NCPA Responds to Medicare Part D Proposed Rule Changes

ALEXANDRIA, Va. (November 20, 2017)—The Centers for Medicare and Medicaid Services’ (CMS) proposed rule for the 2019 Medicare Part D plan year includes important provisions to address concerns of independent community pharmacies and the patients they serve, raised by the National Community Pharmacists Association. In response, NCPA’s Chief Executive Officer B. Douglas Hoey, Pharmacist, MBA, issued the following statement:

“More than a third of the prescription drugs dispensed in independent community pharmacies are for Medicare Part D beneficiaries. NCPA member pharmacies provide access to care and medication in underserved areas. However, several issues threaten continued beneficiary access to these providers.

“The biggest challenge is the retroactive pharmacy Direct and Indirect Remuneration (DIR) fees. NCPA strongly supports CMS’s intention to have all pharmacy price concessions reflected as part of the negotiated price. Doing so would reduce net beneficiary costs by $10.4 billion, CMS concluded, and would give community pharmacies greater predictability regarding reimbursement rates.

“NCPA also supports CMS’s proposal to address concerns regarding plan sponsors or their PBMs limiting patient access and excluding community pharmacies from participation in Part D standard networks based on arbitrary reasons that effectively limit competition and steer patients to PBM-affiliated pharmacies. Contrary to misinformation circulating from the PBMs, this proposed rule would not open Part D preferred pharmacy networks to participation from any willing pharmacy. In addition, NCPA commends CMS for its proposal to give community pharmacies easier access to Part D plan terms and conditions for network participation. We encourage CMS to implement these and other policies in the proposed rule to make it easier for independent community pharmacies to provide seniors with prescription drug services, which means more time can be spent focusing on what matters the most—driving better health outcomes for Medicare beneficiaries.”

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