NCPA Urges Clear Disclosure on “Preferred Pharmacy” Access Limitations

By Kevin Schweers

NCPA expressed strong support in comments submitted to the Centers for Medicare & Medicaid Services (CMS) for a new requirement that Medicare prescription drug plan sponsors provide clear disclosure to beneficiaries when prescription drug plans that advertise “preferred cost sharing” (access to lower co-pays) fail to meet minimum access thresholds in certain geographic areas.

In response to concerns of NCPA and others, CMS is preparing “disclaimer language” to accompany marketing material in such instances. The agency recently sought input on the draft disclaimer language.

NCPA offered constructive suggestions to the disclaimer, including the following points:

  • “Plan marketing materials should be consumer friendly and try to avoid any unnecessary health care-related jargon or terms that may be unfamiliar to those not intimately familiar with the health care industry or marketplace. NCPA is concerned that the draft disclaimer language, while technically accurate, does not provide enough detail in order to clearly convey to the consumer the potential ramifications of choosing such a plan and the impact it may have on their ability to conveniently access their prescription drug benefit.”
  • “NCPA would recommend that CMS stipulate that Plans provide the requisite disclaimer language in a sufficiently large enough font size so that this information does not become the ‘fine print’ that many consumers overlook.”

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