Healthcare organizations continue to advocate for proposed federal legislation that would ban retroactive pharmacy direct and indirect remuneration fees in Medicare Part D.
Here are six things to know.
1. According to the National Community Pharmacists Association, DIR fees are taken from community pharmacies by Medicare Part D plan sponsors and pharmacy benefit managers. "Nearly all pharmacy DIR fees are clawed back retroactively months later rather than deducted from claims on a real-time basis," the organization's website reads.
2. The Improving Transparency and Accuracy in Medicare Part D Drug Spending Act would ban the retroactive fees, according to a news release. The act comes via companion bills proposed in the U.S. House and Senate.
3. Nearly 120 healthcare organizations sent letters voicing their support of the bills to both chambers, according to the release. More than 95 of the organizations showed support in 2016 via similar letters to lawmakers. The additional signatories, which bring the total number of signatories to 118, joined the advocacy movement after the bills were reintroduced this year, the release states.
4. In the letters, the organizations said DIR fees are "often assessed weeks or even months after a prescription has been filled, [and] prevent pharmacies from knowing at the time of dispensing what their true reimbursement will be for that prescription," the release states.
"The lack of transparency and the significant lag time in the pharmacy being notified about these retroactive fees creates an unnecessary burden on pharmacy operations and makes it very difficult to make decisions for the future," the organizations added.
5. The healthcare organizations also address beneficiaries in their letters, saying, "Accounting for these fees at point of sale protects the integrity of the Medicare program, ensures beneficiaries are not being overcharged for their medications and can potentially lower overall costs as fewer beneficiaries reach the catastrophic phase."
6. The National Community Pharmacists Association signed the letters, as did groups representing drug wholesalers, grocery stores, pharmacy buying groups, retailers and major health systems, according to the release.