Groups urging expanded Medicare pharmacy choice

June 13, 2014

Pharmacy groups, patient advocates, and many businesses are urging Congress to pass legislation that would allow Medicare beneficiaries to use discounted or preferred copays at independent pharmacies willing to accept the terms of Part D prescription drug plans.

Pharmacy groups, patient advocates, and many businesses are urging Congress to pass legislation that would allow Medicare beneficiaries to use discounted or preferred copays at independent pharmacies willing to accept the terms of Part D prescription drug plans.

The groups urged congressional action in a letter signed by 130 groups, which include the National Community Pharmacists Association, American Pharmacists Association, AmerisourceBergen, and Cardinal Health.

They are urging enactment of HR 4577. It would allow community pharmacies in underserved areas to participate in all Medicare Part D plans.

Presently, some Medicare Part D prescription drug plans have certain national chain pharmacies selected as the plan's "preferred" pharmacy. Patients who regularly use pharmacies that are not the preferred one must either change pharmacies or pay higher co-pays to continue using their current pharmacy.

"Right now, seniors in many communities face either trips of 20 miles or more to reach a 'preferred' pharmacy or must assume higher copays to use a local pharmacy they have maintained a trusted relationship with for many years," the groups wrote.

 

The groups contend that some beneficiaries, especially those in rural and underserved communities, have a difficult time finding pharmacies that are close and in their preferred network. "We believe that this is simply not right," they wrote.

The letter cites bipartisan support for the change that includes more than 30 members of Congress and numerous consumer groups. The Centers for Medicare & Medicaid Services supports such a policy change and has said it would raise program costs.