Coalition Wins Victories in Congress

Ms. Khani and Mr. Sewell arecopresidents of the Coalition forCommunity Pharmacy Action.

As the 110th Congress windsdown, the Coalition forCommunity Pharmacy Action(CCPA) wishes to thank you for yourhelp in achieving significant victoriesin 3 major areas this year—delay ofpharmacy reimbursement cuts forgeneric drugs in Medicaid, prompt paymentin Medicare Part D, and preservationof pharmacy choice for TRICAREbeneficiaries.

Julie Khani

Vice president

of federal

healthcare

programs at

NACDS

Charles Sewell

Senior vice

president

of government

affairs at

NCPA

Over President Bush's veto, Congresspassed the Medicare Improvements forPatients and Providers Act of 2008(MIPPA), which included several provisionscritical to community pharmacy.First, MIPPA delayed cuts in Medicaidpharmacy reimbursement for genericdrugs until September 2009. The DeficitReduction Act of 2005 applied the useof Average Manufacturer Price (AMP)in calculating federal payment limitsto pharmacies in the Medicaid program.The use of AMP was expectedto reduce pharmacy reimbursementbelow the cost to acquire medicationsand result in the closure of as many as11,000 pharmacies nationwide. Thisdelay, while a short-term solution, iscritically important because it allowscommunity pharmacy additional timeto advocate for a permanent legislativefix to AMP.

Second, MIPPA included an importantrequirement that, starting in 2010,plans must pay pharmacies within 14days after receipt of clean claims submittedelectronically and 30 days forclean claims submitted by other means.This provision, long advocated by theCCPA, will end needless delays in paymentto pharmacies, help many pharmaciesthat have struggled to remainin business, and allow pharmacists tofocus on patient care.

In addition to the provisions containedin MIPPA, community pharmacyachieved a significant victorywhen Congress approved S 3001, theNational Defense Authorization Actfor Fiscal Year 2009. This legislationextends for 1 year the current freezeon retail pharmacy copayments forTRICARE beneficiaries, ensuring that9 million active-duty military personnel,retirees, and their families willnot face cost increases for obtainingprescription drugs and services fromretail pharmacies.

Community pharmacy has workedtirelessly to freeze TRICARE retailpharmacy copayments at current levelsin order to prevent efforts to drivebeneficiaries to mail order. The CCPAstrongly believes that the choice ofwhere to obtain prescription medicationsshould be left to TRICARE beneficiaries.

While the CCPA—in conjunctionwith the National CommunityPharmacists Association and theNational Association of Chain DrugStores—made large strides in Congressthis year, it is vital that we continueto educate lawmakers in the nextCongress on the importance of communitypharmacies and those theyserve.