NCPA Urges Hearing, Action on Medicare Pharmacy Choice Bill

Published Online: Wednesday, May 28, 2014
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ALEXANDRIA, Va. (May 28, 2014) – Key committee leaders should hold a hearing on and ultimately pass legislation addressing exclusionary “preferred” pharmacy arrangements in Medicare Part D prescription drug plans (PDPs) that restrict seniors’ pharmacy choice and lock out independent community pharmacies, the National Community Pharmacists Association (NCPA) wrote in a letter to Capitol Hill.

Some seniors and caregivers are forced to travel 20 miles or more to access discounted co-pays at the plan’s “preferred” pharmacy, even though local community pharmacies may be willing to accept the plan’s terms and conditions. The Ensuring Seniors Access to Local Pharmacies Act (H.R. 4577) would allow “any willing pharmacy” located in a medically underserved area to participate in all Medicare Part D drug plan networks, including the plan’s discounted or “preferred” network. NCPA has endorsed the legislation, introduced by Reps. Morgan Griffith (R-VA.) and Peter Welch (D-Vt.).

“We know that Congress did not intend to create access problems for Medicare patients who depend on the face-to-face counseling services that independent pharmacies have offered to them for so many years,” NCPA CEO B. Douglas Hoey, RPh, MBA, wrote in the letter to leaders of the House Energy and Commerce Committee and Ways and Means Committee. “We respectfully request that you schedule an oversight hearing to examine ways to ensure that small business owner pharmacies have the ability to try and compete with larger stores. We also request that you hold a legislative hearing on, and ultimately consider, the Griffith-Welch bill.”

NCPA also noted in the letter that the Centers for Medicare and Medicaid Services (CMS) continues to express deep concern regarding the restrictions that PDPs are imposing on beneficiaries. In the agency’s recent final regulation for the 2015 plan year, CMS stated the following:

“We agree with many of the commenters who wrote that beneficiaries should be able to choose where they obtain their pharmacy services, and we are very concerned to hear that the current incentives (and potentially current marketing of pharmacies offering preferred cost sharing) lead many beneficiaries to believe that only those pharmacies offering preferred cost sharing can be used. We are also very concerned by the many comments reporting that beneficiaries are now driving 30 – 60 miles to the nearest pharmacy offering preferred cost sharing, or are feeling forced into using mail-order services, despite a preference to stay with a local pharmacy.”

However, CMS has declined for now from taking regulatory action to support beneficiary pharmacy choice. So congressional action is needed and NCPA continues to encourage all community pharmacists to express their support for H.R. 4577 and to engage their patients to do the same, such as through the Fight4Rx patient network.

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