NCAP Legislative Update May 2021

North Carolina Association of Pharmacists Advancing Pharmacy. Improving Health.

Legislative and Policy Update May 13, 2021 At the General Assembly It has been a hard slog at the General Assembly, but we are finally seeing some movement on our legislation. For the most part, the challenge has been working through issues with the North Carolina Medical Society who have taken a keen interest in our policy proposals.

Also, this last week was “crossover” week. “Crossover” is a date by which bills must cross from House to Senate or Senate to House to remain eligible for consideration. Two of our bills subject to crossover were heard and sent to the other body. Getting those two bills to meet the “crossover” deadline has been the focus of our efforts over the last two weeks. Below you will find an update on each of our bills as well as a few others we are following.

NCAP Convention & Long-acting Injectable Law

On March 11 the Governor signed into law House Bill 196 “2021 COVID-19 Response & Relief.” With that legislation, qualified NC pharmacists are authorized to administer long-acting injectable (LAI) medications. The legislation: https://www.ncleg.gov/Sessions/2021/Bills/House/PDF/H196v8.pdf.

During the NCAP Convention to be held June 6-9, there will be a workshop to address LAIs for behavioral health on Sunday, June 6th, 1:00-3:00pm. The workshop will provide a review of long-acting injectable medications for behavioral health conditions, patient check-list, safety protocols and injection technique. Registration for the 2021 Annual NCAP Convention is open, click here for access to the Convention Schedule and to register.

Update on NCAP Bills

S257 Medication Cost Transparency Act Senator Perry, one of our champions, has introduced Senate Bill 257 the “Medication Cost Transparency Act.” Senators Britt and Johnson join him as primary sponsors with senators Corbin, Edwards, Lazzara and Lowe as co-sponsors. This is the title for our “Pharmacy Benefits Manager” bill, and it is designed to put an end to many of the most egregious PBM practices threating pharmacy in our state. Access the bill: https://www.ncleg.gov/Sessions/2021/Bills/Senate/PDF/S257v0.pdf.

Current status: This bill has passed in the Senate Health Committee and has been called up in Senate Commerce & Insurance Committee twice but not heard. We understand that Senator Perry is working out some issues with other stakeholders and intends to put forth a 340B amendment to the current version of the bill. We have assurances from Senate leadership that the bill will be heard and we are optimistic about its passage by the Senate.

H96 Allow Pharmacists to Administer Injectable Drugs We have referred to this bill informally as “medicine administration” but the formal name is “Allow Pharmacists to Administer Injectable Drugs.” The bill will allow pharmacists, pursuant to a prescription, to administer drugs and biologicals that are FDA approved via intramuscular or subcutaneous injection to patients at least 18 years of age or older. We have worked hard to get this bill moving and to address concerns by the NC Medical Society. The bill was heard by the House Health committee, the House Rules Committee, and was most recently passed on the House floor by a vote of 111-0.

The most current edition of House 96 and can be found here: https://www.ncleg.gov/Sessions/2021/Bills/House/PDF/H96v2.pdf Current status: H96 has been sent over to the Senate, and is assigned to the Senate Rules Committee.

S575 Pharmacists Improve Public Health Needs Much work has gone into Senate Bill 575, “Pharmacists Improve Public Health Needs” over the past few weeks. This legislation is attempting to expand pharmacist immunization authority in accordance with the US PREP Act amendments to allow for all FDA-approved vaccinations. In addition, the bill is currently written to allow both immunizing and clinical pharmacist practitioners to both prescribe and administer a specific list of medications, including tobacco cessation products, orally administered hormonal contraceptives, prenatal vitamins, and post-exposure prophylaxis for HIV exposure. The bill was heard in the Senate Health Committee, in Senate Rules and this week was approved by the Senate by a vote of 49-0. A companion bill, H512, was introduced by Rep. Sasser. However, since the Senate bill crossed over first, we will be working with that bill (S575), as we move forward.

This bill has undergone a number of changes since it was first introduced. The latest version of the bill can be found here: https://www.ncleg.gov/Sessions/2021/Bills/Senate/PDF/S575v2.pdf Current status: The bill was sent to the House and is assigned to the House Rules Committee.

H862 Improve Access to Patient Care This is our bill filed to modernize our existing collaborative practice statutes. The bill was filed by Rep. Sasser, and is currently assigned to the House Health Committee. The bill was filed later in our line-up of bills, because it was not subject to the “crossover” deadline. With “crossover” now past us, we expect to be trying to move this bill soon.

Current status: Awaiting a hearing in the House Health Committee.

The bill can be found at: https://www.ncleg.gov/Sessions/2021/Bills/House/PDF/H862v1.pdf

H896 Fair and Equitable Reimbursement/Pharmacists.

