ccpa SPEAKS OUT: CCPA Works to Improve Medicare Part D

Pharmacy Times, Volume 0, 0

The Medicare Part D PrescriptionDrug Benefit would not havebeen a success without theheroic efforts of community pharmacistson behalf of their patients.Community pharmacies, however, haveencountered major cash-flow problemsas a result of Part D that could put themout of business. Improvements must bemade so that community pharmaciesare paid promptly for providing vitalhealth care services.

The Part D plans are paid each monthin advance by Medicare. The Part Dplans are using delay tactics, however,to enjoy a considerable interest-earningfloat on taxpayer dollars intended toreimburse pharmacies for serving theirpatients. These payment delays haveforced many pharmacists to borrowtens of thousands of dollars everymonth to cover payroll, wholesaler bills,and other basic operating costs.

The Coalition for Community PharmacyAction (CCPA) is currently workingto improve Medicare Part D by supportingfederal legislation that willensure timely compensation for theservices community pharmacies provide.Reps Marion Berry (D, Ark),WalterB. Jones (R, NC), Stephanie Herseth (D,SD), and Roger F. Wicker (R, Miss) haveintroduced legislation in the House ofRepresentatives—the Fair and SpeedyTreatment (FAST) of Claims Act of 2007(HR 1474)—that will put an end todelayed reimbursements and materialsthat mislead beneficiaries.

The FAST Act defines clean claimsand requires plans to reimburseproviders via electronic funds transferwithin 14 days for clean claims submittedelectronically.

The FAST Act also provides clarificationof cobranding rules. Advertisingshould not be allowed on the Part Dbenefit card or informational materials.Just as there is no advertising on theSocial Security card, there should notbe any advertising on certain MedicarePart D materials used for patient education.Marketing guidelines expresslyprohibit steering patients in regard toPart D Plans, and likewise plans shouldnot be allowed to steer patientstoward a particular pharmacy bycobranding the benefit card and informationalmaterials. Patients need toknow that they have choices—a keypolicy goal of the creation of Part D.

CCPA is continuously working to gainsupport from members of Congress forthe FAST Act, which so far has beencosponsored by >40 representatives.Similar legislation received the supportof >170 members of the 109th Congress,including current Chairman JohnDingell (D, Mich) of the Energy andCommerce Committee and ChairmanCharles Rangel (D, NY) of the Ways andMeans Committee.

CCPA appreciates the efforts of theoriginal 10 sponsors who supported thislegislation: Reps Walter B. Jones (R, NC),Thomas H. Allen (D, Me), Jo AnnEmerson (R, Mo), Stephanie Herseth (D,SD), Robert B. Aderholt (R, Ala), JoeCourtney (D, Conn), Sam Graves (R, Mo),Jerry Moran (R, Kan), Mike Ross (SD,Ark), and Roger F. Wicker (R, Miss). CCPAis working closely with members of theSenate Finance Committee to have similarlegislation introduced in the Senate.

CCPA needs your help to ensure thatcommunity pharmacies are not forcedto close or reduce hours as a result ofslow Medicare reimbursement andunclear claims processing. Please to contact your representative,and ask him or her tocosponsor the FAST Act.

Ms. Khani and Mr. Sewell are co-presidentsof the Coalition for CommunityPharmacy Action.

The Coalition for CommunityPharmacy Action (CCPA) is analliance between the NationalAssociation of Chain Drug Stores(NACDS) and the NationalCommunity PharmacistsAssociation (NCPA), whichtogether represents more than55,000 community pharmacies.CCPA leverages the support,effort, and infrastructure ofNACDS and NCPA while engagingcommunity pharmacy to participateand advocate on issuesaffecting the industry.