NCPA Backs New Amendments to Senate Health Reform Bill; Expresses Concern over Revised Public Option’s Pharmacy Benefit

(BUSINESS WIRE)--The National Community Pharmacists Association (NCPA) today endorsed three amendments recently proposed to the Patient Protection and Affordable Care Act and raised questions about an emerging public insurance option that would be administered by the federal Office of Personnel Management (OPM). NCPA Executive Vice President and CEO Bruce T. Roberts, RPh, issued the following statement:

“NCPA strongly supports an amendment by Sen. Sherrod Brown (D-OH) that allows pharmacies to continue providing Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Part B drugs to Medicare beneficiaries without purchasing a surety bond. Like the 14 other types of medical professionals that Medicare exempted from the surety bond requirement, pharmacists are licensed and regulated by the states. Requiring surety bonds is duplicative and may lead to loss of patient access to valuable health care services, such as diabetes testing supplies, canes and crutches.

“We continue to work with Congress on both a permanent pharmacy exemption from DMEPOS accreditation requirements, as well as an extension of the current moratorium, which is scheduled to expire on Dec. 31, 2009.

“Sen. Kay Hagan (D-NC) added important language to the Senate ‘Freshmen Value and Innovation Package’ amendment to codify Medicare’s medication therapy management (MTM) program. MTM utilizes community pharmacists to help patients adhere to, and maximize the benefits of, their medicine. The programs have been shown to improve outcomes while lowering health care costs.

“An amendment by Sen. Michael Bennet (D-CO) would require the Government Accountability Office (GAO) to conduct the first detailed study in more than 10 years of pharmacists’ cost of dispensing in the Medicaid program. Private studies have shown community pharmacists to be compensated well below their cost of dispensing and a GAO study could give Congress and the states needed information for measuring the adequacy of the dispensing fees they pay and the impact upon patient access to pharmacy services.

“Various news reports indicate Senators are considering an OPM-administered health plan for the uninsured. Under such a model, we urge lawmakers to utilize a pharmacy benefit administrator (PBA) to manage drug coverage, rather than a pharmacy benefit manager (PBM).

“PBMs have a history of inflating health care costs through bloated administrative fees and questionable practices that are hidden from patients and plan sponsors. OPM’s inspector general told a House subcommittee investigating the PBMs’ effect on the federal employee health plan that ‘there’s a good chance we’re not getting a good deal because of the lack of transparency.’

“A PBA, such as those employed by Medicaid and the Pentagon, would give patients and taxpayers the best bang for their buck by passing through all rebates, discounts, and price concessions. PBM transparency requirements in the current bill should continue to apply to any plan that operates within the exchange, including the public option.

“NCPA is grateful for Congress’ bipartisan support of community pharmacy in health care reform and we will continue to work with lawmakers as the legislative process continues.”

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