Independent Link Tennessee Pharmacists Association May 7, 2019 www.tnpharm.org • [email protected] • 615.256.3023

PBM Reform, Privilege Tax, and Opioids: Pharmacy Advocacy Wins Big in 2019! The 2019 Tennessee General Assembly ad- ing many of our top legislative priorities pro-pharmacy state Senators and state journed last week, bringing an end to one while solidifying our voice and amplify- Representatives, all of whom stood in sup- of the most successful legislative sessions ing our presence at the State Capitol in port of pharmacists and fought for phar- for TPA and pharmacy in several years. Nashville. macy priorities during the 2019 legislative TPA brought an aggressive slate of legisla- TPA greatly appreciates the support session. Below is a summary of the most tive priorities in 2019 to support our mem- from our three pharmacist legislators, important pro-pharmacy and pro-patient bers and pharmacy practice. Thanks to our Speaker Pro Tempore , Sena- legislative wins for TPA and our members many member advocates and association tor , and Lieutenant Gover- in 2019. supporters, we were successful in achiev- nor Randy McNally, as well as our many

Pharmacists Exempted from Comprehensive Professional Privilege Tax PBM Reform Pharmacists will be EXEMPTED from paying the professional privilege tax beginning in Building upon TPA-supported legislation 2020 (YES...you read that right)! For several years, TPA has actively advocated to ex- enacted in 2018 requiring all PBMs op- empt pharmacists from the list of professionals who are required to pay the profession- erating in Tennessee to obtain a license al privilege tax (PPT). I want to specifi cally commend and thank each one of our mem- from the Tennessee Department of Com- bers for supporting TPA even when required to pay the $400 annual tax. It is because merce and Insurance (TDCI), TPA worked of members’ ongoing support and membership that we were successful in seeing this with state legislators to successfully enact priority through to the fi nish line! It is not a random occurrence, but rather the success legislation in 2019 which brings about sev- of a multi-year campaign. eral important reforms to PBM practices in Since 2016, TPA has worked with a coalition of professionals aff ected by the PPT to Tennessee. This legislation is a signifi cant collectively advocate for a repeal of this burdensome provider tax. In 2019, the Tennes- step in the right direction, and TPA will see General Assembly responded by exempting 15 professions, including pharmacists, continue to work to achieve meaningful from having to pay the PPT. The Tennessee General Assembly allocated funding to off - Pharmacy Benefi ts Manager (PBM) reform. set the tax and enacted House Bill 1262 and Senate Bill 398, which specifi cally exempts With strong support from pharmacy cham- pharmacists, along with 14 other professions, from paying the tax starting in 2020. TPA pion legislators Caucus Chairman Camer- greatly appreciates the work of Senator and Representative Andy Holt, as on Sexton and Senator Shane Reeves, and well as the many state legislators who have worked to remove pharmacists from this support from pharmacists and State Sena- tax over the years. The eff ort was supported by Senate Finance Chair , House tors Ferrell Haile and Lieutenant Governor Finance Chair Susan Lynn, Lieutenant Governor Randy McNally, House Speaker Glen Randy McNally, the Tennessee General As- Casada, and the members of the Tennessee General Assembly. sembly enacted House Bill 786 and Senate Please note that the new law applies to Professional Privilege Taxes due in 2020, so Bill 650. This important pro-pharmacy law pharmacists will still need to pay their privilege tax by June 1, 2019. However, starting now heads to the desk of Governor Bill Lee in 2020 and in subsequent years, pharmacists will NO LONGER be required to pay to be signed into law and will become ef- the professional privilege tax. fective on July 1, 2019. Specifi cally, this new law will provide Important Changes to TN Together Opioid Law enhanced contract and audit protections for pharmacies, a state ban on retroac- Based on member feedback and complaints received during the implementation phase tive, non-transparent fees charged by of Governor Haslam’s 2018 TN Together Opioid law, TPA worked to successfully enact PBMs, and added network and contracting legislative changes in 2019 to simplify the law’s pharmacy-specifi c provisions, including protections for our pharmacies and phar- a repeal of the mandate on partial fi lling of opioid prescriptions. macists here in Tennessee. We still have Public Chapter 124, championed by Caucus Chairman and Sena- some work to get done at the federal level tor Shane Reeves, makes needed changes to Governor Haslam’s TN Together Opioid to bring reform to PBM practices within law, which was enacted in 2018. TPA worked closely with bill sponsors, the Tennessee Medicare and other federally-protected Medical Association, Governor Lee’s administration, and the Tennessee Department of plans, but this Comprehensive PBM Re- Health to enact this important law to ease burdens on the pharmacy community and form law is a huge step forward for phar- our patients. macy in Tennessee. This year’s TN Together Opioid cleanup law became eff ective on April 9 upon sig- nature by Governor Bill Lee. Once Public Chapter 124 was published on April 12, TPA emailed a communication to members detailing the key changes in the TN Together MORE ON Opioid law and how the changes aff ect pharmacists. TPA members also have access to updated pharmacy resources refl ecting these changes, on the TPA Practice-Based PAGE 2 Resource Page on Opioid and Prescription Drug Abuse [tnpharm.org/opioid-resource].

