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,QGHSHQGHQW Tennessee Pharmacists Association ZZZWQSKDUPRUJWSD#WQSKDUPRUJ /LQN March 25, 2019 CALL TO ACTION: PBM Reform Hearings TOMORROW, March 26 There are critically important times in a profession when and bring increased transparency within the prescription a massive response from the pharmacy community is drug delivery system. On Tuesday, March 26, the House needed in order to e΍ ect change. TODAY is one of those Insurance Committee is scheduled to hear House Bill times! 786, and the Senate Commerce and Labor Commit- tee is scheduled to hear Senate Bill 650. This legislative Over the past few years, the noise has increasingly grown initiative is critically important to increase prescription louder for prescription drug pricing reform in order to drug pricing transparency to the state and our patients bring down costs for patients. State and federal legisla- in order to drive down prescription drug costs, as well tors and regulators are seeking strategies to bring down as to level the playing ȴ eld between PBMs and pharma- costs for patients in meaningful ways. The rebate system cies. As introduced, this legislation establishes fair con- that has been allowed under our current health care sys- tracting and audit protections for pharmacies, prohibits tem has created opportunities for middlemen like phar- PBMs from utilizing retroactive, non-transparent fees at macy beneȴ ts managers (PBMs) to exert their massive the state level, and requires an audit of all state-funded inȵ uence and gain an incredibly large share of the proȴ t PBMs. This legislation is common-sense reform aimed on prescription drugs, regardless of the overall e΍ ect on at increasing prescription drug pricing transparency and patients and their drug costs. driving down costs for patients. This session, TPA has worked with Representative Cam- It’s time for the pharmacy community to RISE UP and eron Sexton, Senator Shane Reeves, Senator Ferrell Haile, TAKE ACTION! This is your personal call to action to Representative Bryan Terry, and other pharmacy cham- stand up and advocate on behalf of your patients and to pion legislators, to introduce several pieces of legislation share the importance and value of the pharmacy profes- which would provide support to the pharmacy profession sion with legislators. ACTION NEEDED NOW! • Email Key Committee Members: Send an email to the • Make Your Emails and Calls Personal! key committee members listed on the following page to 1. Utilize the attached Quick Guide to Advocating share your personal story and request their support for for Comprehensive Pharmacy Beneȴ ts Manager House Bill 786 and Senate Bill 650. Reform. • Call Key Committee Members: Make calls to the of- 2. Share your experience and explain why comprehen- ȴ ces of the legislators on the following page to voice sive PBM reform is needed. your support for House Bill 786 and Senate Bill 650. 3. Provide de-identiȴ ed examples of negative patient • Meet with Your Elected Oɝ cials: If the legislator be- outcomes caused by PBMs. low is in your district, invite them to meet you at your 4. Share examples of egregious pharmacy audits and pharmacy to educate them on the importance of House contracting issues. Bill 786 and Senate Bill 650. 5. Discuss the negative impact of retroactive fees (such • Show Up in Nashville on Tuesday, March 26! Legisla- as DIR fees) on your practice. tive committee hearings are open to the public. Come 6. Ask legislators to support pharmacists and patients down to the Cordell Hull Building (425 5th Avenue, by supporting and voting for HB 786 and SB 650. Nashville, TN, 37243) on Tuesday, March 26, to show legislators how important PBM reform is to your phar- Go to capitol.tn.gov/legislators to ȴ nd the contact macy practice. If you plan to attend, email a quick note information for your State Representative and State to [email protected] so we can provide you with Senator. additional information about your visit. CONTINUED... THE INDEPENDENT LINK IS PUBLISHED BY THE TENNESSEE PHARMACISTS ASSOCIATION AND SPONSORED BY PHARMACY PLUS Resources to support Independent Pharmacy 0DUFK ,QGHSHQGHQW/LQN 3DJH 7HQQHVVHH3KDUPDFLVWV$VVRFLDWLRQZZZWQSKDUPRUJWSD#WQSKDUPRUJ House Insurance Committee (Sponsor or Co-Sponsor) capitol.tn.gov/house/committees/ Tuesday, March 26, 2019, at 12:00 pm Central insurance.html Ron Travis (Chairman) Dayton [email protected] (615) 741-1450 Mark Hall (Vice-Chairman) Cleveland [email protected] (615) 741-1350 Scott Cepicky Culleoka [email protected] (615) 741-3005 Ron Gant Rossville [email protected] (615) 741-6890 Johnny Garrett Goodlettsville [email protected] (615) 741-3893 Timothy Hill Blountville [email protected] (615) 741-2050 Matthew Hill Jonesborough [email protected] (615) 741-2251 Jason Hodges Clarksville [email protected] (615) 741-2043 Darren Jernigan Old HIckory [email protected] (615) 741-6959 Justin La΍ ery Knoxville rep.justin.la΍ [email protected] (615) 741-4110 Larry Miller Memphis [email protected] (615) 741-4453 Dennis Powers Jacksboro [email protected] (615) 741-3335 Tim Rudd Murfreesboro [email protected] (615) 741-2804 Cameron Sexton Crossville [email protected] (615) 741-2343 Robin Smith Hixson [email protected] (615) 741-2548 Mike Sparks Smyrna [email protected] (615) 741-6829 Bryan Terry Murfreesboro [email protected] (615) 741-2180 Dwayne Thompson Cordova [email protected] (615) 741-1920 Jason Zachary Knoxville [email protected] (615) 741-2264 Senate Commerce and Labor Committee (Sponsor or Co-Sponsor) capitol.tn.gov/senate/committees/ Tuesday, March 26, 2019, at 1:00 pm Central comm-labor.html Paul Bailey (Chairman) Sparta [email protected] (615) 741-3978 Art Swann (1st Vice-Chair) Maryville [email protected] (615) 741-0981 Jon Lundberg (2nd Vice-Chair) Bristol [email protected] (615) 741-5761 Raumesh Akbari Memphis [email protected] (615) 741-1767 Dolores Gresham Somerville [email protected] (615) 741-2368 Jack Johnson Franklin [email protected] (615) 741-2495 Frank Niceley Strawberry Plains [email protected] (615) 741-2061 Steve Southerland Morristown [email protected] (615) 741-3851 Bo Watson Hixson [email protected] (615) 741-3227 SUPPORT: Pharmacy Contract and Audit Protections, Ban on Retroactive Fees, and Increased PBM Transparency TPA has worked with state legislators to introduce comprehen- cess dispensing, and dispensing outside of prescriber's or- sive PBM reform legislation that includes pharmacy contract ders. and audit protections, a ban on PBM use of retroactive fees, • Prohibits PBMs from charging retroactive fees (e.g., DIR fees) and increased PBM transparency. to pharmacists or pharmacies at the state level. • Prohibits PBMs from using contractual language to require a Legislation: pharmacist to dispense a drug or product to a patient. • Senate Bill 650 [bit.ly/2MrKgVw] by Reeves, Haile, Swann, • Establishes notiȴ cation requirements for PBMs regarding a Yager pharmacy's network status. • House Bill 786 [bit.ly/2HEm8yg] by Sexton C, Terry, Powers, • Establishes prohibitions on PBMs from notifying patients Sparks until the pharmacy has received notiȴ cation of removal. Summary: As introduced, makes various changes to law con- • Requires PBMs to disclose any material change to contracts cerning pharmacy beneȴ ts managers; requires the comptroller to a pharmacy or pharmacist in its network at least thirty of the treasury to perform an annual audit of all pharmacy ben- (30) days before the e΍ ective date of the change. eȴ ts managers providing services funded by the state. • Requires the state Comptroller's oɝ ce to perform an audit of all state-funded PBMs and report audit results to certain Here's how this legislation would a΍ ect the pharmacy pro- legislative committees. fession: • Establishes certain contract standards and prohibitions • Strengthens audit protections regarding pharmacy's right to between PBMs and pharmacies. amend claims prior to recoupment. • Establishes that PBMs shall not reimburse a pharmacy or • Prohibits PBMs from recouping the cost of the drug or dis- pharmacist less than it would reimburse itself or an aɝ liate pensed product through audit, except in cases of fraud, ex- for providing the same drug or dispensed product. HB 786 and SB 650: A Quick Guide To Advocating For Comprehensive Pharmacy Benefits Manager Reform Explain Who Pharmacy Benefits Managers Are And What They Role They Play: • Pharmacy Benefit Managers (PBMs) are companies that contract with health plans to assist them with processing prescription drug claims, managing a plan’s prescription drug benefit programs, and also offer additional consultative services. • The three biggest PBMs are Express Scripts (now a part of Cigna), CVS Health (now a part of Aetna), and OptumRx (now a part of UnitedHealthcare). • PBMs administer drug plans to more than 266 million Americans. • They act as a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicaid, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. Discuss Why PBMs Are Facing Increased Scrutiny: • Historically, PBMs have operated in the shadows of the pharmaceutical supply chain. • However, due to the rising costs of drug prices, the public, media, and lawmakers both at the State and Federal level are finally looking more closely at the role that PBMs play in the prescription drug market and their business practices. • “FDA Commissioner, Scott Gottlieb, recently told CNBC the reason drug prices remain high is due to the “wacky” rebate system.
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  • 1 2016 U.S. Political Contribution and Expenditure Policy and Statement

    1 2016 U.S. Political Contribution and Expenditure Policy and Statement

    2016 U.S. Political Contribution and Expenditure Policy and Statement The Company’s policy is to participate in public policymaking by informing government officials about our positions on issues significant to the Company and our customers. These issues are discussed in the context of existing and proposed laws, legislation, regulations, and policy initiatives, and include, for example, Internet commerce, sales tax, intellectual property rights, trade, data privacy, and web services. Relatedly, the Company constructively and responsibly participates in the U.S. political process. The goal of the Company’s political contributions and expenditures is to promote the interests of the Company and our customers, and the Company makes such decisions in accordance with the processes described in this political contribution and expenditure policy and statement, without regard to the personal political preferences of the Company’s directors, officers, or employees. Approval Process The Company’s Vice President of Public Policy reviews and approves each political contribution and expenditure made with Company funds or resources to, or in support of, any political candidate, political campaign, political party, political committee, or public official in any country, or to any other organization for use in making political expenditures, to ensure that it is lawful and consistent with the Company’s business objectives and public policy priorities. The Company’s Senior Vice President for Corporate Affairs and the Senior Vice President and General Counsel review all political expenditures. In addition, the Audit Committee of the Board of Directors annually reviews this political contribution and expenditure policy and statement and a report on all of the Company’s political contributions and expenditures, including any contributions made to trade associations or 501(c)(4) social welfare organizations.