Federal Pharmacy Bills Brief

Each year, it seems that pharmacy gains more traction with federal legislative efforts. This is a trend we have seen in Michigan as well. However, with so much going on it is easy to get lost in the issues or become confused with the purpose of each bill. Below is a brief description of the legislative efforts currently taking place at the national level.  Michigan congressional leaders are stepping up for pharmacy! In a follow-up post next week, I will provide you with some information on what steps you can take to advocate for these issues!

H.R. 4190 (Provider Status): In Michigan, pharmacists have provider status, however, they are not able to bill Medicare for pharmacy-provided services because pharmacists are not considered providers at the federal level. Congresswoman Candice Miller and Congressmen Mike Rogers and Kerry Bentivolio have signed on to support pharmacists becoming providers. Currently, there are 94 co-sponsors (50 Democrats and 44 Republicans). Specifically, this bill would allow for coverage of pharmacy services under Medicare Part B for those patients living in medically underserved areas. This is an important step in allowing Michigan pharmacists to show their value! 

Link: http://www.gpo.gov/fdsys/pkg/BILLS-113hr4190ih/pdf/BILLS-113hr4190ih.pdf

H.R. 4577 (Open Networks): There is some confusion related to this bill, The Ensuring Seniors Access to Local Pharmacies Act of 2014, which is also often referred to as the “Any Willing Pharmacy” or “Open Networks” bill. When bills have several different titles, it can blur the message and, therefore, the mission. It is important for us to be communicating the same information. Many organizations refer to this bill as the “Any Willing Pharmacy” or “Open Networks” bill and we tend to like that language since pharmacists have not received provider status at the federal level.  This bill would give pharmacists the opportunity to provide services in currently restricted networks in a targeted manner such as a medically underserved area or among a medically underserved population. The pharmacy will also need to meet the terms and conditions identified by the plan. Currently, there are 59 co-sponsors (32 Republicans and 27 Democrats), none of which are from Michigan.

Link: http://www.gpo.gov/fdsys/pkg/BILLS-113hr4577ih/pdf/BILLS-113hr4577ih.pdf

H.R. 4437 (PBM Regulations): This bill was introduced on April 9, 2014. The Generic Drug Pricing Fairness Act amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to require each contract entered into with a prescription drug plan (PDP) sponsor from entering into a contract with any pharmacy benefits manager (PBM) to manage the prescription drug coverage provided under such plan, or to control the costs of the prescription drug coverage under it, unless the PBM adheres to specified criteria when handling personally identifiable utilization and claims data or other sensitive patient data. Currently, 12 co-sponsors have signed on to support this bill, none of which are from Michigan.

Link: http://www.gpo.gov/fdsys/pkg/BILLS-113hr4437ih/pdf/BILLS-113hr4437ih.pdf

Michigan is a great state, with many of our congressional leaders holding significant roles in Congress. Let’s Do OUR PART to advocate for pharmacy. To learn how to get involved in the Pharmacy Advocacy Response Team, please contact Amanda Lick, MPA manager of advocacy, governmental and regulatory affairs at Amanda@MichiganPharmacists.org or (517) 377-0254.