Claims by pharmacy benefit managers (PBMs) that a massive cost increase would result from legislation giving Medicare seniors in medically underserved areas more convenient access to discounted or “preferred” copays are “theoretically baseless,” a noted health care economist and antitrust expert argues in a new analysis.
Posts Tagged 'Medicare'
Health Economist Shreds PBMs’ Claim of Large Cost Increase from “Any Willing Pharmacy” Medicare ProposalPublished July 28, 2014 Medicare , pharmacy benefit managers Leave a Comment
Tags: Medicare, pharmacy benefit managers
By Kevin Schweers
NCPA is providing feedback and suggestions to Centers for Medicare & Medicaid (CMS) officials grappling with unintended consequences impacting patient care in hospice settings stemming from a new policy the agency implemented May 1, 2014.
By Stephanie DuBois, Associate Director, Marketing Communications
Community pharmacists rallied on social media last week to highlight the negative impact that exclusive Medicare Part D preferred pharmacy networks have on patients and community pharmacies. Through communications to Capitol Hill as well as tweets and Facebook posts (using the hashtag #pharmacychoice), we continued to spread our message to patients, health care providers, and elected officials that willing community pharmacies are unfairly excluded from participating in “preferred” pharmacy networks.
Some examples of the #pharmacychoice posts we saw on Twitter and Facebook last week include these stories:
- “@Commpharmacy a pt. has to get mail order (no copay) or pay full price for insulin (ave temp high 80/90s) after 2 refills #pharmacychoice” – via @Joe_Greenwood (note: @commpharmacy is NCPA’s Twitter handle.)
- “@commpharmacy We’ve lost patients due to the Medicare Preferred Network and now they drive 40+ miles to get their drugs. #pharmacychoice” – via @StockstillsRx
- “We are @BenFrankApoth & believe everybody should have right to choose their own pharmacy #PharmacyChoice #IAmSmallBiz http://youtu.be/yA-0x8P1pf4” – via @BenFrankApoth
- “We have a lot of patients who have changed due to lower co-pays or “preferred” status.” – via Facebook
- “I still have some patients that prefer our service, enough to pay $75-$125 a copayment, but let’s face it, most people cannot afford to pay a higher copayment, regardless of how good my service is.” – via Facebook
- “I have a patient who can’t afford the extra $27 for her copay at my pharmacy for her pain medication. The chain stores she asked to use won’t order her med until she brings the script. Sometimes she waits a week. With narcotics the chance for withdrawal is constantly on her mind now, but she doesn’t have the choice because of the money.” – via Facebook
Community pharmacists also urged their Representatives to support H.R. 4577, the Ensuring Seniors Access to Local Pharmacies Act, which now has 22 cosponsors. The legislation would allow any willing pharmacy located in a medically underserved area (such as rural areas or certain urban areas) to participate in Medicare Part D preferred networks.
Personal stories are the most effective messages we can share with elected officials. Please keep up the pressure and ask your Member of Congress to cosponsor H.R. 4577 and support #pharmacychoice. Access resources and learn more about this issue at www.ncpanet.org/pharmacychoice.
The lead sponsors of The Ensuring Seniors Access to Local Pharmacies Act (H.R. 4577) are actively generating additional co-sponsors and recently added some particularly influential lawmakers to their ranks.
This week the National Community Pharmacists Association (NCPA) continues the push for pharmacy choice and the “any willing pharmacy” policy. As part of that effort, a new advertisement to Capitol Hill spreads awareness of an “open letter” to Congress on this issue that was signed by 130+ patient advocacy, pharmacist and business organizations. Continue reading ‘NCPA Continues Drive for Pharmacy Choice, Competition in Medicare’
Nearly 400 independent community pharmacists have come to Washington, D.C. to advocate for their patients and their communities as part of the National Community Pharmacists Association (NCPA) Conference on National Legislation and Government Affairs. While they will visit several hundred congressional offices, they may not reach 100 percent of Capitol Hill. So To complement their advocacy efforts, NCPA is running advertisements to echo the work of NCPA members.
While Medicare officials unfortunately put aside for now their proposal to allow “any willing pharmacy” to serve as a “preferred pharmacy” in Medicare Part D drug plans, the shortcomings of these plans continue to be readily apparent.
Tags: Medicare, pharmacist
To advance the pro-patient, pro-pharmacist provisions contained in Medicare’s proposed Part D rule, the National Community Pharmacists Association (NCPA) has launched an advertisement campaign in Washington media outlets this week, in conjunction with a House subcommittee hearing.
Georgia Congressman Once Again Raises Concerns with CMS Over Preferred Networks, Now it is Your TurnPublished February 7, 2014 Medicare Leave a Comment
By Michael Rule, Associate Director of Public Affairs and Grassroots Advocacy
Georgia Congressman Lynn Westmoreland recently sent a follow up letter to the Centers for Medicare and Medicaid Services (CMS) to raise concerns over preferred networks in Medicare Part D, particularly the fact that independent community pharmacies are often not afforded the opportunity to participate. The letter highlights that many Part D beneficiaries rely on the face-to-face counseling and the in-person services provided by independent community pharmacists. Furthermore, his letter notes that independent community pharmacies serve traditionally underserved urban and rural communities where access to care is at a premium. Continue reading ‘Georgia Congressman Once Again Raises Concerns with CMS Over Preferred Networks, Now it is Your Turn’
Tags: compounding, Medicare, pharmacist, pharmacy benefit managers
By Michael Rule, Associate Director of Grassroots and Public Affairs
From a grassroots perspective, 2013 should be a year that is long remembered by pharmacists. Due to pharmacist engagement, independent community pharmacists achieved pro-patient, pro-pharmacist successes at both the state and federal level and continued to build relationships with legislators through hosting pharmacy visits. Continue reading ‘Grassroots Efforts Yield Successes in 2013: Keep it up in 2014′