NCPA said Wednesday that it has sent a letter to House Majority Leader Kevin McCarthy (R., Calif.) and GOP chairs of the House Ways and Means Committee, House Energy and Commerce Committee and House Education and Workforce Committee as they look at ACA replacement package ideas.
The association also sent a sent another letter to Sen. Orrin Hatch (R., Utah), chairman of the Senate Finance Committee, who had previously solicited ideas for Medicaid changes.
Last week, Sen. Mike Enzi (R., Wyo.), chairman of the Senate Budget Committee, introduced a resolution providing for the repeal of the ACA. Included the resolution are reconciliation instructions to authorizing committees to expedite ACA repeal legislation by enabling it to pass with a simple majority in the Senate (as in the House), along with reserve funds to accommodate legislation to repeal and replace the ACA.
In its letters to congressional leaders, NCPA recommended that ACA replacement legislation preserve prescription drug coverage as a core benefit and require a “robust pharmacy network” that includes “meaningful access” to retail pharmacies, including independent pharmacies.
“Through the health exchanges and expansion of Medicaid, the ACA provided access to these necessary medications to over 22 million people, providing the previously uninsured the treatments necessary to manage chronic conditions such as heart disease and diabetes rather than seeking costly emergency room treatment when complications arose,” NCPA’s letter to House leaders said. “Any ACA replacement must preserve prescription drug coverage as an essential benefit to help reduce overall health care costs.
NCPA also said such legislation should maintain the current definition for average manufacturer price (AMP) used for Medicaid reimbursements; sections of the ACA that improve Medicare Part D medication therapy management programs, including an annual comprehensive medication review; and transparency provisions for pharmacy benefit managers (PBMs) serving health insurance exchange plans and Medicare Part D.
“As Congress prepares the coming wave of health care reforms, we felt the voice of America’s more than 22,000 independent community pharmacies and the millions of patients they serve should be heard,” NCPA chief executive officer B. Douglas Hoey said in a statement. “These small business health care providers often reside in underserved communities, are highly accessible and are critical to driving prescription drug access, adherence and proper utilization. We believe these commonsense, bipartisan measures will improve health outcomes, reduce costs and maintain access for patients. We look forward to working constructively throughout the legislative process to achieve those goals.”
Regarding potential changes to Medicaid, NCPA urged lawmakers to uphold prescription drug coverage as an essential component, allow the participation of “any willing pharmacy” in pharmacy networks to avoid impact beneficiary access to prescription drugs, and allow patient choice of pharmacy rather than mandatory mail order for prescriptions.
Other recommendations for Medicaid included better integration of pharmacists into the health care delivery system and more robust oversight of managed care organizations.
“Every day, our members see firsthand and try to address both the struggle that patients face in paying for their medication as well as the financial burden the federal government and states face in trying to provide for the needs of Medicaid patients,” NCPA stated in the letter to Sen. Hatch. “Pharmacists are ready to work constructively with Congress, HHS and individual states to address these issues.”