June

15, 2

019

San

Ant

onio

, Tex

as

Mic

hael

Wri

ght,

Exec

utiv

e D

irec

tor

512-

992-

1219

mw

righ

t@tx

rxco

unci

l.org

2019

Leg

isla

tive

Upd

ate

ACPE

# 0

130-

9999

-18-

153-

L03-

P&T

Conf

lict o

f Int

eres

t: N

one

At th

e co

mpl

etio

n of

this

activ

ity, t

he p

artic

ipan

t will

be

able

:•

Des

crib

e m

ajor

bill

s tha

t pas

sed

in th

e 20

19 Te

xas s

essio

n &

thei

r im

pact

on

phar

mac

y;•

Desc

ribe

maj

or b

ills t

hat p

asse

d in

the

2019

NM

sess

ion

& th

eir i

mpa

ct o

n ph

arm

acy;

• Id

entif

y on

goin

g iss

ues,

chal

leng

es &

prio

ritie

s for

com

mun

ity p

harm

acy

acro

ss th

e na

tion;

• Id

entif

y m

ajor

bill

s bef

ore

Cong

ress

that

wou

ld im

pact

com

mun

ity

phar

mac

y; a

nd•

Disc

uss t

he im

pact

of C

MS’

pro

pose

d PB

M sa

fe-h

arbo

r rul

e on

Med

icare

D

bene

fits &

pay

men

ts.

The

Lead

ing

Texa

s A

dvoc

ate

for I

ndep

ende

nt P

harm

acy

Texa

s Pha

rmac

y Bu

sine

ss C

ounc

il is

the

high

ly s

ucce

ssfu

l adv

ocac

y ar

m o

f Am

eric

an P

harm

acie

s. It

was

uni

que

in th

e U

.S. a

s the

firs

t ful

l-tim

e, se

para

te

advo

cacy

org

aniz

atio

n fo

r a b

uyin

g gr

oup.

TPBC

Boa

rd o

f Dir

ecto

rs

Chai

rman

Bruc

e Ro

gers

, R.P

h., V

icto

ria

Vice

Cha

irAl

ton

Kana

k, R

.Ph.

, Hou

ston

Secr

etar

y/Tr

easu

rer

Dou

g Ea

kman

, R.P

h.,

San

Ange

lo

Dir

ecto

rsLy

nn E

vere

tt, R

.Ph.

, Wac

oBe

n M

cNab

b, P

harm

.D.,

East

land

Bill

Moo

re, R

.Ph.

, Sin

ton

Joe

Och

oa, R

.Ph.

, Edi

nbur

g

TPBC

Leg

isla

tive

Team

Exec

utiv

e D

irec

tor:

Mic

hael

Wrig

ht

Att

orne

y:

Com

mun

icat

ions

:M

igue

l Rod

rigue

zCh

uck

Wat

ers

Cons

ulta

nts:

Step

hani

e G

ibso

nD

enis

e Ro

seJe

rry

Vald

ezG

regg

Kna

upe

We’

re F

ight

ing

for A

ll of

You

!

TPBC

wor

ks to

ad

vanc

e an

d de

fend

the

inte

rest

s of

all

inde

pend

ent

phar

mac

ists

, not

ju

st m

embe

rsof

APR

x.

TPBC

Gui

ding

Pri

ncip

les

Focu

s on

Ach

ieva

ble

Goa

ls Y

ou C

an B

uild

on.

Take

a L

ong-

term

Vie

w: A

llian

ces

& F

ound

atio

ns B

uilt

Toda

y Re

ap F

utur

e Co

oper

atio

n &

Suc

cess

.A

lway

s Be

Will

ing

to D

iscu

ss &

Neg

otia

te D

iffer

ence

s.

Alw

ays

Hon

or Y

our C

omm

itmen

ts.

Cred

it Th

ose

Who

Hel

p –

and

Expe

ct C

redi

t for

You

r Hel

p.Ad

voca

te th

e Va

lue

of Y

our O

wn

Obj

ectiv

es &

Eff

orts

Ra

ther

Tha

n At

tack

ing

Oth

ers.

We

Are

the

Advo

cacy

Lea

der f

or T

exas

Inde

pend

ents

. O

ur B

oard

& O

ur M

embe

rs E

xpec

t Us

to L

ead.

New

Mex

ico

Legi

slat

ive

Upd

ate

Pres

ente

r:D

anny

Cro

ss, R

.Ph.

