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NCPA: Lawmakers urged CMS to enforce ‘prompt pay’

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ALEXANDRIA, Va. — The National Community Pharmacists Association praised two Congressmen for calling on the Centers for Medicare and Medicaid Services (CMS) to force Medicare prescription drug plans to comply with a "prompt pay" provision in legislation effective at the start of this year.

NCPA said Monday that Reps. Marion Berry (D., Ark.) and Walter Jones (R., N.C.) played a pivotal role in urging CMS to enforce full compliance by all Medicare Part D prescription plans with the prompt pay provision in the Medicare Improvements for Patients and Providers Acts of 2008 (MIPPA), which went into effect Jan. 1.

Berry and Jones were the provision’s original authors and are now calling on CMS to use its regulatory power to stop "what appears to be the improper and illegal imposition of extraneous fees and charges on Part D network pharmacies," according to NCPA.

"Reps. Marion Berry and Walter Jones are rightfully upset at those Medicare Part D plans responsible for what has been happening this year," Bruce Roberts, executive vice president and chief executive officer of NCPA, said in a statement. "They worked hard to get legislation that banned an unscrupulous business tactic of certain Part D plans. That is, deliberately lining their pockets by earning interest off the ‘float’ from delaying payment to pharmacies for prescription drug claims."

He noted that because of the delayed reimbursements, many independent pharmacies were forced to take out loans and lines of credits to maintain cash flow, and some financially distressed pharmacies went out of business.

"Now some Part D plans may once again be gaming the system by creating new requirements designed to essentially recoup the money they previously earned off the float," Roberts added. "For a number of pharmacies one headache has been replaced with another series of headaches in the form of unnecessary bureaucratic hurdles and fees. This is certainly not consistent with the spirit or intent of the new law, and for pharmacies it hinders their ability to do what they do best: help patients. That’s why we applaud Berry and Jones for their action and hope CMS will act quickly."

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