NCPA: Medicare Study Demands More Pharmacy Competition, Choice

PRESS RELEASE ALEXANDRIA, Va. (Dec. 16, 2014) —

The National Community Pharmacists Association (NCPA) issued the following statement today from CEO B. Douglas Hoey, RPh, MBA in response to a study by the Centers for Medicare & Medicaid Services (CMS) of beneficiary access to discounted copays at “preferred” pharmacies in Medicare drug plans:

“While minimum access standards have applied to the basic pharmacy networks of drug plans since the inception of the Part D program, the relatively recent and far more limited ‘preferred’ networks have been the proverbial ‘Wild West’ with no consumer safeguards. Many patients are confused and don’t understand terminology like ‘preferred’ versus ‘network’ pharmacies and have long-standing ties to their local pharmacists, whose pharmacy may be excluded.

“NCPA staff and members have long raised concerns regarding the inadequacy of beneficiary access to ‘preferred’ pharmacies in Medicare drug plans, particularly in underserved areas. Independent community pharmacies provide medication access and counseling to such populations, including dense urban areas, but are often excluded from participation in ‘preferred’ pharmacy arrangements, even when these small business providers offer to meet the drug plan’s terms and conditions for ‘preferred’ pharmacies.

“We appreciate CMS undertaking this review, and its conclusion that the findings announced today, ‘

reinforce CMS’ concern that plans are offering access to pharmacies with lower cost-sharing in a way that may be misleading to beneficiaries, in violation of CMS requirements

.’

“During 2014 progress was achieved in support of patient choice and the ability of community pharmacies to participate. Bipartisan ‘any willing pharmacy’ legislation (H.R. 4577) was introduced and garnered 80 cosponsors. Leading consumer and health advocates endorsed the bill as well. Voters expressed their overwhelming support for allowing patients to use a pharmacy that will accept their drug plan’s terms and conditions. An economic analysis demonstrated how, under H.R. 4577, Medicare costs could be the same or even reduced through increased pharmacy choice and competition to drive costs lower.

“However, more must be accomplished. NCPA will continue to work with Congress, CMS and others until

Medicare beneficiaries are allowed to go to any pharmacy willing to accept the pricing and terms of being a ‘preferred’ pharmacy.”

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The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of nearly 23,000 independent community pharmacies. Together they represent an $88.8 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 300,000 individuals, including over 62,000 pharmacists. To learn more, go to www.ncpanet.org, visit facebook.com/commpharmacy, or follow NCPA on Twitter @Commpharmacy.