NACDS Provides Pharmacy Guidance to CMS on Medicare Issues for 2014



March 1, 2013

NACDS: MTM an important tool in improving medication adherence, patient health, and reducing healthcare spending

Arlington, Va. — Following the issuance of the Centers for Medicare & Medicaid Services (CMS) 2014 “call letter” on Medicare, the National Association of Chain Drug Stores (NACDS) today provided guidance on the letter’s pharmacy provisions and desire to work together with CMS to strengthen the Medicare Part D prescription drug benefit. CMS issues this “call letter” on an annual basis, laying out various policies and requirements for the coming program year within the Medicare program.

In the letter NACDS expressed support for CMS’ efforts to increase awareness of MTM services provided by community pharmacists. Citing pharmacists’ education and expertise in medication management NACDS wrote, “Pharmacist-provided MTM services are one of the many ways of using a pharmacist’s clinical skills to improve patient outcomes. Pharmacists already have the training and skills needed to provide MTM services and currently provide many of these services in their day-to-day activities.”

NACDS also expressed its appreciation for the successful launch of the Department of Health and Human Services’ (HHS) Million Hearts Initiative, which seeks to prevent one million heart attacks and strokes by 2017. CMS’ call letter states that CMS will encourage Part D sponsors to offer MTM to beneficiaries who fill one or more prescriptions for anti-hypertensive medication.

“Pharmacist-provided services such as medication therapy management (MTM) are an important tool in the fight to improve medication adherence and patient health, and reduce healthcare spending. Encouraging sponsors to provide more access to beneficiaries who fill one or more prescription for anti-hypertensive medications will lead to better health outcomes and reduce overall healthcare costs at the same time,” NACDS stated in its letter.

NACDS also utilized this letter as an opportunity to highlight other key pharmacy issues under Medicare including payment for hospice and end-stage renal disease drugs, daily cost-sharing requirements, auto-ship refill programs in Part D, applicability of rewards and incentives in Part D, payment for compounded medications, expansion of Part D policy on improving utilization review controls, drug class quantity limits, prescription drug event (PDE) guidance on post-point-of-sale claim adjustments, point-of-sale per claim administrative fees, and preferred/non-preferred pharmacy networks.

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