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NACDS commends House committee for inclusion of PBM reform bill in PATIENT Act

NACDS said this action is an essential component of PBM reform in the Medicaid program and vital for patients and the pharmacies serving them.
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The National Association of Chain Drug Stores president and CEO Steve Anderson released the following statement in anticipation of a legislative markup on May 24 by the U.S. House of Representatives Committee on Energy and Commerce:

“NACDS commends the House Energy and Commerce Committee for their bipartisan commitment to deliver on PBM reform. Last week, the House Energy and Commerce Committee’s Subcommittee on Health took important action in support of patients, communities, employers, taxpayers and pharmacies by passing the Drug Pricing Transparency in Medicaid Act (H.R. 1613) – legislation by U.S. Reps. Buddy Carter (R-Ga.), Vicente Gonzalez (D-Texas), Elise Stefanik (R-N.Y.), Deborah Ross (D-N.C.), Rick Allen (R-Ga.) and Jake Auchincloss (D-Mass.).

“We thank House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Wash.) and Ranking Member Frank Pallone (D-N.J.) for their bipartisan leadership on the issue, and for including H.R. 1613 into the broader PATIENT Act (H.R. 3561).

[Read more: NCPA, NACDS commend House committee investigation on PBMs]

“Including H.R. 1613 into the larger bill is essential for PBM reform in the Medicaid program, and is critical for a truly comprehensive remedy against PBM tactics that threaten pharmacies and the patients who rely on them. These provisions prohibit spread pricing in Medicaid and establish a pass-through payment model. They create in Medicaid managed care a rate floor requirement similar to that of Medicaid fee-for-service that focuses on cost-based pharmacy reimbursement and dispensing fees.

“In the U.S. Congress, we are seeing bipartisan commitment and work across the House of Representatives and the Senate to provide meaningful reform.”

[Read more: AAM report: Middlemen increasingly block patient access to new generics]

Overall, NACDS is advocating for comprehensive PBM reform across all payer segments, consistent with NACDS’ principles of PBM Reform. DIR fee reform remains an important aspect of PBM reform. NACDS’ principles of PBM reform include: stopping explosive retroactive fees; stopping below-cost reimbursement; stopping the gaming of performance measures; stopping “specialty definitions” from steering patients from their pharmacy; stopping mandatory mail-order; stopping limited networks; stopping overwhelming audits; and stopping the undercutting of PBM reform laws.

NACDS also recently lauded the Senate companion to H.R. 1613 — S. 1038.

Commenting on passage of The PATIENT Act by the committee in a unanimous vote of 49-0 on Wednesday, Anne Cassity, senior vice president of government affairs at the National Community Pharmacists Association, said, "NCPA is pleased the House Energy and Commerce Committee passed the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act (H.R. 3561), which includes several provisions vital to lowering prescription drug costs and bringing transparency to anticompetitive practices of pharmacy benefit managers. Patients and community pharmacies have been advocating aggressively for years for reforms and insight into PBM practices,” Cassity said. “This comprehensive package would take significant strides forward in terms of federal oversight, and NCPA is proud to support it. We’re grateful to the committee for its work and hope the full House will soon advance it.”

NACDS also hailed passage of the PATIENT Act, noting that the bill includes provisions that prohibit “spread pricing” in Medicaid and establish a “pass-through payment” model. They create in Medicaid managed care a “rate floor” requirement similar to that of Medicaid fee-for-service that focuses on cost-based pharmacy reimbursement and dispensing fees.

NACDS president and CEO Steve Anderson said, “We applaud House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Wash.) and Ranking Member Frank Pallone (D-N.J.) for their leadership and for their continued work to put patients before PBM profits. The unanimous passage of the PATIENT Act out of the Committee further demonstrates the strong bipartisan commitment that exists to confront the harmful PBM tactics that threaten patients and the pharmacies serving them.”

This article was updated.

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