2020 Tablet

Executive Order 13890, signed by President Donald Trump to “protect and improve the Medicare program,” can only succeed if Medicare beneficiaries have access across the care continuum, including community pharmacies, NACDS has told the Centers for Medicare & Medicaid Services (CMS).

In comments to CMS related to Executive Order 13890, NACDS President & CEO Steven C. Anderson wrote, “The transformation of healthcare in the United States must extend to all facets of the care continuum. NACDS strongly supports this shift; yet, the transformation must include community pharmacy to secure more value, drive innovation and patient outcomes, and accomplish cost-effectiveness. We further support the goal of strengthening the Medicare program by improving Medicare beneficiaries’ access to community-based care, which clearly includes pharmacies as healthcare destinations.”

NACDS’ authoritative comments responded to CMS’ request for input and recommendations “regarding elimination of specific Medicare regulations that require more stringent supervision than existing state scope of practice laws, or that limit health professionals from practicing at the top of their license.”

CMS’ request related directly to Executive Order 13890, Protecting and Improving Medicare for Our Nation’s Seniors, which establishes policy “to protect and improve the Medicare program by enhancing its fiscal sustainability through alternative payment methodologies that link payment to value, increase choice, and lower regulatory burdens imposed upon providers.”

NACDS explained, “In order for the Administration to meet its laudable goals on choice, competition, access, and quality outlined in [Executive Order 13890], and the goals and objectives of the November 2018 ‘Reforming America’s Healthcare System Through Choice and Competition Report,’ we proffer that CMS should: (1) modernize Medicare policies to remove needless and unwarranted barriers with respect to the coverage and payment of pharmacy care services, and (2) take the following proactive initiatives for the benefits of Medicare beneficiaries of Medicare beneficiaries and taxpayers:

  • Recognize pharmacists as providers and suppliers across the Medicare program and in value-based payment programs
  • Require real-time benefit tool integration with pharmacy systems and authorize pharmacists to act on opportunities to initiate cost-effective alternatives
  • Establish pharmacy care incentive programs and standardized quality metrics
  • Allow pharmacist-initiated electronic prior authorization
  • Support coverage and payment for pharmacy-based telehealth services
  • Implement, expand, and clarify general supervision rules for ‘incident-to’ billing
  • Allow pharmacists to help treat patients with opioid use disorder.”

NACDS’ comments went on to validate its case with extensive and thoroughly referenced research.

Discussing NACDS’ submission of comments to CMS on this matter, Anderson noted, “The document that NACDS put together stands as an undeniable pro-patient and pro-pharmacy treatise. These comments touch aspects of all four NACDS campaigns on our priority issues, including preserving pharmacy access through fair reimbursement; enhancing patients’ access to pharmacy services beyond dispensing; reforming direct and indirect remuneration (DIR) fees; and serving as part of the opioid-abuse solution.”

More information is available on NACDS’ Access Agenda microsite.