New Congressional Support for Pharmacy Choice Provision in Medicare Proposed Rule



Alexandria, Va. Mar. 7, 2014 - The National Community Pharmacists Association (NCPA) said today that four recent congressional letters to the Centers for Medicare and Medicaid Services (CMS) reflect support for the "any willing pharmacy" provision contained in CMS’ broader proposed rule for 2015 Medicare Part D prescription drug plans. Under the proposal, more seniors would have access to "preferred" co-pays at independent community pharmacies willing to accept "preferred pharmacy" contracts.

"While the debate continues over certain elements of Medicare’s proposed rule for drug plans, there is substantial support for giving seniors greater pharmacy choice and convenience at no added cost to Medicare," said NCPA CEO B. Douglas Hoey, RPh, MBA. "There is no justification for making seniors travel 20 miles or more to reach a ‘preferred’ pharmacy if a local community pharmacy is willing to fill that prescription. Community pharmacists appreciate the bipartisan and consumer support expressed for this provision of the proposed rule and encourage Medicare to implement it soon."

A letter organized by U.S. Representatives Morgan Griffith (R-Va.) and Peter Welch (D-Vt.), who co-chair the Congressional Community Pharmacy Caucus, and signed by 28 representatives in total offered some historical context for how CMS arrived at their proposal. It states, "As you will recall, in March 2013, a bipartisan group of 31 Members of the House of Representatives contacted you to raise concerns about preferred pharmacy networks and to urge CMS to expand the opportunities for all pharmacies to join and compete with these Part D preferred networks on a level playing field. We wish to express our appreciation regarding the proposed changes to the use of preferred pharmacy networks in the Medicare Part D program."

A letter from Representative Sam Graves (R-Mo.), who is also Chair of the House Small Business Committee, said that he was "encouraged" by the pharmacy choice provision in the proposed rule. He also explained that "As Medicare Part D preferred pharmacy networks grew and expanded in numbers, my constituents grew concerned that this could lead to a decrease in access to quality care and threaten the survival of small business pharmacies that play a vital role in our communities."

Citing seniors in his district who are "often disappointed" at the exclusion of independent community pharmacies from a preferred pharmacy drug plan, U.S. Rep. John Sarbanes (D-Md.) wrote that he is "very encouraged" by the pharmacy choice language. Sarbanes serves on the House Energy and Commerce Committee and also expressed support for the medication therapy management (MTM) and pharmacy reimbursement provisions of the CMS proposal.

Finally, a letter from Representative Trey Gowdy (R-S.C.) indicated that he has heard from independent community pharmacies in his district, and believes "these changes go a long way in addressing my constituents’ concerns with their existing exclusion from preferred networks. It is my hope as you move forward with these proposed changes that you continue to take feedback from independent community pharmacies into consideration."

Previously, House Energy and Commerce Committee Ranking Member Henry Waxman (D-Calif.) as well as Reps. Doug Collins (R-Ga.), Gene Green (D-Texas), Mike Rogers (R-Ala.) and Lynn Westmoreland (R-Ga.) have endorsed the any willing provider policy. In addition, Medicare beneficiary advocates such as the Alliance for Retired Americans; American Federation of State, County and Municipal Employees (AFSCME) California Health Advocates; Center for Medicare Advocacy, Inc.; Families USA; Medicare Rights Center; National Committee to Preserve Social Security and Medicare; National Council on Aging; and National Senior Citizens Law Center have expressed support for this particular provision of the Medicare proposed rule.

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