NCPA Commends Medicare for First Steps to Address Pharmacy Access

February 20, 2015

Beyond urban access issues, need for "any willing pharmacy' policy is clear.

PRESS RELEASE

ALEXANDRIA, Va. (Feb. 20, 2015) — National Community Pharmacists Association (NCPA) CEO B. Douglas Hoey issued the following statement in response to the Centers for Medicare & Medicaid Services (CMS) release of their annual guidance (or “call letter”) to Medicare drug plan sponsors:

“We are still reviewing the proposal issued by CMS. Our initial reaction is that we are encouraged at the first steps that the agency has outlined to address inadequate pharmacy access when it comes to discounted or ‘preferred’ copays. CMS’ initial focus is rightly on the December 2014 Medicare study that found more than half of ‘preferred pharmacy’ drug plans (54 percent) failed to meet the government's threshold for reasonable access to pharmacies in urban areas.

“Earlier this year the confusion beneficiaries and caregivers experienced due to pharmacy network restrictions by Part D plans was illustrated by the glitch-plagued Aetna/Coventry Medicare Part D drug plans. Medicare officials confirmed approximately 400,000 beneficiaries may have been affected because their chosen pharmacy was erroneously advertised as ‘in network’ during the 2014 open enrollment period.

“Those who oppose expanding patient access to ‘preferred’ copay discounts mistakenly claim it would cause chaos for the Medicare Part D prescription drug program. In fact, in recent years more Medicare drug plans have included independent community pharmacies among the ‘preferred’ options, yet overall Medicare average monthly prescription drug plan monthly premiums are at virtually identical levels. Moreover, an analysis by a leading health care economist has demonstrated that an ‘any willing pharmacy’ policy can maintain or even reduce current Medicare costs by promoting additional competition among pharmacies.

“Beyond the initial steps outlined today to address urban access shortcomings, CMS should give more seniors access to discounted or ‘preferred’ copays at community pharmacies willing to accept the plan terms and conditions. CMS can accomplish this by applying the ‘any willing pharmacy standard’ in the future to ‘preferred’ pharmacy networks. In addition, Congress can enact legislation to give seniors more convenient access to discounted or “preferred” copays that was introduced by Reps. Morgan Griffith (R-Va.) and Peter Welch (D-Vt.). H.R. 793 would allow seniors in medically underserved areas to access lower copays at any pharmacy willing to accept the Medicare Part D drug plan’s “preferred pharmacy” terms and conditions (i.e., pricing).

“As an indication of the overwhelming support that exists for this policy, three out of four likely voters (76%) endorsed the common-sense approach, according to a national poll by Penn Schoen Berland. Support for the proposal is high among Republicans, Democrats and Independents alike. In addition, a previous version of this bill introduced last year during the 113th Congress generated substantial backing from consumer advocates.”

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The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of nearly 23,000 independent community pharmacies. Together they represent an $88.8 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 300,000 individuals, including over 62,000 pharmacists. To learn more go to www.ncpanet.org or read NCPA’s blog, The Dose, at http://ncpanet.wordpress.com/.