Legislative progress: Q&A with NACDS’s Steve Anderson

Drug Store News caught up with NACDS president and CEO Steve Anderson for a recap of 2016 and a look ahead at what to expect from a Trump administration.

DSN: What is the RxImpact scorecard for 2016? How did the industry do on the key pharmacy and patient access issues?

Steve Anderson: We have two examples right now. As I’m answering this question, Congress is preparing to consider final passage of two bills — 21st Century Cures and the National Defense Authorization Act. Both bills reflect pro-patient, pro-pharmacy achievements. The Cures legislation, which NACDS supports for its emphasis on fostering healthcare innovation, was finalized without including a damaging provision that would have used reductions in Medicaid pharmacy reimbursement to help pay for the bill. That was something NACDS had to advocate on quite aggressively. The defense bill includes the NACDS-supported TRICARE pilot program, which will maintain the ability of military families and veterans to obtain their prescriptions at the pharmacy of their choice, while providing significant savings to the Department of Defense. Regarding the bill to enhance underserved Medicare patients’s access to pharmacy services — the Pharmacy and Medically Underserved Areas Enhancement Act — it earned the backing of two-thirds of the U.S. House of Representatives and half of the Senate. That bill, which we call the “provider status” bill, has a strong start.

DSN: What major pharmacy-related issues do you expect to be on the table for 2017, and what does the outlook look like? Take provider status — do you think the changes in Congress will help or hurt the industry's chances of seeing meaningful provider status legislation for pharmacists in the next year or two?

Anderson: NACDS already has reached out to President-elect Donald Trump’s transition team and to Congressional leaders. We are putting a number of issues on the table. Provider status is one of them. We have made the case to the NACDS membership that it will be essential to come to Washington for NACDS RxIMPACT Day on Capitol Hill to help fill the void of 40 cosponsors of the bill who are not returning to Congress. We need to keep that bill positioned to be included on some other piece of legislation that may move in Congress. We will be advancing various pharmacist scope-of-practice proposals in the states; bird-dogging the implementation of Medicaid pharmacy reimbursement for prescription drugs and any potential changes to the Affordable Care Act; and keeping up the fight on TRICARE, Medicaid managed care and issues related to healthcare plan practices, such as direct and indirect remuneration fees, among others.

DSN: What are some key pharmacy statistics the new Trump administration and freshman Congressional leaders need to know?

Anderson: Some say that making one’s case in Washington, D.C. comes down to people and data. NACDS has great data and great people. Nearly all Americans (91%) live within five miles of a community pharmacy. For 13 straight years, pharmacists have ranked in the top three professions in Gallup’s national Honesty and Integrity survey — and pharmacists were second, behind nurses, in 2015. Here’s a great one: At the 2016 NACDS RxIMPACT Day on Capitol Hill, advocates met with 90% of the 535 Congressional offices. And, there is a store operated by an NACDS member in every Congressional District.

DSN: What might it mean for community pharmacy if Trump follows through on some form of his promise to “remove and replace” the ACA? He has talked about keeping the pre-existing condition and the extended coverage for adult children provisions, which are both cost centers. How can/is retail pharmacy helping to mitigate those costs?

Anderson: One of the issues on which NACDS will remain very active is fighting for a workable approach to Medicaid pharmacy reimbursement for prescription drugs — an approach that preserves patient access. NACDS did not take a position on the Affordable Care Act as a whole, and rather advocated on pharmacy-specific provisions. Currently, NACDS is focused on ensuring the new reimbursement model under the Affordable Care Act provision is workable in terms of how it is being implemented. If something happens that eliminates the provision entirely, then we are going to have to be right on point to defend pharmacy patient care.

DSN: Looking back on the Obama administration, what would you say have been some of the biggest wins for community pharmacy and/or some accomplishments or moments NACDS is particularly proud of?

Anderson: NACDS placed an ad in The Washington Post in 2007, targeted to all of the Republican and Democratic candidates for their parties’s Presidential nominations in 2008. That was when President Barack Obama was Senator Obama. Healthcare reform discussions were just beginning, and NACDS said that pharmacy wanted and needed to be part of these discussions. Throughout the Affordable Care Act debate, NACDS told pharmacy’s story, and made great progress. NACDS has defended the industry on [such] issues [as] Medicaid reimbursement while charting new territory on everything from point-of-care testing and expanded vaccination authority to new opportunities for medication therapy management. Now, we are working on additional scope-of-practice expansion, the pharmacist provider-status legislation, pharmacy’s role in value-based healthcare models and much more. It is going to be a fast-paced 2017.