Last year, six more states passed laws aligned with ASHP’s model legislation that prohibits insurers and pharmacy benefit managers (PBMs) from selectively reducing reimbursement to 340B covered entities. That brings the total number of states with such laws to 28.

We also made progress at the federal level. The House of Representatives introduced the ASHP-supported PROTECT 340B Act (H.R. 2534), bipartisan legislation prohibiting insurers and PBMs from discriminating against hospitals and health systems participating in the 340B program.

Pharmacist Recognition
Several states passed legislation this past year requiring health plans to reimburse pharmacists for providing covered services to patients, including Virginia, Maryland, Wyoming, North Dakota, and California. Today, 19 states have some version of provider status that requires commercial insurance, Medicaid, or both to reimburse pharmacists for providing any covered service within their scope of practice. Congratulations to all of ASHP’s state affiliates who advanced these substantial pieces of legislation.

ASHP also published model state legislation establishing payment for comprehensive medication management (CMM) services from pharmacists. ASHP’s CMM legislation is modeled on a North Dakota law and is intended to assist state advocacy efforts seeking to ensure clinical pharmacists are reimbursed for their contributions to team-based chronic care management.

In July, Delaware passed Senate Bill 165, authorizing pharmacists to enter collaborative practice agreements with other practitioners. With the enactment of this latest bill, all 50 states now permit collaborative pharmacy practice.

At the federal level, ASHP continues to advocate for the passage of the Equitable Community Access to Pharmacist Services Act (H.R. 1770/S. 2477) and the Pharmacy and Medically Underserved Areas Enhancement Act (S. 1491), both of which would ensure patient access to essential pharmacist services for seniors, rural, and other underserved populations.

Drug Shortages
ASHP continued to lead robust advocacy efforts to curb drug shortages, including testifying before the House Energy and Commerce Committee and joining a White House-sponsored roundtable discussion on the national shortages in key cancer medications. ASHP also released new policy solutions to address the drug shortage crisis that we will continue to advance in the year ahead.

Opioid Use Disorder Treatment
Following ASHP’s persistent advocacy efforts, the Biden administration announced the elimination of the X-waiver, a federal barrier to pharmacist prescribing of medications for opioid use disorder (MOUD). In a letter sent to President Biden, I urged the administration to take immediate action to utilize pharmacists as clinical care providers to help address our nation’s opioid epidemic.

At the state level, ASHP released model legislation and a model protocol enabling pharmacists to prescribe MOUDs and met with Drug Enforcement Administration (DEA) officials, clinicians, and representatives of medical and pharmacy groups to discuss access barriers to treatment with MOUDs. Eleven states now allow pharmacists to register with the DEA as controlled substance prescribers and issue prescriptions for MOUD under state scope of practice laws.

Payer-Mandated White Bagging
Six states enacted laws in 2023 to restrict or prohibit payer-mandated white bagging and brown bagging in line with ASHP’s key elements of white bagging policy. Since ASHP launched this effort in 2021, 32 states have introduced legislation to restrict or prohibit payer-mandated white bagging practices, and 13 states have enacted laws to curtail payer-mandated white bagging and/or brown bagging.

Pharmacy Residency Funding
I personally spoke with Department of Health and Human Services Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure at the White House about the ongoing alarming threats to pharmacy residency program funding. At ASHP’s urging, several members of Congress requested clarification from CMS on pharmacy residency requirements and advocated against funding clawbacks until CMS provides further guidance. This will continue to be an ASHP priority until CMS provides clear guidance.

Site-Neutral Payment
ASHP partnered with the American Hospital Association to advocate against harmful site-neutral payments for drug administration in hospitals. Our widely circulated infographic identifies how this policy threatens patient safety.

Thank you to all our ASHP members who have helped advocate for patients and the pharmacy profession, including participating in ASHP’s annual Legislative Day, where nearly 120 members visited more than 110 offices on Capitol Hill to build support for many of these critical advocacy priorities.

While we have made significant progress this past year, we have much more work to do. In 2024, ASHP will continue to advocate for these important issues and further accelerate our advocacy supporting the needs of the pharmacy technician workforce with the recent launch of The Pharmacy Technician Society^SM. We invite you to learn more about ASHP’s expanded 2024 advocacy agenda, including our efforts to support residency programs, enable technician final product verification, and protect 340B contract pharmacy relationships.

Thank you for all you do for your patients and our profession.

Sincerely,

Paul

Posted on January 11, 2024