Now What?

Dear Colleague,

"Take a deep breath." That's the best advice coming out of the capital this week about the fate of health care reform legislation. Close behind is, "Don't believe any predictions until you've taken that deep breath—or three."

Republican Scott Brown's upset win in Massachusetts Tuesday for the Senate seat held by Edward Kennedy for 47 years ends the Democrat's 60-vote supermajority—the number needed to halt a filibuster. Right now, congressional Democrats and President Obama are weighing their options.

To get around the filibuster hurdle, the House could just accept word-for-word the bill that passed the Senate in December 60-39 on a party line vote. From NCPA's perspective, that could be described as "a half a loaf is better than none." It would provide a Medicaid generic drug reimbursement formula that sets the FUL at 175% of a weighted AMP and includes an exemption from the Medicare Part B accreditation requirements for pharmacies that get no more than 5% of total prescription sales from DME, such as diabetes testing supplies.

The PBM transparency requirements in the Senate bill could be strengthened by combining them with those from the House-passed version as would the MTM provisions. Ratifying the Senate plan also would preclude House-Senate negotiations to increase the 175% AMP multiplier. Just last week we held a conference call for reporters with two community pharmacy stalwarts, Reps. Marion Berry (D-Ark.) and Jerry Moran (R-Kan.), who said they were working with the negotiators to get the figure closer to 300%.

One big question is would, or could, the House swallow the Senate version whole even with the promise of separately enacting remedies to fix the parts it doesn't like? (There are some observers who doubt, given the near panic mode gripping a sizeable number of Democratic lawmakers here, that the House today could even pass its own health care reform bill that squeaked through 220-215 last November.)

There also is talk of a scaled-down version with less coverage and cost, breaking the package into individual bills, or going back to the drawing board entirely.

So where does that leave NCPA? To say we're "closely monitoring the situation" wouldn't do justice to what our government affairs team is doing and what we have accomplished in this past year.

We know that community pharmacists are critical component of the health care team and have the vast potential to improve care and reduce costs. That has been and will continue to be our message. We will continue to advocate for those provisions that we have fought to have included in the bills and also to produce desirable outcomes for those provisions, such as the LTC "short cycle" provision, that could be helpful or detrimental depending on how they are implemented.

We're in this fight for the long haul, and it certainly looks like that's what it will be.

Another long-haul prospect is the tragedy in Haiti. In e-News Weekly next Tuesday, we're going to have some first-person accounts and pictures from an NCPA member who deployed to Port au Prince with a U.S. emergency medical response team. I'm sure many of you would like to help and we'll include information about National Pharmacy Response Teams that can be activated for service to cope with medical catastrophes around the corner or the globe.

I know there are many worthy charities funneling aid to Haiti, and I'm not trying to play favorites, but the situation is so dire, I'd like you to consider right now making an instant contribution via your cell phone. You can make a $10 one to the Red Cross by texting the word "Haiti" to 90999, which automatically adds a $10 pledge to your bill.

Regards,

Bruce Roberts, R.Ph.

Executive Vice President & CEO