Medicare Proposes to Open Preferred Part D Networks to Any Willing Provider
On January 6, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would open preferred networks offered in Medicare Part D plans to any willing provider starting in 2015. NCPA and independent community pharmacies nationwide have been pleading with CMS for several years to open these plans to any willing provider. Now, thanks to CMS’ own research that shows restrictive networks often do not result in cost savings for Medicare, this goal is one step closer to reality.
The proposal also addresses MACs and the need for them to be frequently updated. Needless to say, this proposal is a step forward for independent community pharmacy, but we need to ensure the rule is enacted as proposed. There will be a public comment period after which CMS will issue a final rule. It’s important that CMS hear from you during the public comment period so please be on the lookout for sample comments that NCPA will provide soon for you to personalize with your own experiences and submit to CMS.
NCPA Requests Congressional Inquiry into Generic Price Spikes
NCPA recently sent a letter to the leadership of the Senate Health, Education, Labor and Pensions (HELP) Committee and the House Energy and Commerce (E&C) Committee requesting Congressional inquiries into the skyrocketing price increases of generic drugs, which are harming patients and community pharmacies.
Pharmacy acquisition prices for many essential generic drugs have risen by as much as 1,000% or more, according to a survey conducted by NCPA. It found that patients are declining their medications due to increased copays and that the trend has forced more seniors into Medicare’s coverage gap (the “donut hole”), where they must pay far higher out-of-pocket costs.
A Congressional hearing is a first step to uncovering not only the cause of the price hikes but also the discrepancies between what the pharmacy is charged to acquire the medication and what the PBMs are reimbursing the pharmacies and where the difference is ending up.
Fight4RX Now on Facebook!
NCPA recently launched a new Fight4RX Facebook page. This is another tool to keep patients informed on the role pharmacists are playing in the healthcare system and on legislative matters that impact their choice of pharmacy or the quality of care they are receiving. Please take a moment to “like” our Facebook page and urge your patients to do likewise.
*News of Note
NCPA Grassroots Mobilizations:
– There have been several developments over the last month that required grassroots mobilization:
o Alert sent to pharmacists represented by a member of the Senate Health, Education, Labor and Pensions (HELP) Committee or the House Energy and Commerce (E&C) Committee asking that they call their legislator and ask for a hearing to investigate generic price spikes.
o Alert sent to Kansas and South Dakota asking pharmacists to thank Senators Moran and Thune for introducing legislation to reverse the ban on pharmacies providing home delivery of DTS.
NCPA Press Releases & Statements:
- NCPA Supports Senate Bill Allowing Pharmacy Deliveries of Diabetes Testing Supplies
- Preferred Pharmacies, Mail Order May Mean Higher Costs for Medicare Part D
- Patients Benefit from Pharmacy-Provided Medication Synchronization Programs
- Needy Patients Suffering Due to Uneven Access to Painkillers, Pharmacist Survey Finds
- Generic Drug Price Spikes Demand Congressional Hearing, Pharmacists Say
- Pharmacists React to Medicare’s Proposed Changes for 2015 Drug Plans
- Independent Pharmacies to Help Fill Medication Gaps for New ACA/Obamacare Enrollees