In the News

Tell CMS to Ban DIR Fees!

We’re excited to see progress at the federal level regarding direct and indirect remuneration, or, DIR fees. CMS’s new proposed rule, Rule: Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out of Pocket Expenses proposes several critical policy changes, among them DIR fee reform.

In a recent blog post, HHS Secretary Alex Azar and CMS Administrator Seema Verma wrote, “Independent pharmacies have raised concerns that back-end deals with health insurance plans are eroding competition and making it harder for them to continue providing medications to beneficiaries. Plans can set performance requirements for pharmacies that may not be achievable, leading to large financial clawbacks from pharmacies and swings in revenues that pharmacies cannot manage. What’s worse, beneficiaries are not benefitting from these discounts in the amount that they pay at the pharmacy counter—they are paying cost-sharing based on a price that is higher than the amount that pharmacies are actually reimbursed for drugs.”

While we’re pleased at the proposed new rule, we encourage every Louisiana independent pharmacy to take a moment to raise your voice and share your experience, feedback and concerns about the impact of DIR fees on your pharmacy and patients. Retroactive DIR fees cost independent pharmacies in the tens of thousands annually, with no clear evidence the fees are returned anywhere but to a pharmacy benefits middleman’s pocket.

The public comment period is open until January 25, 2019 at 4 pm CT. You can share your thoughts with CMS here, and we encourage you to do so now. The current government shutdown does not affect the transmission of your comments.

You can read the proposed law in its entirety here.

 

Investigate TV: Medical Waste and the Whistleblower

In a new documentary, InvestigateTV Director of Investigations Lee Zurik unveils the whistleblower who started a three-year investigation into health care prices that saved Americans millions and changed federal law. Meet the Hammond, LA pharmacist whose courage resulted in sweeping changes to the common practice of PBM contract "gag clauses" and the signing of the Know the Lowest Price Act of 2018 and Patient Right to Know Drug Prices Act

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