NCPA said the Ensuring Seniors Access to Local Pharmacies Act of 2017 (H.R. 1939), introduced by Reps. Morgan Griffith (R., Va.) and Peter Welch (D., Vt.), would enable pharmacies in medically underserved communities to participate in Part D preferred pharmacy networks if they accept the same contract terms and conditions as existing in-network providers.
“Community pharmacies play a critical role in providing seniors in southwest Virginia and other rural areas with an ability to fill prescriptions for the medications they depend on,” Griffith said in a statement. “The network pharmacy designation allows rural residents to receive the same reductions in coinsurance or copayments that those in higher population areas are able to receive.”
Currently, independent community pharmacies are often not allowed to participate in some preferred pharmacy arrangements, even if they offer to accept the Part D plan’s contract terms and conditions.
“Vermont seniors need reliable access to affordable medicines no matter where they live,” Welch stated. “Our legislation will help ensure that seniors are able to fill their prescriptions at their local pharmacy.”
H.R. 1939 would boost competition among pharmacies and Part D drug plans by expanding the number of pharmacies that can offer discounted co-payments for Part D prescription drugs, according to NCPA. That, in turn would seniors in medically underserved areas, medically underserved populations or health professional shortage areas broader access to discounted co-pays for drugs at their pharmacy of choice, the association said.
In addition, the measure would encourage “price competition and lower costs in the Part D program,” according to the Centers for Medicare & Medicaid Services (CMS).
“Consumer choice is hallmark of a free market economy, but many preferred pharmacy Medicare Part D plans effectively limit where seniors can get their prescriptions filled by making seniors pay higher co-pays if they don’t get their prescriptions from specific large chain or mail order pharmacies,” NCPA chief executive officer B. Douglas Hoey said in a statement. “By creating a level field for all pharmacies to compete, H.R. 1939 ensures that seniors can use the pharmacy of their choice, not one assigned to them by a pharmacy benefit manager.”
NCPA noted that the legislation would especially benefit patients in underserved urban and rural communities who rely on independent pharmacies. According to a Medicare study, more than half of PBMs’ preferred pharmacy drug plans (54%) failed to meet the government’s threshold for reasonable access to pharmacies in urban areas. In many rural areas, the closest PBM-preferred pharmacy can be more than 20 miles away.
“Why should seniors have to drive long distances to a preferred pharmacy or use a mail order pharmacy when a nearby community pharmacy is able and willing to serve the patient?” Hoey added.