Association Perspective
Scott J. Knoer, MS, PharmD, FASHP, APhA EVP and CEO
Over the last few weeks, there have been some sensational developments for pharmacists and our patients. I hope you’re as excited about them as I am.
At the end of July, President Trump signed an executive order resurrecting a rule that could force PBMs to pass on to Medicare Part D beneficiaries any discounts from manufacturer rebates and other price concessions at point of sale.
It was a rare L for PBMs, and it’s a positive sign that the executive branch recognizes that PBMs do not make drugs more affordable to patients—yet it’s not quite a W for us. Now, our job is to work with the U.S. Department of Health and Human Services (HHS) and our pharmacy partners to ensure the agencies implementing the rebate rule also end PBMs’ gaming of Medicare regulation loopholes that allows them to inflate patients’ prescription-drug costs and put pharmacies on life support by extracting vampiric direct and indirect remuneration (DIR) fees—not just retroactively, but once and for all.
A few weeks later, CMS issued updated guidance granting new flexibility for accredited and recognized diabetes self-management training (DSMT) programs already billing Medicare Part B for DSMT services. These programs, CMS said, may furnish and bill for DSMT services provided via telehealth during the COVID-19 public health emergency. This is a huge triumph for diabetes care and education specialists and the Medicare beneficiaries with diabetes whom they serve.
Then HHS announced it would authorize licensed pharmacists to provide all vaccines recommended by CDC’s Advisory Committee on Immunization Practices and approved or licensed by FDA to all children ages 3 to 18 during the COVID-19 pandemic, regardless of state laws and regulations to the contrary.
This is great news. APhA has long advocated that pharmacists are uniquely positioned to address this public health emergency, and we worked with HHS to develop this strategy to engage all pharmacists. As Admiral Brett Giroir, the HHS assistant secretary for health, said in the announcement, pharmacists have always been a trusted voice in the community, and they’re readily accessible. We couldn’t agree more.
We’ve still got some milestones to reach. Congress must include coverage for pharmacists’ COVID-19 and flu testing and immunizing services under Medicare Part B in the next coronavirus stimulus package. Keep writing and calling Capitol Hill to tell your patients’ stories and how much more pharmacists could be doing to help them stay safe and healthy, during the public health crisis and beyond.
We aren’t done, but I’m thrilled with the progress we’re making and more optimistic than ever about pharmacy’s future. Let’s get there together!