Responding to concerns of pharmacists
over slow-footed drug-claim reimbursement
under the new Medicare
Part D prescription programs, members
of Congress are sponsoring legislation
to correct the problem.
One new bill, introduced by Sen Max
Baucus (D, Mont), would require
Medicare prescription drug plans to
pay interest on approved claims to
pharmacies if the plans do not provide
reimbursements in a timely manner.
The bill would require drug plans to
pay reasonable dispensing fees to participating
pharmacies, as well as providing
toll-free hot lines to furnish
pharmacists with timely answers to
their questions.
The bill would further prohibit the
"cobranding" of Part D identification
cardsa practice that critics say
misleads many beneficiaries into
believing that they may obtain benefits
only at the drug chain named on
the card.
Separate legislation, introduced by
Sens Thad Cochran (R, Mo), Mike Enzi
(R, Wyo), and Jim Talent (R, Mo), also
would require prompt payment of
pharmacies' Part D claims and restrict
cobranding. In addition, this new legislation
would establish guidelines for
medication therapy management programs
under Part D and would institute
a 2-year community-based demonstration
program.