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NCPA urges House passage of PBM reform package

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ALEXANDRIA, Va.  – The National Community Pharmacists Association issued the following statement from Anne Cassity, senior vice president of government affairs, as the House of Representatives prepares to vote today on the Lower Costs, More Transparency Act (H.R. 5378):

“Community pharmacy has been pushing consistently for the last 15 years for transparency into PBM operations and reforms to their tactics. During that time, care has only grown more difficult for patients to afford and to access and for pharmacies to provide. This legislation would help provide desperately needed relief while also saving taxpayer resources, prohibiting spread pricing and seeing that pharmacies are paid in a way that would cover their dispensing costs. We’re grateful to our allies in Congress for keeping PBM reforms on their agenda and are eager to see these and other changes enacted as quickly as possible.”

H.R. 5378 is NCPA-priority legislation that follows a months-long process to combine efforts of the House Energy and Commerce, Ways and Means, and Education and the Workforce Committees into a single legislative package. It includes the Drug Price Transparency in Medicaid Act (previously H.R. 1613), which would bring greater transparency to the Medicaid program, save taxpayers more than $1 billion over 10 years, and provide fair and transparent reimbursements to pharmacies. It also prohibits spread pricing/requires a full pass-through in all Medicaid managed care programs; requires pharmacy reimbursements in all state Medicaid managed care programs be at a rate of pharmacy’s average acquisition costs and the state’s Medicaid fee-for-service dispensing fee; limits payments to pharmacy benefit managers to solely administrative fees; and creates savings for taxpayers.


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