WASHINGTON, DC, May 02, 2022 (GLOBE NEWSWIRE) — May 02, 2022 07:00 AM ET | Source: National Association of Specialty Pharmacies (NASP)
On Friday, April 29, the Biden administration released final regulations for the Medicare Advantage (MA) and Medicare Part D programs, including significant reforms affecting seniors and pharmacies. National Association of Specialty Pharmacy (NASP) President and CEO, Sheila Arquette, RPh, commends the Centers for Medicare and Medicaid Services (CMS) for taking the right steps to dramatically reduce drug costs borne by all Medicare beneficiaries through the Pharmacy DIR’s initial reforms, although it also expresses disappointment that CMS has delayed implementing these critical reforms until January 2024. The NASP also calls on the Congress to further strengthen the rule by establishing statutory protections that will support patient access to their pharmacies and ensure fair reviews of specialty pharmacy performance.
Arquette said, “CMS has taken a big step towards reducing drug costs for seniors through some necessary reforms to the pharmacy DIR. However, the rule does not prohibit all retroactive charges on pharmacies. Failure to process all retroactive charges could limit patients’ access to the pharmacy of their choice and negatively impact competition in the pharmacy marketplace. The rule makes several important reforms, but Congress and CMS need to get it right and work together to ensure comprehensive DIR pharmacy fee reform.
Pharmacy DIR fees are monies received by Pharmacy Benefit Managers (PBMs) and Part D plans and include price concessions and other fees that pharmacies are obligated to pay after dispensing drugs to people elderly. Pharmacy DIR fees are manipulated by PBMs/payers and often force pharmacies to fill Medicare prescriptions below cost.
“Pharmacies have been waiting for these reforms for far too long. With a gap before implementation, Congress and the administration must work to prevent further anticompetitive abuses against pharmacies. Monitoring finalized CMS reforms will also be critically important, and further reforms are needed to ensure reimbursement is reasonable and performance reviews by schemes are fair so that specialty pharmacies can remain open and available in network for specialist patients.
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The National Association of Specialty Pharmacy (NASP) is the only national association representing all stakeholders in the specialty pharmacy industry. NASP members include the nation’s leading specialty pharmacies, pharmaceutical and biotechnology manufacturers, group purchasing organizations, patient advocacy groups, integrated delivery systems and health plans, technology providers and data management, logistics providers, wholesalers/distributors and practicing pharmacists, nurses, and pharmacy technicians. With more than 150 corporate members and 2,500 individual members, NASP is the unified voice of specialty pharmacy in the United States.