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NCPA urges Congress to take action on preferred networks
May 29th, 2014
ALEXANDRIA, Va. – The National Community Pharmacists Association has reiterated its call for Congress to hold a hearing and pass legislation on exclusionary practices by preferred pharmacy networks in Medicare Part D prescription drug plans.
NCPA said Wednesday that it has sent a letter to key House committee leaders to reassess preferred pharmacy arrangements, which often lock out independent community pharmacies and in turn limit seniors' choice of pharmacy.
The Ensuring Seniors Access to Local Pharmacies Act (H.R. 4577) would allow "any willing pharmacy" located in a medically underserved area to participate in all Part D drug plan networks, including a plan's discounted or "preferred" network, NCPA noted. The association has endorsed the legislation, introduced by Reps. Morgan Griffith (R., Va.) and Peter Welch (D., Vt.).
NCPA pointed out that some seniors and caregivers must travel 20 miles or more to access discounted co-payments at a Part D plan's preferred pharmacy, even though local community pharmacies may be willing to accept the plan's terms and conditions.
"We know that Congress did not intend to create access problems for Medicare patients who depend on the face-to-face counseling services that independent pharmacies have offered to them for so many years," NCPA chief executive officer B. Douglas Hoey wrote in the letter to leaders of the House Energy and Commerce Committee and Ways and Means Committee. "We respectfully request that you schedule an oversight hearing to examine ways to ensure that small-business owner pharmacies have the ability to try and compete with larger stores. We also request that you hold a legislative hearing on, and ultimately consider, the Griffith-Welch bill."
Also in the letter, NCPA cited concern by the Centers for Medicare & Medicaid Services (CMS) about restrictions that Part D plans are imposing on beneficiaries.
"We agree with many of the commenters who wrote that beneficiaries should be able to choose where they obtain their pharmacy services, and we are very concerned to hear that the current incentives (and potentially current marketing of pharmacies offering preferred cost sharing) lead many beneficiaries to believe that only those pharmacies offering preferred cost sharing can be used," CMS stated in its recent final regulation for the 2015 plan year. "We are also very concerned by the many comments reporting that beneficiaries are now driving 30 to 60 miles to the nearest pharmacy offering preferred cost-sharing or are feeling forced into using mail-order services, despite a preference to stay with a local pharmacy."
NCPA said that since CMS, for now, has declined to take regulatory action, congressional action is needed, notably to pass H.R. 4577.
In late March, NCPA had sent a letter to the Senate and House Small Business committees to hold a hearing to gauge the impact of preferred pharmacy networks in Part D drug plans.
About a month earlier, CMS, in its proposed regulation for 2015 Part D plans, had called for allowing any pharmacies to participate as preferred pharmacy providers as long as they are willing to accept the contract terms offered by a drug plan. However, a couple of weeks later, CMS decided to drop the "any willing pharmacy" provision from its proposed regulation.