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Advancing Pharmacy through the Legal Defense Fund

Your support will help drive the pharmacy agenda:

Legal Battles

APhA’s contributions to Rutledge v. Pharmaceutical Care Management Association, the U.S. Supreme Court case that was unanimously decided in favor of Arkansas’s right to regulate PBMs opened the door for more successful state challenges. We are currently supporting a similar lawsuit out of North Dakota, as well as NCPA v. Becerra, which would prohibit PBMs from “clawing back” retroactive direct and indirect remuneration (DIR) fees.

Regulatory issues

APhA's expert team consistently advocates to the Administration and federal agencies (HHS, CMS, FDA, CDC, NIH, DEA, FTC, and others) on issues of importance to pharmacy and pharmacists, including recognition of pharmacists as providers, payment reform, expansion of pharmacists’ patient care services, addressing the opioid crisis, health IT, telehealth, and other policies to improve public health.

Sweeping expansion of pharmacists’ scope of practice during COVID-19

APhA is pushing to make permanent the largest expansion of pharmacist authorities that were introduced as part of the pandemic response including allowing pharmacies to offer FDA-approved vaccines and therapeutics, point-of-care tests, and Medicare reimbursement for administration of COVID-19 vaccines at a rate nearly double the current rate, flexibility to compound medications in shortage for hospitalized patients, and flexible telehealth authorities. We’ve already helped increase the number of pharmacies participating in the Federal Retail Pharmacy Program for COVID-19 vaccines from 17,000 to nearly 40,000.

Federal legislative efforts

APhA facilitated the introduction of legislation that would recognize pharmacists as providers in Medicare Part B and is vigorously fighting to get it passed. When enacted, certain pharmacists will be able to bill Medicare Part B for patient care services they are already licensed to provide.

APhA is also laser-focused on legislation to prohibit pharmacy benefit managers from using retroactive DIR fees in their contracts. Retroactive DIR fees or other “clawback” mechanisms, often assessed months after a prescription has been filled, prevent pharmacies from knowing at the time of dispensing what their true reimbursement will be for a prescription. The result is a final reimbursement often below the cost of the medication paid by the pharmacy to its wholesaler. These DIR fees have no relationship to the actual price paid by the pharmacy for the product.

Education and training

APhA sets the standard for specialized and advanced pharmacy training. Our publications, certificate training, and certification/recertification programs open new opportunities for patient care and patient relationships, billable services, and an expansion of product offerings in community pharmacies. Over the years APhA has prepared over 400,000 pharmacists and 75,000 technicians to offer immunization services and countless pharmacists are also trained to provide patient care in diabetes, cardiovascular, Medication Therapy Management (MTM), and other services because of APhA’s innovative education and practice resources.

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