NACDS: Community pharmacy critical to Part D success

May 7, 2007

In a statement submitted recently to a Senate Finance Committee hearing, NACDS recommended eight specific enhancements for the Medicare Part D prescription drug benefit program.

In a statement submitted recently to a Senate Finance Committee hearing, NACDS recommended eight specific enhancements for the Medicare Part D prescription drug benefit program. They include:

  • Establish a "rolling" approach to beneficiary enrollment, with enrollments effective at the time that the plan delivers the identification card and all necessary billing information to the beneficiary.
  • Clarify that Part D plans are to allow any pharmacy that is willing to meet the plan's terms and conditions to participate in their network at the time the pharmacy is willing to do so, and not be required to wait until the following year.
  • Ensure implementation of Congress' intent that beneficiaries be able to obtain through any willing retail pharmacy an extended-day supply of Part D medications, such as a 90-day supply.
  • Require that plans pay retail pharmacies promptly for Part D prescription claims and update their pricing benchmarks on a daily basis.
  • Enhance information provided to pharmacies by Part D plans about generic drug reimbursement rates.
  • Implement a "plan-to-plan" billing reconciliation mechanism that would allow plans to account for beneficiaries' changes in coverage.
  • Move all Medicare Part B oral and inhalation medications to Part D.
  • Require Part D plans to report to CMS information about their delivery of medication therapy management (MTM) services.

NACDS also emphasized the essential and continued role of community pharmacy in educating seniors about Part D and in fostering its efficacy and effectiveness.

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