Vice

Cha

irN

ew M

exic

o Ph

arm

acy

Busi

ness

Cou

ncil

Boar

dO

wne

rSo

uthw

est P

harm

acy,

Ad

vanc

ed M

edic

atio

n In

Car

lsba

d, N

M

NM

Pha

rmac

y Bu

sine

ss C

ounc

il

Form

ed in

Dec

embe

r 201

5.Li

ke T

PBC,

is a

n in

depe

nden

t sub

sidia

ry fu

nded

100

% b

y Am

eric

an P

harm

acie

s.Go

vern

ed b

y 5-

Mem

ber B

oard

.Ex

ecut

ive

Dire

ctor

: Mich

ael W

right

Has c

ontr

act l

obby

ist in

San

ta F

e.

New

Mex

ico

Boar

d

Chai

rman

Ashl

ey S

eyfa

rth,

Pha

rm.D

.Bl

oom

field

, NM

Vice

Cha

irD

anny

Cro

ss, R

.Ph.

Carls

bad,

NM

Se

cret

ary-

Trea

sure

rD

avid

Lan

sfor

d, R

.Ph.

Clov

is, N

M

Dir

ecto

rs

Nea

l Dun

gan,

R.P

h.Ca

rlsba

d, N

M

Har

vey

McC

rosk

ey, R

.Ph.

Ret

. Sa

nta

Fe, N

M

Exec

utiv

e D

irec

tor

M

icha

el W

right

Au

stin

, TX

Lobb

yist

Min

da M

cGon

agle

Al

buqu

erqu

e, N

M

2019

New

Mex

ico

PBM

Ref

orm

Hard

Foug

ht a

nd H

ard

Won

Two

gam

e-ch

angi

ng la

ws

pass

ed w

ith fu

ll su

ppor

t of L

egis

latu

re &

G

over

nor

PBM

Reg

ulat

ory

Act R

efor

ms

Phar

mac

y Au

dit R

efor

ms

Initi

al in

crea

se in

dis

pens

ing

fee

from

NM

Hum

an S

ervi

ces

Dep

artm

ent f

or M

edic

aid

Man

aged

Car

e

Gro

w O

ur F

ootp

rint

Le

ad c

olla

bora

tion

with

in th

e N

M in

depe

nden

t pha

rmac

y co

mm

unity

Stre

ngth

en in

vest

men

t in

NM

Inde

pend

ent P

harm

acy

PAC

New

Mex

ico

Legi

slat

ive

Vict

ory

2019

New

Mex

ico

Phar

mac

ists

Ass

ocia

tion

NM

PhA

Inde

pend

ent C

omm

unity

Pha

rmac

y M

embe

rsN

ew M

exic

o O

ffic

e of

the

Supe

rinte

nden

t of I

nsur

ance

Nat

iona

l Com

mun

ity P

harm

acis

ts A

ssoc

iatio

nAm

eric

an P

harm

acie

s fo

r fun

ding

NM

PBC

TPBC

for p

rovi

ding

gui

danc

e &

sup

port

Spec

ial T

hank

s to

:M

icha

el W

right

for l

eade

rshi

pM

igue

l Rod

rigue

z fo

r leg

al s

uppo

rt

Chuc

k W

ater

s fo

r leg

isla

tive

cam

paig

n &

mat

eria

ls s

uppo

rtJe

nnife

r Ols

en fo

r PAC

& a

dmin

istr

ativ

e su

ppor

t

Now

thro

ugh

2020

MA

INTA

IN O

UR

MO

MEN

TUM

Cont

inue

edu

catin

g st

ate

leve

l pol

icym

aker

s on

the

cons

eque

nces

of P

BM p

rofit

eerin

g an

d ex

ploi

tatio

n of

pow

er

Prov

ide

polic

y &

lobb

ying

lead

ersh

ip o

n be

half

of In

depe

nden

t Ph

arm

acy

Supp

ort N

MPh

Aon

clin

ical

ser

vice

s re

imbu

rsem

ent l

egis

latio

nCo

ntin

ue e

mph

asis

of P

BM o

vers

ight

thro

ugh

regu

lato

ry

effo

rts

by O

ffic

e of

the

Supe

rinte

nden

t of I

nsur

ance

(O

SI)

Advo

cate

for i

ncre

ased

bud

get s

uppo

rt fo

r OSI

’s P

BM te

amFo

cus

on H

uman

Ser

vice

s D

ept.

