NACDS: Budget Proposals Pose Challenges for Patients

Urging recognition of pharmacists as health care providers under Medicare Part B, NACDS cited that retail pharmacies are often the most readily accessible health care provider.


Arlington, Va.

— Emphasizing pharmacy’s role in the healthcare delivery system and expressing concerns about pharmacy-related budget proposals, the National Association of Chain Drug Stores (NACDS) submitted a statement to the U.S. House Committee on Energy and Commerce Subcommittee on Health. The subcommittee held a hearing today on “Examining the FY 2015 HHS Budget,” featuring testimony delivered by Secretary of Health and Human Services (HHS) Sylvia Mathews Burwell.

Urging recognition of pharmacists as healthcare providers under Medicare Part B, in its statement NACDS cited that retail pharmacies are often the most readily accessible healthcare provider.

“Recognition of pharmacists as providers under Medicare Part B would help to provide valuable and convenient pharmacist services to millions of Americans, and most importantly, those who are already medically underserved,” NACDS wrote. “Although retail community pharmacists can provide high quality, cost efficient care, the lack of pharmacist recognition as a provider by third party payors including Medicare and Medicaid has limited the number and types of services pharmacists can provide, even though fully qualified to do so.”

NACDS also expressed concerns with some HHS budget proposals, including a provision that excludes brand and authorized generic drugs from the calculation of average manufacturer price (AMP), which would calculate Medicaid federal upper limits (FULs) based only on generic drug prices.

“While the goal of this provision may be to decrease Medicaid costs, we believe it may in fact reduce access to prescription drugs and pharmacy services for Medicaid patients, resulting in increased overall healthcare expenditures,” NACDS wrote.

NACDS also cited that given that AMP has never been used as a basis for pharmacy reimbursement, and that the AMP-based FULs remain in draft form, changing the calculation of FULs is premature.

“We urge CMS to utilize the rulemaking process to implement the Medicaid pharmacy provisions in a manner consistent with Congressional intent, rather than pursuing policies that would further cut pharmacy reimbursement,” NACDS wrote.

NACDS also took issue with a provision in the HHS budget to limit Medicaid reimbursement for durable medical equipment (DME) to the rates paid by Medicare, and urged CMS to refrain from making any changes to Medicaid reimbursement for diabetes testing supplies (DTS).

“Reducing Medicaid reimbursement for DTS to match the Medicare rate could similarly produce hardships for Medicaid beneficiaries in terms of reducing access to needed supplies and threatening the health of an already fragile population,” NACDS wrote.

In its statement, NACDS threw its support behind a provision in the HHS budget that would increase the use of generic drugs, citing increased utilization of generic drugs as one of the most effective ways of controlling prescription drug costs. The statement also cited the growing recognition of pharmacist-provided medication therapy management (MTM) in improving adherence to medication, which lowers overall healthcare costs.

“Since pharmacists have the proven ability to provide services that lead to better clinical outcomes and lower healthcare costs, we urge the implementation of budget proposals that allow all healthcare providers, including retail pharmacists, to practice to their maximum capabilities, working in partnership to provide accessible, highly efficient, high quality care to patients,” NACDS concluded in its statement.