The Top Six Ways Trump’s Policies Will Impact Pharmacies
We're still within the first 100 days of a new administration. What is happening, and what can you expect?
1. Affordable Care Act reform
One of the issues that will demand “substantial effort” this year include advocating for appropriate reimbursement amid potential changes to the Affordable Care Act (ACA), Steven C. Anderson, president and CEO of the National Association of Chain Drug Stores (NACDS), wrote in a recent blog post. The National Community Pharmacists Association (NCPA) is primarily concerned about how ACA changes will affect Medicaid reimbursements. “We believe that prescription drug coverage must remain an essential benefit, and that large pharmacy networks, which include independent community pharmacies, should be maintained,” NCPA CEO B. Douglas Hoey, RPh, told Drug Topics.
“It’s also important that specific ACA provisions, such as continuing the progress made in improving Medicare Part D medication therapy management (MTM) programs; annual comprehensive medication reviews; efforts to further integrate pharmacists into the health care delivery system; and most importantly, pharmacy benefit manager (PBM) transparency requirement be kept.” Changes to Medicaid should keep the average manufacturer price (AMP) formula that is currently used to determine Medicaid reimbursements, Hoey added.
In addition, “robust oversight of managed care organizations is needed, including state inspection and audits of PBMs that administer the drug benefi t. If Medicaid is block- granted to the states, then we will also turn our attention to governors, who will have a much larger role in determining how the program is administered.” Mandatory mail order pharmacy requirements should also be prohibited in new ACA language pertaining to Medicaid, Hoey said.