NACDS submitted a statement to the House Committee on Energy and Commerce’s Subcommittee on Health in advance of a hearing today expressing concerns with some proposals in the FY2016 Health and Human Services Budget. The hearing featured testimony from HHS Secretary Sylvia M. Burwell.
In the statement, NACDS underscored the proven effectiveness of the services pharmacists provide, but noted that pharmacists are still not recognized as providers by third party payors. NACDS urged the implementation of budget proposals which would allow all healthcare providers—including retail pharmacists—to practice to their maximum capabilities, within the scope of state laws.
HHS has proposed excluding brand and authorized generic drugs from the calculation of average manufacture price (AMP), and calculating Medicaid Federal Upper Limits (FULs) based only on generic drug prices, with the likely goal of decreasing Medicaid costs. NACDS stated that those exclusions might reduce access to prescription drugs and pharmacy services for Medicaid patients, which could actually increase overall healthcare expenditures.
NACDS urged the Centers for Medicare & Medicaid Services to follow the rulemaking process—consistent with congressional intent—to implement the Medicaid pharmacy provisions rather than pursuing policies that would further cut pharmacy reimbursement.
The FY2016 HHS Budget includes a proposal to limit Medicaid reimbursement of durable medical equipment (DME) to the rates paid by Medicare. NACDS cautioned that implementing a blanket proposal to reduce payment for Medicaid DME has the potential to disrupt access to DME, which could lead to poorer health outcomes.
Pointing to the documented role pharmacists have played in increasing medication adherence through pharmacist-provided medication therapy management (MTM), NACDS urged Congress to adopt policies that increase access to services like MTM, which improve the health outcomes of Medicare beneficiaries and reduce overall healthcare costs.
NACDS stated its ongoing commitment to working with policymakers on these critical healthcare issues.