The National Community Pharmacists Association is urging the Senate and House Small Business committees to hold a hearing to examine the impact of preferred pharmacy networks in Medicare Part D prescription drug plans.


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NCPA calls for hearing on preferred pharmacies

March 26th, 2014

ALEXANDRIA, Va. – The National Community Pharmacists Association is urging the Senate and House Small Business committees to hold a hearing to examine the impact of preferred pharmacy networks in Medicare Part D prescription drug plans.

NPCA said Tuesday that it has sent a letter to committee leaders to highlight the "unintended consequences" of preferred pharmacies on Part D patients and independent pharmacies.

"Small-business community pharmacies across the country are losing patients due to their inadvertent exclusion from these preferred networks. Additionally, CMS itself has released data showing that these networks, in their current form, might not even be saving money for the federal government," NCPA chief executive officer B. Douglas Hoey wrote in the letter. 

Hoey noted that for 2014 over 70% of Part D plans have a preferred pharmacy network, "and the trend appears to be growing."

"We request that you schedule an oversight hearing to determine what changes need to be made to the statute in order to level the playing field for independent community pharmacies," he said in the letter. "As you know, our members serve a disproportionate share of Medicare patients in highly rural and low-income urban areas across the country; therefore, it is critical that Congress continue to work to eliminate any barriers which may result in a disruption of care, counseling or access to medications for these patients."

NCPA's letter comes in the wake of a setback for its efforts to expand pharmacy participation in preferrred networks. Earlier this month, the Centers for Medicare & Medicaid Services (CMS) pulled a provision in its proposed regulation for 2015 Part D plans that sought to allow any pharmacies to participate as preferred providers as long as they're willing to accept the contract terms offered by a drug plan.

CMS' proposal on preferred pharmacies received support from dozens of members of Congress from both parties, including House Small Business Committee Chair Sam Graves (R-Mo.), as well as from key Medicare beneficiary advocates, NCPA pointed out. The association stated Tuesday that CMS shelved the proposal "largely as a result of political opposition to other, unrelated provisions contained in the agency's broader proposed rule."

"When the Part D law was first enacted, there was no need for any small business set aside, because it included an 'any willing provider' provision that mandated that any pharmacy willing to accept the terms and conditions of a plan could participate," Hoey said in a statement on Tuesday. "Now, as a result of CMS' faulty interpretation of this provision, small businesses need Congress to act more than ever."

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