THE INDEPENDENT LINK IS PUBLISHED BY THE TENNESSEE PHARMACISTS ASSOCIATION AND SPONSORED BY PHARMACY PLUS

Resources to support Independent Pharmacy May 7, 2019 Independent Link Page 2 Tennessee Pharmacists Association • www.tnpharm.org • [email protected] • 615.256.3023

Continued... State Funds a Consultant to Develop PBM Best Practices In addition to the successful passage of the Comprehensive PBM Reform law described on the previous page, the Tennessee General Assembly allocated $200,000 in state funds to direct the Tennessee Department of Commerce and Insurance (TDCI) to hire a consul- tant to develop best practices around state-licensed PBM practice. This initiative, led by Senator Ferrell Haile, Representative Bryan Terry, and our other pharmacy champion legislators, will be important in creating best practices around PBMs to ensure transpar- ency and oversight of PBMs operating in our state. Thanks to Our Association Members, Supporters, and Volunteers TPA is fortunate to have engaged mem- addition, TPA also formed a Legislative do to improve the lives of your patients. bers, supporters, and volunteers work- Advocacy Coalition supported by sever- With members’ ongoing support and en- ing hard for the success of TPA’s legislative al pro-pharmacy organizations to amplify gagement, TPA will continue to collectively advocacy eff orts. Association members our presence at the State Capitol. move pharmacy practice forward in Ten- are our our most important priority and I would also like to take this opportu- nessee! The success of TPA is the suc- primary source of information regarding nity to recognize and thank the TPA staff . cess of the entire pharmacy profession, daily pharmacy practice. Members’ grass- These individuals are a tremendous source and every TPA member should be com- roots advocacy, engagement, and support of knowledge, support, and strength for mended for their eff orts! made these legislative wins possible, and I me and the association, and I am very am extremely proud of the pharmacy pro- proud of our team. Dr. Lucy Adkins, Lisa Yours respectfully, fession for stepping up and speaking out! Hull, Brittany Jernigan, Shawna Lightfoot, Support from our PharmPAC donors and Julie Schuff man, as well as Dr. Bae- Micah Cost, PharmD, MS and PharmPAC Chair, Dr. Leslie Shepard, teena Black and Dr. Aaron Garst, work Executive Director is essential to our advocacy eff orts, and tirelessly to keep the wheels turning at members’ generous contributions are the association and provide support for One more thing: Support for pharmacy also vital to our profession’s current and our members, especially during the legis- practice only happens when our legislators future advocacy eff orts. Contributions to lative session. This year has been unique recognize the value in our profession and PharmPAC [tnpharm.org/pharmpac] have and challenging for us as we transition show support for our priorities. Pharmacy increased over the past few years, and into the new TPA offi ce. Our staff has suc- practice is stronger and more advanced in these contributions allow us to show sup- cessfully navigated uncharted waters and Tennessee because of our collective ad- port for our key pharmacy champion legis- worked remotely during this transition, vocacy eff orts and the support from our lators. and we are looking forward to hosting state legislators. I am asking that you send The TPA ad hoc Legislative and Reg- you in our new offi ce very soon! a note, text, or email, or place a call, to your ulatory Committee, chaired by Dr. Stacey Finally, I want to thank members for elected state Representative and state Grant, met weekly and provided support, the opportunity to serve in this position. Senator as soon as possible, to thank them input, and resources to facilitate member It is both an incredible honor and a tre- for their support for pharmacy. Please engagement on important pharmacy pri- mendous responsibility. I, as well as our continue to cultivate relationships with ority issues. TPA has a solid pharmacy lob- TPA staff , are grateful to represent mem- your elected offi cials throughout the year. bying team to amplify pharmacy’s voice at bers as the voice for the pharmacy pro- Solidifying your relationships with state the legislature and help pharmacy priori- fession, because we truly believe in the legislators will ensure their future support ties move forward at the State Capitol. In importance and value of the work you for pharmacy priorities. Thank you!

Three Things Every Pharmacist Should Do Today • Personally Thank Your State Legislators for Supporting Pharmacy • Invite Your State Legislators to Visit You at Your Pharmacy Practice Site • Cultivate Strong Relationship with Your State Legislators

Contact Information for Your State Legislators: capital.tn.gov/legislators

TPA Members: Watch Your Email for a Comprehensive Legislative Summary Coming Soon