Latebreakers: Half of Part D payments take 30 days or more

September 17, 2007

A University of Texas study reveals that many pharmacies wait longer than 30 days for payment for Medicare Part D prescriptions.

A University of Texas study examining three million Medicare Part D claims in 2006 found that half of the claims for independent pharmacies took 30 days or more to pay and 17% took more than two months to process. Researchers looked at electronic claims processed by switches and calculated the time between when pharmacies submit claims and when they receive payment for those claims. Represented in the study were 145 community pharmacies and 17 small and regional drug chains. Because the data were not randomized and considered only electronic claims, the results may not be representative for the entire industry. For example, researchers noted that claims paid by mail are likely to be even slower. Overall, the study found that 44% of the claims for chains and independents took at least 30 days. According to Rep. Marion Berry (D, Ark.), who has introduced the Fair & Speedy Treatment of Medicare Prescription Drug Claims Act of 2007, the new study may put renewed pressure on the lawmakers to take up the bill. "Some of our pharmacists do not have the luxury of time," he said. "The study is going to be a big help."