Bipartisan Congressional Coalition Formed To Support Independent Pharmacists

Main Category: Pharmacy / Pharmacist
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 03 Oct 2007 - 12:00 PDT

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Thirty-one members of Congress have formed a bipartisan group to advocate for passage of bills that would establish reimbursement schedules and other guidelines for independent pharmacists working with insurers and pharmacy benefit managers, CQ HealthBeat reports. The formation of the Congressional Community Pharmacy Coalition comes amid concerns over conditions set under the 2003 Medicare Part D prescription drug plan, which allows insurers and pharmacy benefit managers to set drug sales rates at just above cost, independent pharmacists say. In addition, community pharmacists say that insurers and PBMs have been taking too much time to complete reimbursements, forcing the pharmacists to take loans to maintain their businesses or shut down.

Large pharmacy retailers are not affected by the problem because they are big enough to negotiate directly with drug companies, and they can establish their own corporate pharmacy benefit managers to work with the insurers, CQ HealthBeat reports. Rep. Anthony Weiner (D-N.Y.), the coalition's chair, in a press release said, "The deck is stacked against community pharmacists." One of the bills (HR 1474) being supported by the coalition calls for reimbursement of pharmacists within 14 days. The Pharmaceutical Care Management Association in a statement said the 14-day time limit is unfair and would raise drug costs. PCMA also said that "member companies have routinely paid clean claims within 30 days" and that the 14-day proposal "exceeds the payment requirements of 43 states" (Lubbes, CQ HealthBeat, 10/1).

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