(Med

icai

d) d

ispe

nsin

g fe

eBe

on

guar

d ag

ains

t PBM

man

euve

rs to

circ

umve

nt c

ompl

ianc

e

New

Mex

ico

Legi

slat

ure

2021

MAI

NTA

ININ

G TR

AJEC

TORY

Mic

higa

n &

Ten

ness

ee

Gran

t Bro

wn

John

Gro

ss

Mic

ah C

ost

Your

Edu

catio

n &

Lic

ensi

ng

Requ

irem

ents

How

You

Buy

, Sto

re &

Dis

pens

e Pr

oduc

ts Y

ou S

ell

The

Stor

es Y

ou O

wn

and

Wor

k in

Why

You

Mus

t Eng

age!

Yo

ur P

rofe

ssio

n &

Bus

ines

s Ar

e H

ighl

y Re

gula

ted:

The

Patie

nt R

ecor

ds Y

ou K

eep

How

You

Get

Pai

d; H

ow M

uch

You

Get

Pai

dW

hat Y

ou C

an o

r Can

not D

o as

a H

ealt

h-ca

re P

rofe

ssio

nal

― N

ow o

r in

the

Futu

re

Joe

Och

oaTP

BC A

dvoc

acy

Hon

oree

(Abo

ve) J

oe O

choa

with

U.S

. Rep

. Vi

cent

e Go

nzal

ez in

Was

hing

ton;

(R

) with

Sta

te S

en. J

uan

Hino

josa

Test

ified

on

HB

1905

.

Num

erou

s ca

lls to

legi

s-la

tors

durin

g se

ssio

n to

su

ppor

t TPB

C po

sitio

ns.

Met

with

U.S

. Rep

. Vi

cent

e G

onza

lez

in

Was

hing

ton

and

pers

uade

d hi

m to

sig

n on

as

co-s

pons

or o

f 5

phar

mac

y bi

lls!

TPBC

Boa

rd M

embe

r

PAC

Don

or

John

Hic

kman

TPBC

Adv

ocac

y H

onor

ee

(L) J

ohn

Hick

man

with

U.S

. Rep

. Van

Tay

lor i

n W

ashi

ng-

ton;

(R) w

ith S

tate

Sen

. Pat

Fal

lon

Test

ified

twic

eon

TP

BC’s

HB

2817

and

H

B 14

55.

Mad

e nu

mer

ous

calls

to

legi

slat

ors

durin

g se

ssio

n to

sup

port

TP

BC p

ositi

ons.

Part

icip

ated

in N

CPA’

s Ap

ril C

ongr

essi

onal

Fly

-In

—ha

d m

ultip

le v

isits

. PA

C D

onor

John

is a

repe

at

win

ner o

f TPB

C’s

Advo

cacy

Aw

ard

Cons

erva

tive

Cont

rol

= Gr

eate

r Fis

cal F

ocus

+

Less

Gov

ernm

ent S

pend

ing

+ No

New

Tax

es

+ 20

18 E

lect

ion:

2 D

Sen

ator

s12

D H

ouse

Less

Gov

ernm

ent S

pend

ing

= Li

mite

d Fu

nds f

or S

ocia

l Pro

gram

s=

Redu

ctio

ns in

Hea

lth C

are

=De

crea

sed

Paym

ents

to P

rovi

ders

The

Texa

s Le

gisl

atur

e

Prop

erty

Tax

Cap

Tax

Relie

f: P

rope

rty,

Sal

es, F

ranc

hise

Publ

ic S

choo

l Fun

ding

H

arve

yCh

ild &

Pro

tect

ive

Serv

ices

Gro

wth

of o

ver 3

0,00

0 ne

w T

exan

s pe

r mon

th

Maj

or S

tate

wid

e Is

sues

2019

Pha

rmac

y Pr

iori

ty Is

sues

PBM

Ove

rsig

ht:

