Welcome to the Community Pharmacy Advocacy Coalition (CPAG) weekly communication. The CPAG is a coalition of community pharmacists who are concerned about the impact of Pharmacy Benefit Manager (PBM) continued erosion of pharmacy practices, as well as recent devastating cuts to pharmacy reimbursement form the state Medi-Cal program.
As a member of the coalition, you will receive two email updates per week. On Mondays an update will be sent to all coalition members with information on what is happening related to PBM activities. On Thursday, you will receive an update on all the efforts to eliminate the Medi-Cal clawback and NADAC formula.
Georgia Leading the Way Against PBMs
Big News! On Wednesday, May 8, Georgia signed into law a bill known as the "Pharmacy Anti-Steering & Transparency Law." This bill bans the practice of PBMs steering patients to PBM-owned pharmacies. Additionally, this bill creates restrictions and regulations on the large chain pharmacies associated with PBMs. The important aspect of this bill is that it places the requirement on the pharmacy, not the PBM or health plan, which is a very important distinction to avoid ERISA pre-emption issues. Watch for more information on this issue in future editions.
PBM Update
As a result of CPhA’s sponsored bill, AB 315 (Wood) on PBM regulation, the Department of Managed Healthcare (DMHC) is obligated to create a task force on PBM regulation that will consider, at minimum, the following:
- Wholesale acquisition costs of pharmaceuticals
- Rebates obtained by health care service plans or PBMs from pharmaceutical manufacturers
- Payments to network pharmacies
- Exclusivity arrangements between health care service plans or contracted PBMs with pharmaceutical manufacturers.
The Task Force put out a notice for solicitation of members and CPhA submitted the required documentation to participate on the task force. We are still waiting to hear back on membership of the task force.
The Task Force will meet at least once a month from June 2019 to December 2019 to determine what information related to pharmaceutical costs, if any, DMHC should require to be reported by health care service plans or their contracted Pharmacy Benefit Managers (PBM). DMHC is required to submit a report with the Task Force’s findings and recommendations to specified persons and entities within the Legislature by February 1, 2020.
Building Bridges
A new member has joined the coalition! We welcomed the United Nurses Associations of California (UNAC) as a new coalition member. They represent a group of 32,000 strong that include nurses, pharmacists and other health care professionals. Partnership with UNAC will justify our case that many who work with pharmacies will be effected not only pharmacists and their patients.
Updated CPhA Website
We have made some recent upgrades to the coalition
website page
. We have consolidated the website to be a central hub for all useful resources related to the coalition just like our newsletter. This is a great resource for informing other pharmacists on our coalition efforts and how to stay connected during this time.
Soliciting Support for the Coalition
A number of resources have been developed to assist coalition members with soliciting support from your fellow owners and suppliers. There are approximately 2,400 independent owners in the California so we have a long way to go to get other to join. The resources available to assist you in reaching out include:
- Donation request letter and contribution form link on the website.
- Request for support from allied pharmacy groups (suppliers, etc), linked here.
- Script for assisting you in making the phone call to ask for support, linked here.
- Information for fellow owners to provide a legal declaration for the clawback lawsuit, linked here.
If there are additional resources that you need to assist you in asking others to join the coalition efforts, please do not hesitate to contact us at
nchiappe@cpha.com and we will get those out to you.
Telling Your Story
Part of the public relations efforts to outline the negative impacts that PBMs have one the viability of community pharmacies. One strategy is to provide a video testimonial that will be used in advocacy and media outreach efforts. If you are willing to share your story, please email Nick Chiappe at
nchiappe@cpha.com and we will add you name to the list of interview candidates.
