NCAP Legislative Update August 6, 2021

North Carolina Association of Pharmacists Advancing Pharmacy. Improving Health.

Legislative and Policy Update August 6, 2021 At the General Assembly Here is the latest news on our legislative agenda. We lead off with a recent victory.

Combined House 96: “Allow Pharmacists to Administer Injectable Drugs” and Senate 575: “Pharmacists Improve Public Health Needs” Passes As noted in our last update, House 96 “Allow Pharmacists to Administer Injectable Drugs” and Senate 575 “Pharmacists Improve Public Health Needs” were combined into one bill.

As a result of combining the bills it is more complex. We have worked with the NC Medical Society and other groups to address their concerns. This has taken a lot of effort, but it appears that all parties are happy with the result. The bill will allow pharmacists to administer a number of injectable medications, and provide oral and transdermal hormonal contraceptives, post exposure prophylaxis medications for HIV exposure, and more. The bill passed in the Senate and went over to the House for concurrence, which happened yesterday with a vote of 106 to 5.

Here is the latest version of the bill: https://www.ncleg.gov/Sessions/2021/Bills/House/PDF/H96v4.pdf

Current status: The bill is now headed to the Governor’s Office. NCAP has sent a letter to Governor Cooper encouraging him to sign the bill into law.

S 711 “NC Compassionate Care Act” Senator Rabon has brought this bill up for consideration. It would legalize the use of cannabis for medical purposes. Pharmacy has a keen interest in this bill and your NCAP has been actively engaged with the bill sponsors from the time it was introduced.

If the purpose is to treat cannabis as a medication, then in our view pharmacists should have a key role in how medical cannabis is used in the care of patients in North Carolina. Our state is looking at strict

quality controls on growing and processing, a doctor’s recommendation for its use for a specific medical condition, registration process for patients, as well as key role for pharmacists in the dispensing and clinical use of medical cannabis. The bill has made progress through the Senate, but its future remains uncertain. We are working to ensure that pharmacy and pharmacists are at the table during important discussions. We are advocating that, similar to a number of other states, to do medical cannabis the right way, North Carolina should utilize pharmacists in some capacity to ensure appropriate clinical decision making, dispensing and patient education occur. There are a lot of interested parties weighing in on this legislation. Not all of them are aligned with our perspective. Stay tuned for further updates on this important bill. The latest version of the bill can be found here: https://www.ncleg.gov/Sessions/2021/Bills/Senate/PDF/S711v3.pdf Senate 257: “Medication Cost Transparency Act” Senator Perry, one of our champions 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 bill will require PBM’s to be licensed by the Insurance Commissioner.

That will allow the commissioner to police these groups and hopefully prevent them from many of the practices they engage in that damage the practice of pharmacy. https://www.ncleg.gov/Sessions/2021/Bills/Senate/PDF/S257v3.pdf

Current status: This bill is due to be heard in the House Health Committee next. Prior to that, there will be a stakeholder meeting. During this meeting, all interested parties will be able to have their say as to the bill. Your NCAP will have 5 representatives there who will reinforce our perspective on the negative role that PBM’s have had on our profession. The bill then goes to the floor of the House for a vote. We do not yet have a date for the Health Committee meeting but we think it will be called soon after the stakeholder’s meeting.

House 896: “Fair and Equitable Reimbursement/Pharmacists” This is the official title of what we have called the “Pay Parity” Bill. It would provide for the fair and equitable reimbursement of health care services or procedures that are performed by a pharmacist within that pharmacist’s scope of practice and that are equivalent to services performed by other health care professionals.

There is no additional news on this legislation. As reported in our last update, BCBS of North Carolina raised objections to the bill with the sponsor, effectively killing it. They did this without the courtesy of talking to NCAP first. When asked why they opposed the bill, their representative said “We don’t support legislation that regulates the private market.” Given that BCBS NC is a virtual monopoly this response is disingenuous at best. If anything is preventing the market from operating it is BCBS’s monopoly status.

It appears that BCBS does not want pharmacists to be paid fairly for their services. In the end, its about their bottom line. They can fatten it while pharmacists pay the bill. Your NCAP legislative team is going to be discussing future strategy on this important legislation.

https://www.ncleg.gov/Sessions/2021/Bills/House/PDF/H896v1.pdf Current status: This legislation appears to be dead for this session.

H 862: “Improve Access to Patient Care” This is our “Collaborative Practice” legislation. This bill was assigned to House Health and has not moved. There are challenges to it doing so. First, our legislative champions have spent a LOT of time on our other legislation. Second, the Senate has said they are not happy with the number of House bills they are being asked to consider. The best chances for this legislation to gain traction would be for your lobbyists to find another vehicle (another bill) to add this one to: A bill that is already well along in its legislative progress. We are looking for such a bill and will try to pursue this avenue.

Current status: Uncertain.

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

Other Legislation Two 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 Rules Committee. The bill can be found here: https://www.ncleg.gov/Sessions/2021/Bills/House/PDF/H93v3.pdf Current Status: This bill has not moved since our last update on it.

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 Current Status: This bill has not moved since our last update on it.

Next Steps: We will keep working to get those bills that are still “alive” passed this session. Please keep in mind that the version of a bill you see today might not be the same one you see tomorrow. But rest assured, your NCAP is working to advance the practice of pharmacey 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 MUST NOT 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.

Please thank the following legislators: 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

Money Talks Everyone, pharmacy & NCAP have experienced some wins this year! We have managed to get longacting and self-administered injectable drugs administration, as well as our public health bill passed.

Our PBM bill is teed up to be successful, next. It has not been easy, and for each of our bills, we have been met with significant opposition.

One reason BCBS and other groups like doctors, insurance companies, Pharma, and other interests are successful at the General Assembly is that they have well-funded Political Action Committees. Money is the life blood of politics and well financed groups are able to get people elected and keep people in office who will look out for their interests.

With over 12,000 pharmacists in our state, PILL PAC has the potential to be one of the best funded PACs in North Carolina. But its up to each of us to contribute. We have a lot more work to do, and it takes money. Help us celebrate these recent wins by giving. Legislators pay attention to wellfunded PAC’s and we are determined to make pharmacy a powerhouse in this arena.

Donating to “PILLPAC” is super easy, and you can choose how much you want to give.

Every dollar helps. Just text the word ‘PILLS’ to (704) 396-5553, to receive a link to donate. You can make a one-time donation or set up a monthly contribution.

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