Med

icai

d/Te

xas

Dep

t. of

PB

M O

vers

iP In

sura

nce

Opi

oids

s———

Mul

tiple

Bill

s: P

MP

Opi

oid

Os

Mul

tiple

Bill

s: P

MP

Mex

pans

ion,

pre

scrib

ing

rest

rictio

ns,

expa

nsio

n, p

rw

hole

sale

rsPh

ysic

ian

Dis

pens

ing

of A

esth

etic

Ph

ysic

ian

Dis

pens

iP D

rugs

/All

Dru

gs

gg

Tele

phar

mac

y Ex

pans

ion n

———Ca

rdin

alp

yp

Scop

e of

Pra

ctic

e

TPBC

201

9 Pr

iori

ty Is

sues

Phar

mac

y Be

nefit

Man

ager

sAu

dit R

efor

ms

Term

inat

ion

–N

etw

orks

Fees

Ove

rsig

ht/R

egis

trat

ion-

Texa

s D

epar

tmen

t of I

nsur

ance

TPBC

HB

1455

― A

udits

PBM

s ar

e pr

ohib

ited

from

aud

iting

pha

rmac

y cl

aim

s ad

min

iste

red

by a

noth

er h

ealth

pla

n or

PBM

.It

isno

t an

audi

t dis

crep

ancy

if N

DC

is fo

r a q

uant

ity th

at

is a

sub

-uni

t or m

ultip

le o

f pur

chas

ed d

rug

as re

flect

ed

on th

e in

voic

e.Th

e au

dite

d ph

arm

acy

clai

m re

flect

s th

e co

rrec

t qu

antit

y di

spen

sed.

Dis

pens

ed d

rug

shar

es a

ll bu

t the

last

2 d

igits

of t

he N

DC

show

n on

the

invo

ice.

Def

ines

all

allo

wab

le s

uppo

rtin

g ev

iden

ce.

TPBC

HB

1905

― T

erm

inat

ions

Due

-pro

cess

rem

edy

to te

rmin

atio

n w

ithou

t pro

per

revi

ew o

r fin

ding

.

Susp

ensi

ons

from

a n

etw

ork

over

alle

gatio

ns o

f fra

ud o

r m

alfe

asan

ce w

ould

be

trea

ted

sam

e as

oth

er re

ason

s,

with

righ

t to

revi

ew p

rior t

o pe

rman

ent s

uspe

nsio

n.

Writ

ten

notic

e &

righ

t to

revi

ew.

Fina

l det

erm

inat

ion

to re

sum

e or

term

inat

e w

ithin

3 d

ays

afte

r the

insu

rer r

ecei

ves

the

reco

mm

enda

tion

of th

e re

view

pan

el.

Sect

ions

of I

nsur

ance

law

cou

ld n

ot b

e w

aive

d,

term

inat

ed o

r nul

lifie

d by

con

trac

t.

TPBC

Hou

se B

ill 2

817 ―

Fees

PBM

s co

uld

not a

sses

s re

troa

ctiv

e fe

es a

gain

st a

pha

rmac

y ex

cept

as

a re

sult

of a

legi

timat

e au

dit o

utco

me.

Proh

ibits

sel

f-dea

ling

by p

ayin

g af

filia

te s

tore

s at

hig

her r

ate.

PBM

mus

t pro

vide

acc

ess

to fe

e sc

hedu

les

that

det

ail s

ervi

ces

& p

aym

ent a

mou

nts,

incl

udin

g m

etho

dolo

gy fo

r cal

cula

tions

.

PBM

may

not

pro

hibi

t a p

harm

acy

that

bel

ongs

to a

PSA

O

from

rece

ivin

g a

copy

of r

elev

ant c

ontr

act p

rovi

sion

s.

PBM

mus

t allo

w m

ail-o

rder

ser

vice

s to

pat

ient

s up

on re

ques

t.

PBM

may

not

requ

ire p

harm

acie

s to

mee

t acc

redi

tatio

n st

anda

rds

that

exc

eed

fede

ral &

sta

te s

tand

ards

to o

pera

te.

Prev

entio

n of

reta

liatio

n fo

r pha

rmac

ies

exer

cisi

ng th

eir r

ight

s un

der t

he p

rovi

sion

s of

this

bill

.

Texa

s PM

P Ch

ecks

& R

epor

ts

HB

3284

: Mov

es e

ffec

tive

date

for a

ll pr

escr

iber

s &

di

spen

sers

from

Sep

tem

ber 2

019

to M

arch

202

0 to

repo

rt

to P

MP

prio

r to

pres

crib

ing

& d

ispe

nsin

g.H

B 21

74:

Man

dato

ry E

-Pre

scrib

ing

of a

ll CI

I-CV’

s Ja

nuar

y 20

21. L

imits

pre

scrib

ing

for t

he in

itial

trea

tmen

t of a

cute

pa

in to

a 10

-day

sup

ply.

Eff

ectiv

e Se

ptem

ber 1

, 201

9.H

B 20

88:

TSBP

to a

dopt

rule

s on

loca

tions

whe

re s

afe

disp

osal

mig

ht o

ccur

.SB

683

: Pha

rmac

y th

at d

oes

not d

ispe

nse

Sche

dule

IIs

with

in 7

day

s m

ust r

epor

t tha

t to

TSBP

. Pre

scrib

ers

acce

ss

to p

resc

riber

dat

a by

thos

e de

lega

ted

by p

resc

riber

.

