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Important Rx Legislation Introduced in Congress!

April Legislative Update

Two Important Pieces of Pharmacy Legislation Introduced in Congress

Two very important pieces of pharmacy legislation have been introduced recently in Congress.  Please take the time to read about the bills and then contact your Congressperson and encourage him/her to support community pharmacy by co-sponsoring both of these bills.

H.R. 1204: Community Pharmacy Fairness Act of 2009

In an effort to permit community pharmacies to negotiate fairer contracts that benefit their patients, Reps. Anthony Weiner (D-NY) and Jerry Moran (R-KS) have introduced H.R. 1204, the Community Pharmacy Fairness Act of 2009.  The bill helps level the playing field between more than 23,000 community pharmacies and the multi-billion dollar pharmacy benefit managers (PBMs) who administer the prescription drug plans by creating a narrow exemption to current antitrust law.

Currently, independent community pharmacies are offered take-it-or-leave-it contracts by the PBMs. Giant PBMs have voiced concern over allowing pharmacies to negotiate for fear of losing the PBMs' monopoly over these small businesses that allows them to dictate terms and create windfall profits for their shareholders. If pharmacies were allowed to enter into negotiations, they could have a chance of enacting terms in contracts that could:

  • protect patients from shrinking and shifting formularies that confuse and restrict a patient's treatment options (formularies are the lists of drugs that are covered for specific groups in a health insurance plan);
  • reduce the pre-authorization hassles to obtain refills or formulary-restricted medications that generate red tape and create hurdles for patients trying to obtain their medications;
  • limit the switching of patients to higher-cost medications that may not be better for them therapeutically, but that earn higher brand-name drug rebates for the PBM.

The bill also reflects the changes that were made when the previous version of this bill was voted out of the House Judiciary Committee last year:

  • limit pharmacy negotiating pools to 25 percent of market share in a Medicare Part D region;
  • definition of independent pharmacy is less than 10 percent of market share of a PDP region and less than 1 percent of market share of the United States;
  • 5-year sunset clause from the bill's passage;
  • Government Accountability Office study six months before sunset to examine the impact.

Rep. Charlie Wilson and Rep. Steve Driehaus have signed on as co-sponsors of this legislation.  We need all 18 Ohio members of Congress to know just how important this legislation is for community pharmacy and our patients.  Please email your Representative today and ask him/her to co-sponsor H.R. 1204.

H.R. 616: Exempt Pharmacists and Pharmacies from DME Accreditation

Reps. Marion Berry (D-AR) and Jerry Moran (R- KS) have introduced H.R. 616, legislation that will add pharmacies and pharmacists to the list of health care providers that CMS could exempt from meeting the September 30, 2009 DME accreditation deadline. This legislation aims to correct unfair treatment of community pharmacists.  Community pharmacists are the only medical professionals that must meet the new accreditation requirements of Medicare Part B suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS).  The accreditation process is both very expensive and very time-consuming.  

Without the adoption of H.R. 616, three issues will arise immediately.
(1)  Many community pharmacies will discontinue providing DMEPOS services for their patients.

(2)  Patients in underserved communities will have to travel much longer distances to get these services, or even be forced to use mail order and Internet operations where fraud is more prevalent.

(3)  If pharmacists stop providing DMEPOS services, patients will lose their advice and expert training, which would dramatically undermine the potential benefits of these medical supplies.

Rep. Charlie Wilson is currently the only Ohio Congressperson to co-sponsor this bill.  We would like to have all 18 Ohio members of Congress sign onto this very important piece of legislation.

Please contact your Congressperson TODAY and ask them to co-sponsor H.R. 616.


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