Why It Matters
Pharmacy benefit managers are squeezing reimbursement rates below acquisition costs which are leading to closures particularly in rural and underserved communities. The National Association of Specialty Pharmacy is pursuing two primary legislative remedies: mandating "any willing pharmacy" provisions requiring health plans to contract with pharmacies accepting standard terms, and restricting Medicaid spread pricing where PBMs charge states more than they reimburse pharmacies.
These provisions appear in multiple bills advancing through Congress, including the PBM Reform Act of 2025 and the Protecting Pharmacies in Medicaid Act. NASP’s strategy leverages an exceptionally receptive congressional environment: the Consolidated Appropriations Act of 2026 already enacted landmark PBM reforms, multiple committees have held bipartisan hearings on PBM abuses, and the FTC is pursuing enforcement actions against major PBMs.
By the Numbers
NASP spent $120,000 in the final quarter of 2025 with Powers Pyles Sutter & Verville PC, continuing a six-year relationship worth $3.07 million since August 2019.
The organization registered four in-house lobbyists: Julie Scott Allen (lobbying since 2003), Julie Snyder Hyams (since 2010), Taryn Couture (since 2020), and Natalie Keller (since 2023). Couture leads NASP’s account with $2.64 million across 22 disclosures.
The Agenda
NASP is lobbying on pharmacy market competition, Inflation Reduction Act implementation, and Medicare/Medicaid reimbursement reform, specifically targeting Medicaid spread pricing and "any willing pharmacy" provisions.
Relevant legislation includes the PBM Reform Act of 2025, Patients Before Middlemen Act, and Protecting Pharmacies in Medicaid Act, all containing provisions targeting NASP’s priorities.
Broader Context
Congress is actively reshaping pharmacy economics through landmark federal action. The Consolidated Appropriations Act of 2026 enacted comprehensive PBM reforms including "any willing pharmacy" standards—directly aligned with NASP’s priorities. Meanwhile, independent pharmacies are closing at alarming rates, with roughly one per day shutting down.
The FTC has secured landmark settlements against major PBMs for price manipulation, while the Inflation Reduction Act’s Medicare drug price negotiation program continues implementation.
Between The Lines
Multiple congressional committees have held bipartisan hearings on PBM competition issues, with the Senate Judiciary Committee examining pharmacy closures and House Energy and Commerce pursuing reforms.
Key bills advancing through Congress directly address NASP’s objectives: H.R. 4317 and S. 882 include "any willing pharmacy" provisions, while S. 927 targets spread pricing.
Competitive Landscape
NASP faces a crowded advocacy environment. Allied pharmacy interests include American Pharmacy Cooperative Inc., which lobbies on similar PBM reform issues.
PhRMA represents pharmaceutical manufacturers with significant lobbying resources on drug pricing, while PBMs like Navitus Health Solutions advocate for industry-friendly transparency reforms rather than structural changes.
The Bottom Line
NASP’s $120,000 fourth quarter lobbying spend reflects strategic timing amid active congressional reforms. While "any willing pharmacy" provisions gained traction in enacted legislation, Medicaid spread pricing remains unresolved, creating opportunities for future advocacy. The organization’s continued engagement with experienced healthcare counsel positions it to influence ongoing regulatory guidance and potential legislative modifications affecting specialty pharmacy access and reimbursement.
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