Legislation would allow community pharmacies to participate in Part D networks if they accept regulations and conditions that other in-network pharmacies operate within.
Last week in Congress, Reps Morgan Griffith (R-VA) and Peter Welch (D-VT) introduced bipartisan HR 1939, Ensuring Seniors Access to Local Pharmacies Act of 2017. The newly proposed bill would allow Medicare beneficiaries living in underserved areas to access pharmacy services.
HR 1939 would amend title XVIII of the Social Security Act to improve care for beneficiaries by including community pharmacies located in unserved areas in Part D programs.
“Community pharmacies play a critical role in providing seniors in Southwest Virginia and other rural areas with an ability to fill prescriptions for the medications they depend on,” Congressman Griffith said in a press release. “The network pharmacy designation allows rural residents to receive the same reductions in coinsurance or copayments that those in higher population areas are able to receive.”
HR 1939 would allow willing community pharmacies to participate in Part D networks if they accept regulations and conditions that other in-network pharmacies operate within, according to the legislation.
“Vermont seniors need reliable access to affordable medicines no matter where they live,” Congressman Welch said in a press release. “Our legislation will help ensure that seniors are able to fill their prescriptions at their local pharmacy.”
The National Community Pharmacists Association (NCPA) endorsed the legislation, saying the bill would increase access to beneficiaries, while providing increased Part D competition.
"Consumer choice is hallmark of a free market economy, but many preferred pharmacy Medicare Part D plans effectively limit where seniors can get their prescriptions filled by making seniors pay higher copays if they don't get their prescriptions from specific large chain or mail order pharmacies," said B. Douglas Hoey, RPh, MBA, NCPA CEO. "By creating a level field for all pharmacies to compete, HR 1939 ensures that seniors can use the pharmacy of their choice, not one assigned to them by a pharmacy benefit manager."
The competition would likely cause pharmacies to expand their services offered, such as discounted co-payments for prescription drugs, according to a press release from NCPA. Additional pharmacy options would also allow patients to seek care at a pharmacy that best meets their needs.
This bill is important because some patients in underserved locations may have to travel long distances to obtain proper care. A Medicare study indicated that 54% of a pharmacy benefit manager’s preferred pharmacy drug plans did not meet the government’s standards for reasonable access to pharmacies in rural areas, according to the release.
"Why should seniors have to drive long distances to a preferred pharmacy or use a mail order pharmacy when a nearby community pharmacy is able and willing to serve the patient?” Hoey asked.
A lack of pharmacy access can lead to poor patient health, hospitalization, and increased costs. By enacting this law, elderly patients would likely receive better care and achieve optimal outcomes.