NACDS President and CEO Steven C. Anderson released the following statement today 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. Representatives Buddy Carter (R-GA), Vicente Gonzalez (D-TX), Elise Stefanik (R-NY), Deborah Ross (D-NC), Rick Allen (R-GA) and Jake Auchincloss (D-MA).
“We thank House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) and Ranking Member Frank Pallone (D-NJ) for their bipartisan leadership on the issue, and for including H.R. 1613 into the broader PATIENT Act (H.R. 3561).
“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.”
Overall, NACDS is advocating for comprehensive PBM reform across all payer segments, consistent with NACDS’ Principles of PBM Reform. Direct and indirect remuneration fee (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.
More information is available at an NACDS web page.
