NCAP Legislative Update February 2020

North Carolina Association of Pharmacists Advancing Pharmacy. Improving Health.

Legislative and Policy Update February 12, 2020 Legislative Day June 9th.

Please mark your calendars for this important event.

Our annual legislative day is especially important this year.

We have an active legislative agenda over the next 18 months. There is no better way to build support for our policy proposals than visiting legislators and making our voice heard. Policy makers value what pharmacists have to say and there is no substitute for your voice.

You will find the day interesting, informative and empowering. I will be there to see that you get where you need to go and that you are well prepared with key talking points. Let’s show policy makers that NCAP members are knowledgeable, active and that we are expecting them to support our profession.

Please get in touch with the NCAP offices or write to me at the contact information below to confirm your participation. We have a lot of preparatory work to do and it is a great help to us to know who is coming as soon as we can.

NCAP Advocacy On-Demand Video

We think you will find this video informative and helpful. In this video, our lobbyist, Tony Solari, covers: • • • •

A research-based model of how legislators make decisions, How that knowledge shapes our advocacy plans, Some simple advocacy strategies for us to use, and An overview of our current legislative and policy agenda.

The environment at the General Assembly and knowing how policy makers decide things both play a critical role in our ability to move the profession forward through legislative action. It is important that you understand how things work… or don’t work…. on Jones street.

The video is available to NCAP Members at https://www.youtube.com/watch?v=jp9MVpWlPo&feature=youtu.be.

Legislative and Policy Matters

Since leaving town in mid-January, there has been little happening at the General Assembly (GA). The adjournment resolution, which sets rules for the next time the GA meets puts a lot of limitations on the kinds of bills eligible for consideration. The General Assembly will meet again on April 28th.

As you know, NCAP has been working with allied groups to pass legislation that will limit harmful practices engaged in by Pharmacy Benefits Managers. (Senate bill 432) We are going to be working hard to get this legislation over the finish line.

NCAP has been working hard over the last couple of legislative sessions to pass a “collaborative practice” bill. The most recent version of this legislation, House bill 659 titled “Improve Access to Patient Care” was introduced and sent to committee but not heard. This legislation is a priority for the NCAP during 2020. We will be working hard to advance it. Look for more updates on this legislation as the General Assembly begins their work.

Other matters on our legislative and regulatory radar for 2020 and 2021 are tele-pharmacy, medical cannabis, long-term care medication access and disposal issues, as well as pharmacists role in treatment access for public health issues such as hormonal contraceptives, substance use disorders, as well as vaping and tobacco cessation.

Of course, as your state association and lobbyist, we will be carefully monitoring all legislation that works its way into the process for any issues of concern, which could negatively or positively impact the pharmacy profession.

Federal Advocacy News Arkansas vs. PCMA SCOTUS Case Update Arkansas previously passed a state law restricting negative reimbursement, by a pharmacy benefit manager (PBM), for a drug dispensed by a pharmacy. When a pharmacy is reimbursed less than their acquisition cost, the PBM would have to demonstrate that the drug could have been acquired at a lower cost through a wholesaler who does business in the state, or failure to demonstrate would require the PBM to reimburse the pharmacy at their acquisition cost. Pharmaceutical Care Management Association (PCMA), the national association representing PBMs, filed a lawsuit against Arkansas, in U.S. District Court for Eastern Arkansas, stating that their law was preempted by the federal Employee Retirement Income Security Act (ERISA) of 1974, which sets minimum standards for private industry, employersupported retirement and health plans. The District Court ruled Arkansas’s law as preempted by ERISA, though it admitted, but for a prior decision of the U.S. Court of Appeals for the Eight Circuit, it would have ruled in favor of Arkansas. The state then appealed to the U.S. Court of Appeals for the Eight Circuit, which covers AR, IA, MN, MO, NE, ND and SD, where by the Eight Circuit court held firm stating the Arkansas law was preempted by ERISA. Arkansas then filed a petition asking the Supreme Court to review the Eight Circuit’s decision. Thousands of petitions are filed with the Supreme Court, of which only 70-80 cases are heard each year. On January 10th, Arkansas Pharmacy Association got word that the Supreme Court would hear the case. The case has been estimated to cost hundreds of thousands of dollars and the timeline for the process is as follows: February 24th, Arkansas AG office merit brief is due to the U.S. Supreme Court; March 2nd, pharmacy association amicus brief due; April 20-22nd, time frame projected for oral arguments in Washington, DC; June 30th, written decision projected release.

How You Can Help With the SCOTUS Case The U.S. Supreme Court case, Rutledge (AR) vs. PCMA potentially one of the most pivotal cases involving the profession of pharmacy. This is an historical moment for our profession, patients and communities. The Arkansas Pharmacy Association has already spent $225,000 just getting this case to SCOTUS. Going forward, the legal fees alone are estimated at $200,000+, with $125,000 needed for the amicus brief that all state pharmacy associations will be asked to sign. Our colleagues at the Arkansas Pharmacy Association have asked for our help.

So here’s the ask: NCAP will match dollar for dollar, up to the first $2500 received from NCAP members. Any amount of contribution is appreciated, and if we raise more than our $5,000 goal, anything above the goal will go to the Arkansas Association to help with the SCOTUS case fees.

Helping is easy, just do one of the following two options: 1. Make a check out to Arkansas Pharmacy Association and mail to NCAP at 1101 Slater Road, Suite 110, Brighton Hall, Durham, NC 27703 and we will forward all checks, along with an NCAP matching funds check, to the Arkansas Pharmacy Association; OR 2. Contribute directly to the Arkansas Pharmacy Association online at

https://www.arrx.org/ldf Please make your donation, now. Don’t wait. This is one case we cannot afford to sit on the sidelines!

This case is monumental! If Arkansas wins this case, the win will benefit all states. Also, it is important for ALL pharmacists to see the bigger picture in this battle with PCMA. The PBM issue, exponentially impacts our profession. If you think this issue only impacts community pharmacists, well then, you need to take a moment to envision the ripple effect. When any sector of our profession is threatened or negatively impacted it creates a ripple effect that impacts all of us. The hospital patient that gets readmitted because they could not get their new discharge medication expeditiously, from their local pharmacy, after being discharged, and forced to wait on mail order. The jobs lost and the communities that lose a local pharmacy due to poor reimbursement. The negative impact on work environment in high volume chain pharmacies forced to take on even more business due to unfair, steering practices by PBMs. Let’s show our Arkansas colleagues that North Carolina pharmacists and technicians understand the ‘bigger picture’ and that we are in the fight with them.

Never hesitate to contact us with concerns, insights, or information that can be of use and which can enhance our efforts. Always feel free to contact our lobbyist, directly. His email is Solarigovernmentsolutions@gmail.com or phone number (919) 744-8803. As our lobbyist he is happy to answer any questions members have about our work, and he stands ready to assist you in any way possible.