Phar

mac

y L

egis

latio

n Th

at P

asse

d

HB

3496

: M

anda

ted

sure

ty b

onds

& fi

nanc

ial d

iscl

osur

e.TS

BP to

con

duct

rule

mak

ing

with

pub

lic c

omm

ent p

erio

d.

HB

3441

: Pr

ohib

its h

ealth

pla

ns, P

BMs,

insu

rers

from

den

ying

re

imbu

rsem

ent t

o a

phar

mac

ist f

or p

rovi

ding

a s

ervi

ce th

at is

w

ithin

the

scop

e of

the

phar

mac

ist’s

lice

nse.

HB

1757

: Ad

ds “

phar

mac

ists

” to

the

list o

f rec

ogni

zed

prov

ider

s in

Tex

as In

sura

nce

Code

.

SB 6

70 –

Tele

med

icin

e. B

ill a

men

ded

to

allo

w te

leph

arm

acy

in a

ll Fe

dera

lly Q

ual-

ified

Hea

lth C

ente

rs (F

QH

Cs) –

74 in

TX.

HB

1325

–H

emp

Farm

ing

Act

: Jo

int

over

sigh

t by

TDA

& D

SHS.

Hem

p-de

rived

can

nabi

noid

s no

t con

side

red

cont

rolle

d su

bsta

nces

. Pro

duct

s in

tend

-ed

for c

onsu

mpt

ion

cons

ider

ed fo

ods.

H

emp-

deriv

ed it

ems

with

a m

axim

um

THC

conc

entr

atio

n of

0.3

% ar

e le

gal.

Lega

lizes

hem

p cu

ltiva

tion

in T

exas

; st

ate

easi

ly h

as p

oten

tial t

o be

the

lead

ing

hem

p pr

oduc

er in

nat

ion.

Phar

mac

y Le

gisl

atio

n Th

at P

asse

d

HB

1076

Mas

sive

exp

ansi

on o

f Tel

epha

rmac

y la

titud

e. T

his

bill

wou

ld h

ave

allo

wed

for 2

,000

+ en

titie

s to

ope

n. B

ill

adva

nced

by

Card

inal

Hea

lth &

sup

port

ed b

y TM

A,

Wal

gree

ns, T

exas

Hos

pita

l Ass

ocia

tion,

TO

MA

HB

1622

/HB

434/

HB

460

Exte

nsiv

e ex

pans

ion

of p

hysi

cian

di

spen

sing

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Phar

mac

y Le

gisl

atio

n th

at D

ied

Phar

mac

y Le

gisl

atio

n th

at D

ied

HB

3388

Mov

e to

NAD

AC m

etho

dolo

gy in

Med

icai

d M

anag

ed C

are

with

a

disp

ensi

ng fe

e of

$10

.00+

(sam

e as

Med

icai

d FF

S). A

ver

y go

od b

ill.

Amen

ded

on th

e Se

nate

floo

r lat

e in

Ses

sion

to a

llow

HHS

C to

set f

ee

less

than

FFS

$10

.18 &

allo

w M

COs t

o en

cour

age

valu

e-ba

sed

paym

ent

mod

els a

nd p

erfo

rman

ce-b

ased

fees

. (So

unds

like

Med

icar

e DI

R….)

TPBC

mov

ed to

a p

ositi

on o

f opp

ositi

on a

nd w

e ar

e gr

atef

ul to

AIP

&

TFDS

for s

imila

r sup

port

. Tex

as P

harm

acy

Asso

ciat

ion,

Tex

as

Inde

pend

ent P

harm

acy

Asso

ciat

ion

& T

exas

Tru

e Ca

re su

ppor

ted

the

bill

with

no

fee

floor

and

the

perf

orm

ance

-bas

ed fe

e m

odel

lang

uage

.

TPBC

stro

ngly

enc

oura

ged

the

spon

sor t

o no

t brin

g th

e am

ende

d bi

ll up

for c

onsi

dera

tion

and

the

bill

died

at t

hat t

ime.

Fede

ral L

egis

lativ

e &

Reg

ulat

ory

Revi

ew

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ente

r:Ch

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ect0

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atio

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r Ser

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by R

eps.

Dou

g Co

llins

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Dav

id

Loeb

sack

(D-Io

wa)

Wou

ld e

ncou

rage

gre

ater

use

of g

ener

ic d

rugs

and

wou

ld

ince

ntiv

ize

phar

mac

ists

to a

ctiv

ely

prom

ote

gene

rics.

