MOST INDEPENDENTS HIT WITH LENGTHY PART D PAYMENT DELAYS

Pharmacy Times, Volume 0, 0

At least half ofthe Medicare PartD drug-reimbursementclaims submittedby independentpharmacieswere not paidwithin 30 days, and more than 1 in 6 wentunpaid for at least 2 months, according tonew research by the University of Texas atAustin's Center for PharmacoeconomicStudies.

The researchers traced payments for~600,000 Part D claims from independentpharmacies. They found that 50% of thoseclaims were paid >30 days after adjudication,and 17.1% took >60 days. Less than1% of the Rx claims were paid within 2weeks, which is "typically how often communitypharmacies have to pay theirwholesalers," said officials at the NationalCommunity Pharmacists Association(NCPA).

Ironically, pharmacies are sufferingcash-flow problems even though the pharmacybenefit managers (PBMs) responsiblefor administering the various Part Dplans are getting paid in advance by thefederal government, said NCPA. The newTexas study "presents strong evidencethat PBMs are gaming the system, makinginterest on the float they get by not payingpharmacies in a timely manner."