NCPA says PBM reform provisions included in pending CR
By HME News Staff
Updated 9:54 AM CST, Wed December 18, 2024
ALEXANDRIA, Va. – The National Community Pharmacists Association says that a continuing resolution that Congress is readying includes provisions for two of its top priorities for reforming pharmacy benefit managers: it would require PBMs to reimburse pharmacies at national average drug acquisition cost plus the state’s fee for service dispensing fee for all Medicaid managed care programs in all 50 states; and it would require CMS to establish reasonable and relevant contract terms, including pharmacy reimbursements, in Medicare Part D and create a mechanism for pharmacies to dispute contract violations and penalize PBMs. “We’re very grateful that Congress has included NCPA’s top priorities in the continuing resolution, but now is not the time to celebrate, because the health insurance companies and their PBMs will try desperately to stop this measure from passing,” said NCPA CEO B. Douglas Hoey. “Independent pharmacists across the country have done the grassroots lobbying, the letter writing, the congressional visits, and all the news interviews. Their efforts and the NCPA team’s boots-on-the-ground lobbying have all put us in scoring position. Now we’re on the goal line, and we need to punch it into the end zone.”
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