Wou

ld e

stab

lish

tran

spar

ency

in M

AC p

ricin

g &

re

imbu

rsem

ent c

alcu

latio

n.W

ould

est

ablis

h ef

fect

ive

appe

als

proc

ess

to c

onte

st

belo

w-c

ost p

aym

ents

.W

ould

pro

tect

pat

ient

cho

ice

of p

harm

acy.

W

ould

pro

hibi

t PBM

s fr

om re

quiri

ng o

r inc

entiv

izin

g pa

-tie

nts

to u

se m

ail o

rder

& s

peci

alty

pha

rmac

ies

they

ow

n.N

O H

EA

RIN

G, N

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OV

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T

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escr

iptio

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rug

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ct

HR

803

filed

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y Re

ps. P

eter

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ch (D

-VT)

& M

orga

n G

riffit

h (R

-VA)

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o-sp

onso

rs, i

nclu

ding

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s. V

icen

te G

onza

lez

and

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d D

ogge

tt o

f TX

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Sen

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lley

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re C

aput

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g Se

n. M

arsh

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ackb

urn

of T

N

Wou

ld p

rohi

bit M

edic

are

Part

D p

lan

spon

sors

/PBM

s fr

om

retr

oact

ivel

y re

duci

ng p

aym

ent o

n cl

ean

clai

ms

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itted

by

phar

mac

ies.

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803

refe

rred

to E

nerg

y &

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mer

ce, W

ays

& M

eans

; re

ferr

ed to

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com

mitt

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n H

ealth

on

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refe

rred

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e Fi

nanc

e

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ME

NT

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ILL

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prov

ing

Tran

spar

ency

and

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ccur

acy

in M

edic

are

Part

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rug

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Act

File

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y Pe

ters

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aben

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ll of

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ld m

ake

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er

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rt B

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ce 2

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anity

is d

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the

sam

e th

ing

over

and

ove

r aga

in a

nd e

xpec

ting

diff

eren

t res

ults

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AM

E R

ES

ULT

= N

O H

EA

RIN

GS

, NO

MO

VE

ME

NT

Obs

tacl

es:

Pow

erfu

l PBM

Lob

by |

Hug

e Ca

mpa

ign

Don

atio

nsCo

mpl

exity

of I

ssue

s | M

ajor

Dis

trac

tions

Redu

ced

Cons

titue

nt A

cces

s

Stat

e Le

gisl

ator

s A

re F

ar M

ore

Acc

essi

ble

to C

onst

ituen

ts, B

ut

Cong

ress

is L

arge

ly a

Lob

byis

t’s

Gam

e. F

eder

al L

eade

rs a

re

Rem

otel

y Lo

cate

d &

Alw

ays

Dis

trac

ted

in W

ashi

ngto

n. W

ritin

g Le

tter

s &

Vis

its to

D.C

. are

Rar

ely

Effe

ctiv

e.

BU

ILD

ING

& M

AIN

TAIN

ING

HO

ME

-BA

SE

D R

ELA

TIO

NS

HIP

S I

S

CR

ITIC

AL

TO F

UT

UR

E S

UC

CE

SS

. SE

E Y

OU

R R

EP.

AT

HO

ME

A

WAY

FR

OM

TH

E C

IRC

US

!

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se W

ays

& M

eans

Cha

irs

in 2

1stCe

ntur

y

Prop

osed

Rul

e Pu

blis

hed

by C

MS

Com

mis

sion

er A

zar i

n Fe

brua

ry 2

019.

Wou

ld E

limin

ate

Safe

Har

bor f

or P

harm

aceu

tical

M

anuf

actu

rer R

ebat

es th

at C

urre

ntly

Go

to P

BMs

& P

art D

Pl

an S

pons

ors.

Wou

ld re

quire

that

Reb

ates

be

Appl

ied

to B

enef

icia

ry

Cost

s to

Red

uce

POS

Paym

ent W

ith L

ower

Co-

pays

.Tr

ue-u

p to

Pha

rmac

ies

to B

ring

Reim

burs

emen

t in

Line

W

ith A

ctua

l Acq

uisi

tion

Cost

.W

ould

Elim

inat

e D

IR F

ees

as W

e Cu

rren

tly K

now

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m.

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inal

ly to

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e Ef

fect

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. 1, 2

020

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osed

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inat

ion

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afe

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bor

for M

edic

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or P

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