NCPA Provides Recommendations for Strengthening Medicare Part D

Article

ALEXANDRIA, Va. (May 2, 2017) The National Community Pharmacists Association (NCPA) has submitted five recommendations for improving and transforming the Medicare Part D program in response to a Request for Information (RFI) from the Centers for Medicare and Medicaid Services (CMS). NCPA's input is based on the experiences of the independent community pharmacies NCPA represents, which on average see 35 percent of their dispensed prescriptions covered under Part D, according to the 2016 NCPA Digest, sponsored by Cardinal Health.

"The Medicare Part D program is vital to improving health outcomes for seniors, but it can and should be strengthened," said NCPA CEO B. Douglas Hoey, RPh, MBA. "NCPA's recommendations are intended to increase beneficiary access to pharmacies and make the program more financially sound. We're confident CMS will agree with our suggestions, and we look forward to helping in whatever capacity we can."

NCPA recommended that CMS:

  • Finalize the concept included in 2014 proposed guidance on Direct and Indirect Remuneration (DIR) that sought to implement the new definition of "negotiated price" to include all pharmacy price concessions that can be reasonably estimated based on historical data;
  • Issue guidance for Maximum Allowable Cost (MAC) drug pricing that requires MAC lists that are given to pharmacies be in an interactive spreadsheet format and require PBMs to establish a valid MAC appeals process;
  • Establish access standards for preferred cost-sharing pharmacies or require plans to disclose in plan offerings and on Medicare Plan Finder the actual number of preferred pharmacies in each region;
  • Address concerns about the implementation of the Comprehensive Addiction and Recovery Act (CARA) regarding the definition of frequently abused drugs, who is included in the list of exempted individuals, the standardization of notices about lock-in notices, and whether senior access to opioids will be unnecessarily compromised; and
  • Assess the reliability of existing Pharmacy Quality Alliance (PQA) measures currently being used to determine performance at the pharmacy level.

Related Videos
Laboratory test tubes and solution with stethoscope background | Image Credit: Shutter2U - stock.adobe.com
Image credit: Andrea Izzotti
Inflation Reduction Act is shown using the text and the US flag - Image credit: Andrii | stock.adobe.com
Pharmacy Interior | Image Credit: Tyler Olson - stock.adobe.com
Male pharmacist selling medications at drugstore to a senior woman customer | Image Credit: Zamrznuti tonovi - stock.adobe.com
Pharmacist assists senior woman in buying medicine in pharmacy - Image credit: Drazen | stock.adobe.com
Pharmacy, medicine and senior woman consulting pharmacist on prescription. Healthcare, shopping and elderly female in consultation with medical worker for medication box, pills or product in store - Image credit: C Daniels/peopleimages.com | stock.adobe.com
Image credit: fidaolga - stock.adobe.com
Pharmacists checking inventory at hospital pharmacy- Image credit: Jacob Lund | stock.adobe.com
Young male pharmacist giving prescription medications to senior female customer in a pharmacy | Image Credit: Zamrznuti tonovi - stock.adobe.com
© 2023 MJH Life Sciences

All rights reserved.