NACDS hosted the 2014 State Government Affairs Seminar in Kansas City, Mo. last week for chain pharmacy executives representing all 50 states and the District of Columbia. CEO Issue Update caught up with NACDS Vice President of State Government Affairs Sandra Guckian for a recap of key points from the member-driven meeting, which focused on Medicaid reimbursement; interchangeable biosimilars; pharmacist scope-of-practice; and drug take-back programs.

NACDS member companies delivered the majority of the presentations, with Tim Weippert, R.Ph., executive vice president of pharmacy for Thrifty White Pharmacy and NACDS Policy Council chair, delivering the opening industry overview.

Guckian said Medicaid reimbursement remains a “number-one issue” for members. Discussion centered on member concerns about the timing of the Centers for Medicare & Medicaid Services’ release of the final Medicaid covered outpatient drug rule, which could happen as early as spring 2015, and the finalization of the average manufacturer price (AMP)-based federal upper limits (FULs). NACDS has been advocating for a one-year implementation period as many states will need legislation and/or regulation to implement new reimbursement methodologies. Members directed NACDS to continue to educate state legislators and Medicaid officials about the potential impact of the new reimbursement policies and the need for cost of dispensing studies to determine fair and accurate reimbursement for both product and dispensing fees.

Members expressed ongoing commitment to expanding scope-of-practice laws for pharmacists, with a focus on allowing pharmacists to administer the full Centers for Disease Control and Prevention’s schedule of vaccinations for adults and for adolescents, ages 7–18. They also want to continue to advocate for medication therapy management programs in Medicaid and state employee health plans and authority for pharmacists to provide CLIA-waived tests.

Following the recent issuance of the Drug Enforcement Administration’s Final Rule on Disposal of Controlled Substances, there has been concern that some states could mandate that pharmacies take back medications, including controlled substances. NACDS will work to keep take back programs voluntary.

The issue surrounding interchangeable biosimilars, Guckian said, is that most states have generic substitution laws that, as written today, would not accommodate the substitute of interchangeable biosimilars, so most of those state laws need to be changed, which pharmacies and manufactures agree needs to be done. There is, however, disagreement between manufacturers and pharmacy stakeholders because a coalition of manufacturers would like to require pharmacists to notify physicians of the product dispensed when they have substituted with an interchangeable biosimilar.