (APIs). “Our strategic asset, tightening predictability, accountability, accessibility essential medicines care,” said Ilisa Bernstein, PharmD, JD, FAPhA, media release. Bernstein APhA’s senior vice president government affairs. “COVID-19 shown us fragility supply, steps strengthen integrity robustness availability United States.” More HillAPhA officially endorsed explore savings associated investment preventive services. Preventive Savings (S. 1685) was Sen. Ben Cardin (D-MD).The define “an designed avoid future demonstrated credible publicly epidemiological projection models, incorporating clinical trials observational studies humans, longitudinal studies, meta-analysis.” If enacted, allow Congressional Budget Office make estimates accurately reflect costs.It leaders relevant congressional committees request analysis extends current 10-year window additional periods. (D-MD). costs. It 8 announcement stemmed 24, executive order, America’s Supply Chains (apha.us/EO_14017) directed complete review risks 100 days. declarations accompanied release final report, Building Resilient Chains, Revitalizing American Manufacturing, Fostering Broad-Based Growth (apha.us/100-day_Report). Highlights ▪Ensuring drugs available: establishing public–private consortium advanced manufacturing States initially focus 50 FDA’s list▪Onshore APIs: investing $60 million domestic production APIs▪Improving transparency: greater insight throughout chain▪Strengthening global chain: working allies partners decrease chains ensure security our assist initiatives. Rohit Chopra, commissioner Federal Trade Commission (FTC), issued statement calling crackdown troubling practices. Read 28, apha.us/ChopraStatement. followed FTC “rebate walls,” manufacturers pay plan formularies exclude competitors those formularies. per order Congress. apha.us/RebateWalls. “FTC concrete conflicts interests embedded structure industry,” Chopra said. “In addition problematic rebating practices, we examine whether engaged coercive practices harm pharmacists, health.” He recommended “conduct rulemakings specify when certain industry such rebating, unlawful Section 5 Act.” acknowledged routinely undermined state stop abuses. noted member newsletter met several times present examples abusive business “We continue directly recommend options vertically merged PBMs’ ‘unfair methods competition,’ patients.”