At the 47th annual Congressional Pharmacy Summit held at the end of May by the National Community Pharmacists Association (NCPA), more than 300 pharmacists were in attendance to support legislation that is intended to bring greater clarity to prescription drug pricing.
H.R. 244, the âMAC Transparency Act,â which was introduced in 2015 by Rep. Doug Collins of Georgia, would amend title XVIII of the Social Security Act to provide standards for pharmacy benefits managers (PBMs) under the Medicare prescription drug program to further transparency of payment methodologies to pharmacies.
In addition, Rep. Earl L. âBuddyâ Carter (R-Ga), the only pharmacist currently serving in Congress, and three of his colleagues, Reps. Austin Scott (R-Ga), Dave Loebsack (D-Iowa), and Peter Welch (D-Vt), are circulating a letter to their colleagues asking them write to Acting Administrator Slavitt at the Centers for Medicare and Medicaid Services (CMS) and ask CMS to finalize and implement its âProposed Guidance on Direct and Indirect Remuneration (DIR) and Pharmacy Price Concessions.â
Because of the growing use of post-claim adjudication price concessions and fees imposed by PBMs, independent community pharmacies âare facing increasing uncertainty about their ability to serve Medicare beneficiaries,â the letter stated.
Rep. Carter explained in a media call that DIR fees have been a âthorn in our side, specifically pharmacists, primarily because of clawbacks that occur weeks to months following an adjudicated claim.â
NCPA CEO B. Douglas Hoey, RPh, MBA, noted that the CMS guidance, when finalized, âwonât fix the problem, but it would certainly provide clarity.â
Other bills to consider
NCPA is also advocating for passage of H.R. 793, the âEnsuring Seniors Access to Local Pharmacies Act of 2015,â which would allow any willing community pharmacist to participate in a Part D preferred network. H.R. 592, the provider status bill, which has 282 co-sponsors, is also top of mind for NCPA members this year.