This is the official title of what we have called the “Payment Parity” Bill. It is House Bill 896. The bill would provide for the fair and equitable reimbursement of health care services or procedures that are performed by a pharmacist within a pharmacist’s scope of practice, if the service was covered had it been performed by other health care professionals.

Representative Mitch Setzer has agreed to sponsor this important bill, which is a key companion to the other legislation we are pursuing. We are working to have this bill heard soon. It was assigned to the House Insurance Committee. The bill can be found here: https://www.ncleg.gov/Sessions/2021/Bills/House/PDF/H896v1.pdf Current status: Awaiting a hearing in the House Insurance Committee.

Other Legislation Three other pharmacy-related bills of particular note have been introduced by Rep. Sasser.

House Bill 93 “Allow Naloxone Scripts with Opioid Scripts” This bill would direct doctors to prescribe Naloxone in addition to prescribing opioid type medications of 50 or more morphine milligram equivalents. Since our last reporting, the bill has been voted on by the House and has been sent to the Senate and assigned to the Senate Rules Committee. The bill can be found here: https://www.ncleg.gov/Sessions/2021/Bills/House/PDF/H93v3.pdf House Bill 178 “Access to Prescription Drug Cost Information” would require “access to accurate prescription drug benefit cost information at the time of sale. Since our last reporting, this bill has also cleared the House and been sent to the Senate where it is currently awaiting a hearing in the Senate Rules committee. The bill language can be found here: https://www.ncleg.gov/Sessions/2021/Bills/House/PDF/H178v2.pdf House Bill 683 “Prescription Drug Disposal/John’s Law” would require pharmacies to provide patients with written information on prescription drug disposal methods and to make available on-site at least one consumer method for prescription drug disposal. This bill was filed on April 26 and moved quickly through the House Health and the House Rules committees and passed on the House floor, 112-0, on May 11th.

Next Steps:

We will be working to move all of our legislation along as soon as possible. As we have noted before, this is a long process with many twists and turns. The version of a bill you see today might not be the same one you see tomorrow. But rest assured, NCAP is working to advance the practice of pharmacy in every way we can.

Your Role

It is VERY IMPORTANT for you to thank the legislators who are going to bat for pharmacy. A short phone call or note saying thank you for introducing these bills would be greatly appreciated. We can forget to let legislators know we are grateful for their work and we can tell you that these legislators have worked hard and tirelessly with us to move our legislation forward. Here is their contact information: Senator Jim Perry: Jim.perry@ncleg.net 919-722-5621 Senator Jim Burgin: jim.burgin@ncleg.gov 9197335748 Rep. Wayne Sasser: Wayne.sasser@ncleg.gov 919-733-5908 Rep. Mitch Setzer: mitch.setzer@ncleg.gov 919-733-4948 If the only time they hear from us is when we need something, that doesn’t bode well for our profession or who we are as an association. Please take a few minutes over the next few days to reach out to these legislators to thank them. It is extremely meaningful that we foster these relationships, and that we acknowledge their support.

Changes Coming to Pill PAC We are working to bring PILL PAC up to speed. We have hired a firm that is designing a platform that will allow direct contributions online. Up until now, those contributing had to mail in a check. Also, the same firm will be working with us to craft a series of campaigns designed to get pharmacists across the state contributing to this important effort.

With over 12,000 pharmacists in our state, PILL PAC has the potential to be one of the best funded political action committees (PAC) in North Carolina. But its up to each of us to contribute. We cannot let a small number of pharmacists do the work for us all, which has been the case up until now.

Legislators pay attention to well-funded PACs, and we are determined to make pharmacy a powerhouse in this arena.

Donating to “PILLPAC” is the way that pharmacy can support legislators who have supported us, and elect individuals who will be good for the profession.

WE’RE NOT ASKING FOR ANY MONEY NOW, but in the coming weeks, you will be receiving a solicitation from the firm that is working with us to make PILL PAC a force in North Carolina politics. Please consider a monthly contribution to this effort. A small monthly contribution can make all the difference.

What’s the Difference in PILLPAC and the NCAP Advocacy Fund?

When you give to PILLPAC as described above, those funds go to support the campaigns of legislators we want to see in office because we know they will be supportive of pharmacy’s needs. The PILLPAC Board, on which two representatives from NCAP serve, decides the amount and which legislators the PAC will support.

The NCAP Advocacy Fund is our Association’s fund that is used to help fund our lobbyist and our grassroots work. The money raised for this fund are applied to offset expenses incurred for things like,

hosting town hall events, fax blasts or other communications for legislative alerts, and monthly lobbyist fees. Like PILLPAC, NCAP is looking into software that will make it much easier for individuals to donate to our Advocacy Fund. More to come soon!

As always, send your thoughts, input and suggestions to me, Tony Solari at solarigovernmentsolutions@gmail.com