Scott J. Knoer, MS, PharmD, FASHP, APhA EVP and CEO
If you know me, you know my top pharmacy priorities: payment reform, payment reform, and payment reform. Well, my friends, it’s on! Along with our heavy push for the passage of federal provider status recognition legislation, APhA has joined a federal lawsuit to end retroactive DIR fees.
Let’s talk about this lawsuit, NCPA v Becerra. NCPA originally filed the federal suit in January 2021, and now APhA has signed on to become equal partners in the case. You can learn more of the legal nitty gritty at https://apha.us/DIR_lawsuit and in this issue on page 57, but it boils down to this: HHS opened a loophole that allowed PBMs to extract billions from pharmacies without passing savings along to Medicare Part D beneficiaries. HHS openly admits it was a huge mistake—and yet, it has repeatedly shirked its responsibility to fix the problem.
Our diseased payment system has let this go on far too long, and too many APhA members are suffering. Pharmacies and the patients they serve cannot tolerate a system in which PBMs profit by destabilizing businesses—the impact has been fatal to many of them—and threatening access to care from a long-trusted pharmacist. They are crying for justice. With this lawsuit, we demand that HHS do the right thing and move retroactive DIR fees to point of sale.
Last month we announced the launch of the APhA Pharmacy Advancement Legal Defense Fund (LDF) to support and amplify our legal, legislative, and regulatory efforts on behalf of pharmacy and the patients who rely on pharmacists’ care. This includes our federal lawsuit but also initiatives such as securing provider status, ensuring payment for pharmacists’ services, reforming PBMs at the federal and state level, and advancing pharmacists’ practice authorities. You can help! Learn more at http://apha.us/LDF.
We know that pharmacy is public health infrastructure, and the stakes are high. We can’t back down—we must win. Our patients’ lives depend on it.
APhA is giving everything we’ve got to make real change for our members, their patients, and the pharmacy profession. We need the support of every pharmacy advocate to make an impact. APhA has the most talented and dedicated team leading the charge, but we need all our pharmacy advocates to help in this fight. Stay connected with APhA to hear the latest updates and seize opportunities to get involved.
Thank you for all you do for your patients and communities!