NCAP Legislative Update April 2020

North Carolina Association of Pharmacists Advancing Pharmacy. Improving Health.

Legislative and Policy Update April 13, 2020

NCAP To Speak With COVID-19 Committee Dear Member: First and always, from everyone at the NCAP, our best wishes to you and your families. We hope that you are healthy and staying safe and we hope that the economic challenges we know you are facing are as short in duration as possible.

Tomorrow, NCAP leadership will speak to the NC General Assembly House COVID-19 Health Workgroup. Penny Shelton will emphasize for policy makers the ways that pharmacists can help them to address the COVID-19 pandemic. She will also discuss the challenges that pharmacists face both in delivering services and financially as they work the front lines to address the needs of their patients. Final decisions about exact content are being worked out. You can listen to the committee proceedings beginning at 9:30 tomorrow morning via https://www.ncleg.gov/ On the right side of the page, see the “Legislative Calendar” “House Select Committee on COVID-19 Health” and click on the little audio sign next to “1124/1224 LB” notation.

NCAP Meets With Medical Society Last Thursday, the NCAP Executive Director and I met with Chip Baggett, Lobbyist for the Medical Society, to discuss ways that pharmacy and medicine could work more closely on health care initiatives for our state. The agenda included reopening dialogue regarding modernizing collaborative practice, addressing chronic disease burden and public health needs, as well as engagement around the healthcare levers included in the 2030 Healthy North Carolina Report. The meeting was productive, the conversation rich, and we agreed to provide each other with additional thoughts on how we can work together to advance care and improve the health of North Carolinians, prior to our next meeting.

Pharmacy Legislative Day Postponed NCAP leadership has decided to postpone our legislative advocacy day. We are hearing from a number of reliable sources that leadership at the General Assembly has decided to have the 2020 session sometime in July or August.

This will present us with the opportunity to meet in person with legislators, which is, to be honest, preferable to virtual meetings.

If, however, circumstances do not allow for us to meet in-person, we can still make use of “plan-B” and go to virtual meetings.

The opportunity to meet with legislators in person was a deciding factor in the decision. Once the General Assembly decides on a date for their session we will be able to set a date for our advocacy day.

Thanks for working with us on this. We are responding to changing circumstances as best we can and looking for the best opportunities to represent you with policy makers and advance the pharmacy profession.

Supporting Those Who Support Pharmacy NCAP is making plans to grow our fundraising in support of legislators who have stood up for pharmacy.

We are planning a series of regional “meet and greet” fundraisers, for later in the year, where you can meet key legislators, tell them how important their support of pharmacy, and the NCAP agenda is, as well as make a contribution to those who have “walked the walk” for us. Contributions are especially appreciated and noted during election years, so please consider making a contribution to support a deserving legislator. Keep an eye open for dates, times and venues.

You don’t need to wait for one of our events to contribute. You can do your part by contributing to the NCAP advocacy fund at https://secure001.membershipsoftware.org/NCAPsecure/donation_pay.asp Your contribution supports the work of your lobbyist and other in-house advocacy efforts at NCAP NCAP is also joining in a collaborative effort with other pharmacists to raise advocacy funds and pool them to have greater impact. Your contribution to that effort is also greatly appreciated. You can support this effort by mailing a contribution to: PILL PAC: 209 Fayetteville Street: Raleigh, NC 27601 No amount is too small and every dollar counts.

On the National Front Supreme Court PBM Case

NCAP is working to raise funds to support litigation at the Supreme Court when it hears Rutledge V. Pharmaceutical Care Management Association. Arkansas passed legislation in 2015 that required PBM’s to raise reimbursement rates for drugs if they fell below the pharmacy’s wholesale costs and created an appeal process for pharmacies to challenge PBM reimbursement rates. This effectively prohibited PBMs

from reimbursing pharmacies below the pharmacies’ cost of acquisition.

In his brief to the US Supreme Court, Solicitor General Noel Francisco sided with Arkansas in the dispute, stating that a ruling against the Arkansas law by a federal court was contrary to the Supreme Court’s precedent and should be reviewed and corrected. He urged the court to take up the case, siding with attorney generals from 31 states and the District of Columbia that want the US Supreme Court to reverse the Eighth Circuit’s negative ruling.

This legislation is of importance to North Carolina and indeed all states seeking to reform PBM practices.

But litigation before the Court is costly. NCAP is a good partner with national organizations who also help us when we need it. It is important that we demonstrate our willingness to ante-up in support of this important litigation. Due to the impact of COVID-19, Arkansas Pharmacy Association just received word this morning that the case will be moved to either October or November 2020.

Emergency Provider Status to Facilitate COVID-19 Testing NCAP and other state pharmacy associations through the help of the National Alliance of State Pharmacy Associations spent time last week advocating at the federal level for emergency pharmacist provider status in response to the COVID-19 crisis. Pharmacies and pharmacists across the country are ready to help and can help provide both the access and expertise necessary to accelerate testing.

Leader McConnell indicated he would consider the request. NC Representatives Butterfield, Holding and Hudson were contacted to ask for their support to enable pharmacists to use their expertise in scaling up testing, and in particular antibody testing to help in determining who is safe to return to work.

USP Releases Guidance on Compounding and Beyond Use Dates During Pandemic The global drug supply chain is impacted by the COVID-19 pandemic, leading to supply disruptions and shortages of drug products. Several drugs required to care for ventilator patients have been in critically short supply. Pharmacies in areas with widespread COVID-19 infections are sometimes faced with difficult decisions to discard these medications or use them past the current maximum <797> beyonduse dates. In response, on Saturday, April 11th, USP posted a document with considerations from the Compounding Expert Committee with considerations for sterile compounding during the COVID-19 pandemic. The document includes a statement from USP supporting risk-based enforcement discretion related to compounding standards. It addresses the assignment of beyond-use dates, considerations for certification and recertification of engineering controls, and recommendations for cleaning and disinfecting a facility when someone is sick.

We cannot emphasize strongly enough the importance of your voice and engagement as part of our efforts. Please take time to learn what you can do to ensure that policy makers hear your concerns and act to support your work.

We want to hear your thoughts on how we can be successful. 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 me directly. My email is Solarigovernmentsolutions@gmail.com and my phone number is 919-744-8803. As your lobbyist I am happy to answer any questions you have about my work and I am ready to assist you in any way possible.