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Senate bill takes aim at DIR fees

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ALEXANDRIA, Va. — Congressional support continues to build for cracking down on direct and indirect remuneration (DIR) fees.

The National Community Pharmacists Association said that four U.S. senators on Monday introduced a bill that would boost transparency in Medicare Part D drug spending and prohibit retroactive DIR fees.

The Improving Transparency and Accuracy in Medicare Part D Spending Act (S. 3308) — sponsored by Sens. Shelley Moore Capito (R., W.Va.), Jon Tester (D., Mont.), John Boozman (R., Ark.) and Tom Cotton (R., Ark.) — is companion legislation to H.R. 5951, introduced last week by nine House members. The bill would end huge clawbacks, known as DIR fees, assessed by Medicare drug plans or pharmacy benefit managers, long after prescriptions are filled, according to NCPA.

“Since the inception of the Medicare Part D drug benefit, independent community pharmacists have tirelessly served seniors to help them get the most out of the program. Over the years, Medicare officials and Congress have occasionally stepped in to make enhancements so Part D operates more smoothly. That action is certainly needed now to address out-of-control DIR fees,” NCPA chief executive officer B. Douglas Hoey said in a statement.

Many community pharmacists say they receive no information about when DIR fees will be collected or their amount, and the fees can total thousands of dollars each month. As a result, pharmacists explain, it’s often impossible to determine at the time of dispensing whether the net reimbursement will cover their costs, such as purchasing drugs.

“In banning retroactive DIR fees, S. 3308/H.R. 5951 would improve transparency in Medicare Part D as many members of Congress, Medicare officials and NCPA have urged. The bill would also lower beneficiary cost-sharing at the pharmacy counter without increasing Medicare Part D costs,” Hoey added. “NCPA congratulates Sens. Capito and Tester and their colleagues on introduction of this important legislation. It would go a long way to addressing the problems that NCPA has raised and educated Congress, Medicare and others about.”


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