Pharmacists Endorse Bill to Expand Medicare "Preferred" Pharmacy Networks in Underserved Areas



Alexandria, Va. May 7, 2014 - Bipartisan legislation that would give many seniors greater choice of pharmacy in their Medicare drug plan has been introduced in the U.S. House of Representatives and was endorsed today by the National Community Pharmacists Association (NCPA).

The Ensuring Seniors Access to Local Pharmacies Act (H.R. 4577) was introduced by U.S. Reps. Morgan Griffith (R-Va.) and Peter Welch (D-Vt.). It would allow "any willing pharmacy" located in a medically underserved area to participate in all Medicare Part D drug plan networks, including the plan's discounted or "preferred" network.

"We commend Representatives Griffith and Welch for their leadership and moving forward with the first legislation to address 'preferred' networks in Medicare," said NCPA CEO B. Douglas Hoey, RPh, MBA. "NCPA's top priority is ensuring that every community pharmacy has the opportunity to participate as 'preferred' pharmacies in Medicare drug plans. This bipartisan legislation is a critical first step toward that end.

"NCPA is proud to support H.R. 4577. We will continue to work diligently toward the enactment of 'any willing pharmacy' legislation in both houses of Congress and to urge Medicare to support this policy," Hoey added. "It is vital for all community pharmacists to take grassroots action to express their support for this legislation."

Currently, drug plan middlemen known as pharmacy benefit managers (PBMs) arbitrarily decide which pharmacies can offer "preferred" co-pays. The nation's 23,000 independent community pharmacies are often left out of such arrangements, even though they play a large role in caring for medically underserved populations. The result is seniors in rural communities often face either higher co-pays or trips of 20+ miles to a "preferred" pharmacy—likely passing many excluded community pharmacies along the way.

Patients located in medically underserved areas may benefit the most from convenient access to needed medications and expert counseling at a community pharmacy. Providing this expanded access should lead to greater medication adherence rates and more positive health outcomes, including the avoidance of higher-cost health interventions. The costs of improper medication use, or non-adherence, have been estimated to be as high as $290 billion annually, according to the Network of Excellence in Health Innovation. The 2013 Medication Adherence in America: A National Report Card found that the biggest predictor of medication adherence was patients' personal connection with a pharmacist or pharmacy staff and that patients of community pharmacies reported the highest level of personal connection.

Earlier this year more than 30 Members of Congress and a wide array of consumer groups and unions voiced their support for applying an "any willing pharmacy" policy to Medicare drug plans. Those organizations included 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; National Rural Health Association; National Senior Citizens Law Center; and SEIU.

Introduction of H.R. 4577 came in conjunction with NCPA's two-day Conference on National Legislation and Government Affairs May 7 - 8 in Washington, D.C.

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