2021-10-11 Advisory Group on Pharmacy Policy and Operations

Date 17 Nov 2020

Agenda

Welcome
NACHC Governance Structure
Questions and Answers for Jacki
Policy Updates
Review of Minutes
Priorities Discussion
Closing

Resources

Attendees

NACHC
Kathleen McNamara (Deactivated) Vacheria Tutson (Unlicensed) Gervean Williams (Deactivated) Andrea Price Old Account (Deactivated) Jacki Leifer	Kemi Alli Anthony Armstrong Mary Blankson Anthony Fortenberry	Jennifer Kreidler-Moss, Chair Marisa Rowen Nicole Thibeau Vicki Young

Discussion items

Time	Item	Who	Notes	Action Items
5 min	Welcome	Jennifer Kreidler-Moss
10 min	NACHC Governance Structure	Jacki Leifer, NACHC's General Counsel.	Role within the Committee Structure of NACHC; The Committees are committees of the Board, this group makes recommendations to the Board. There is a duty to: Keep mission in mind (see Mission Statement), and the recently approved strategic goals of NACHC. Maintain confidentiality of NACHC information until and unless the NACHC Board decides to share info No-one should speak for the Board, Committee or Subcommittee without authority to do so. The group makes recommendations as a group, not individuals. Do not speak for NACHC without authority to do so.
5 min	Questions and Answers for Jacki	Jennifer Kreidler-Moss	Q: Jacki, what are your thought about 340B? Vacheria will be speaking on that.
10 min	Policy Updates	Vacheria Tutson	Opening up the statute via the "Protect the 340B Act." On Friday 08 Oct 2021 NACHC's petition to the ADR process was deferred. Sanofi protested. Caldera sued HRSA. There are many nuances, given the variety of Medicare expansion (or not) in states, contract pharmacies role, carve ins for 340B and carve outs for pharmacy services. Think through all the elements in the threats to 340B. Attacks have escalated. Opening the statute is not he sole answer. Pharma manufacturers are poking holes in HRSA's authority. HRSA is trying to protect the programs. A Armstrong - Each fall there is a new issue, and so many nuances that affect. V Young - Are there alternatives/workarounds to opening up the 340B statute? Yes, NACHC provided a proposal but ( ) said no, we cannot fix the Medicaid coverage gap with this. The goal is not to fix Medicaid, but to expand Medicaid to the 12 states that do not have it, TX, FL, GA. This would keep the status quo and expand the existing flawed system to additional states. Congressional members are avoiding making decisions because of risk. Pharma's strategy is to sue and keep things tied up. Best to craft a proactive strategy that has the viability and savings that CHCs need, not to respond to every change that is proposed. N Thibeau - Difficult to help patients when things are changing and the impacts seriously affect service (having to lay off employees when even COVID caused so much stress on the system, but this is causing greater effect. Gilead change. K Alli - Is there a way to create new legislation to solve some of the dilemmas without touching the existing legislation, that layers on top to fix the problems. Can we create the program that we want? G Williams - This would give us the opportunity to design the system we want. J Kreidler-Moss - Align with allies in the field. Maybe we need to talk about the unpopular option of NOT basing financial models on 340B.	Vacheria Tutson (Unlicensed) can consult 340B experts to see if there are alternative legislation on top of 340B to replace it.
5 min	Review of Minutes	Jennifer Kreidler-Moss	Approved.
15 min	Priorities Discussion	Jennifer Kreidler-Moss
1 min	Closing	Jennifer Kreidler-Moss	Next meeting is November 8^th from 12 noon to 1:00 pm ET Scheduling Note: Jennifer Kreidler-Moss' birthday - Vacheria is getting married on the 6th and will be on honeymoon on the 8th.	Vacheria Tutson (Unlicensed) will ask Joe to sit in in her absence.
	Action Items from September Meeting		Anthony Armstrong to share data Kathy will compile and list of participants/bios and share Done Kathy will compile draft Minutes Done Vacheria will share latest Medicare Bill for comment TBD Andrea will establish a site on Confluence. Done.
				If anyone sees errors or updates needed in the Bios, please notify Andrea aprice@nachc.org
	Anthony Armstrong		CHC engaged a team to develop a ( ) and testing it since April to manage the program. V Tutson - Might be helpful to tell the story, not only say there were savings and here is the number. G Williams - How intensive was it to provide data to the third party to create these visualizations? Not labor intensive on staff. If we share data, can it somehow be used against CHCs? N Thibeau - Can she share with her policy team the things that we talk about it our meeting. J Leifer - There was nothing that was discussed in this conversation that could not be shared. V Tutson agreed.
			Decision Tweak or Reinvent? We need new models that offer stability, we need to tell that story with data, and we need to do this without burdening CHC staff. We need to pull apart models - beyond 340B - to build models for CHCs. No CHC should have to build its own systems, let's share systems and ideas like Anthony's to tell the data story. A Armstrong: Also important to also include data needs, differences, availability for in-house pharmacies vs contract pharmacy. I personally only have contract pharmacy experience V Tutson - Explore ways in targeted conversations later in this group for how we can use data K Alli - Next conversation; how do we share (data) on what we do with the 340B savings.	Anthony will continue to converse with the third party that created the data.