Sen. Shelley Moore Capito, R-W.Va., and Sen. Jon Tester, D-Mont., have reintroduced the Improving Transparency and Accuracy in Medicare Part D Drug Spending Act.
The legislation, previously introduced in the 114th Congress, would prohibit Medicare Part D plan sponsors and pharmacy benefit managers (PBMs) from retroactively reducing payments on accurate reimbursement claims submitted by pharmacies.
In 2008, Congress required that pharmacies be paid promptly, within 14 days, for accurate Medicare Part D reimbursement claims to ensure pharmacies could meet their financial obligations and continue to serve Medicare beneficiaries.
Recently, Medicare Part D sponsors and PBMs have begun imposing a variety of retroactive fees on pharmacists which are collected weeks or even months after a prescription was filled.
The senators said the Improving Transparency and Accuracy in Medicare Part D Drug Spending Act would prohibit the imposition of such fees for accurate claims, allowing pharmacists to continue to serve Medicare beneficiaries and others in their communities.
In addition, it would provide greater transparency in drug pricing for the Part D beneficiaries who will have more accurate information available online.
“Community pharmacies are important to our small towns and rural areas, and must remain open and accessible to Medicare patients,” Capito said. “The uncertainty in Medicare Part D drug pricing has posed many challenges for these small operations, but our bill will help stabilize the prices community pharmacies pay for prescriptions and allow more patients to access the medications they need.”
Tester said seniors are being forced to pay more for prescription drugs than ever before.
“This is a major problem and we have to hold everyone accountable,” Tester said. “No one should raise prices and grow profits at the expense of seniors and the medical providers and pharmacies that serve rural families.”