September 16, 2016 Pharmacists Mobilize Support for Federal Bills to Boost Medicare Transparency & Ban Retroactive "DIR Fees" There is broad, bi-partisan alarm in Congress and from Medicare officials over DIR fees. To date 18 U.S. Senators and 30 U.S. Representatives have written to CMS to urge the agency to implement proposed guidelines to address pharmacy price concessions such as DIR fees.

Reps. Griffith (R-VA), Welch (D-VT), Barletta (R-Pa), Blum (R-IA), Carter (R-GA), Crawford (R-AR), Jones (R- NC), Rodgers (R-WA), and Sessions (R-TX) on 9/8/2016 introduced H.R. 5951 "Improving Transparency and Accuracy in Medicare Part D Spending Act". The legislation would address what has become a top concern for independent community pharmacy owners: huge clawbacks assessed by Medicare drug plans, or their intermediaries, pharmacy benefit manager (PBM) corporations, long after prescriptions are filled. These fees are often labeled direct and indirect remuneration, or DIR fees. H.R. 5951 would prohibit the imposition of such fees after pharmacies fill prescriptions.

A similar bill in the Senate has been introduced by Sen. Moore (R-WV) and co-sponsors to date are Senators Tester (D-MT), Boozman (R-AR) and Cotton (R-AR).

Call to Action: NC pharmacists please contact your Congressmen to support H.R. 5951 and S.3308.

Update as of 9/23/2016 5:00 pm: Only Rep. Walter Jones (R-NC, 3rd District) has signed on to co-sponsor H.R. 5951. Pharmacists from NC District 3, please write Rep. Jones to thank him for signing on in support of H.R. 5951. All other pharmacists from all other districts please contact your representative. Currently, neither Senator Burr nor Tillis have signed on to S. 3308.

Links to information about these bills: Improving Transparency and Accuracy in Medicare Part D Spending Act H.R. 5951 S. 3308

August, 2016 NASPA forwarded information to all state pharmacy associations from the Patient Access to Pharmacists' Care Coalition stating that now is the critical time for pharmacists to push for a vote on H.R. 592/S. 314 Pharmacy & Medically Underserved Areas Enhancement Act (often referred to as provider status bill).

This is your chance as a pharmacist to allow your voice to be heard, and it's time for our profession to speak loudly. We have work to do on this piece of legislation here in North Carolina. As of this morning, 3 of our 13 representatives and both of our senators had still not signed on as co-sponsors of this important bill. Click the following link to take you to the NCAP Advocacy webpage where you will find: a) a map of the 13 congressional districts in NC b) a list of the NC members of the U.S. House of Representatives and their status regarding H.R. 592- -use this document to see if your representative has signed on as a co- sponsor c) a sample RPh grassroots letter that you can use/edit to write your representative (if they are not a co-sponsor yet) and both NC Senators (Burr/Tillis) d) a sample RPh grassroots letter thanking your representative if he/she is a co- sponsor already e) a sample Patient grassroots letter that you can have patients write their representative f) a link to govtrack.us/congress/members for easy access to contact your legislators (site enables email communication with congressional members)

PLEASE take about 30 minutes of your time to make a difference in the lifetime of your profession.