PHARMACY

NRHA supports ‘common-sense’ Medicare bills pending in Congress

BY Drew Buono

ALEXANDRIA, Va. The National Rural Health Association is backing three legislative solutions currently in the Senate and House of Representatives that would remove steps blocking the financial viability of community pharmacies who endure slow reimbursement of Medicare Part D claims, pending cuts to Medicaid generic prescription drugs, and an inability to effectively bargain for fair contracts with the pharmacy benefit managers who administer drug plans.

The NRHA supports H.R.1474, the Fair and Speedy Treatment of Medicare Prescription Drug Act of 2007, and S.1954, the Pharmacy Access Improvement Act of 2007. These similar bills fix the slow pharmacy reimbursement of Medicare Part D prescription drug claims by PBMs, which cause cash flow problems for community pharmacies that force loans in the tens to hundreds of thousands of dollars to be taken out. The bills require complete and accurate Part D claims submitted electronically to be paid within 14 days by electronic funds transfer, and paper claims within 30 days.

The House and Senate are also considering bills tackling the Centers for Medicare and Medicaid Services’ Medicaid generic prescription drug pharmacy reimbursement formula based on what pharmacy groups are calling a “flawed” average manufacturer price. While the approaches are a bit different, NRHA endorses the inherent goal of each bill: to limit the damage AMP would have on community pharmacies and the patients they serve.

According to a Government Accountability Office study, community pharmacies, on average, will be reimbursed 36 percent below their acquisition costs for these drugs when the change is fully implemented in January 2008. H.R.3140, the Saving Our Community Pharmacies Act, establishes a new and fair pharmacy reimbursement benchmark reflective of what the actual retail costs are and includes provisions to drive generic drug utilization that increase taxpayer savings,. while S.1951, the Fair Medicaid Drug Payment Act of 2007 is focused on improving the AMP formula criteria for determining the averages and raises the maximum amount of potential reimbursement.

In addition, the NRHA supports the companion bills in the House and Senate—H.R. 971, the Community Pharmacy Fairness Act of 2007, and S.2161, which has the same title. These bills target the continuing problem of community pharmacies being offered take-it-or-leave-it contracts by the PBMs. They create a narrow exemption to current antitrust laws that allows community pharmacists to negotiate contracts as a group, which is essentially the arrangement under which the large, publicly held chain drug stores already operate.

“The National Rural Health Association’s endorsements of these common-sense bills is vital to presenting a united front of organizations that Congress will respond to in the near future,” said Charles Sewell, senior vice president of government affairs for the National Community Pharmacist Association. “The message should be loud and clear: if these bills are not acted upon, Congress will bear responsibility for the hardships and lack of services that community pharmacy patients will experience.”

keyboard_arrow_downCOMMENTS

Leave a Reply

No comments found

TRENDING STORIES

Polls

Which area of the industry do you think Amazon's entry would shake up the most?
PHARMACY

Celgene to acquire Pharmion for $72/share

BY Drew Buono

SUMMIT, N.J. Celgene and Pharmion have announced a merger agreement, under which Celgene has agreed to acquire Pharmion. Celgene will acquire all of Pharmion’s outstanding shares of common stock for $72 per share payable in cash and share of Celgene common stock.

Under the agreement, Celgene will acquire the rights to three popular Pharmion oncology drugs: Revlimid, Thalomid, and Vidaza. Thalmoid and Revlimid are used to treat patients with multiple myeloma. Vidaza is used to treat myelodysplastic syndromes.

“The acquisition of Pharmion is an exceptional strategic fit that will expand our role as a leader in hematology and oncology,” said Sol Barer, chairman and chief executive officer of Celgene Corporation. “Our combined global infrastructure will leverage the therapeutic and commercial potential of Pharmion’s products, particularly Vidaza, which has the potential to become a major global therapy. By bringing together the talents and resources of both companies, we move closer to our vision of becoming a leading hematology and oncology company in the world, expanding our industry leading programs for safety, access and patient support.”

keyboard_arrow_downCOMMENTS

Leave a Reply

No comments found

TRENDING STORIES

Polls

Which area of the industry do you think Amazon's entry would shake up the most?
PHARMACY

RxHub introduces Rx 4 Success e-prescribing program

BY Drew Buono

ST. PAUL, Minn. RxHub, a company that keeps track of patient-specific medication history and pharmacy benefit information, has announced a new product for e-prescribing, the Rx 4 Success.

The new program was developed to target four main areas of e-prescribing: utilization of Centers for Medicaid and Medicare Services approved ePrescribing transactions including eligibility, formulary and benefits, and medication history. The program will also integrate true electronic delivery of prescriptions to retail and mail order pharmacies. It will also keep consistent rules-based applications of clinical decision support content and formulate transactional data to support the development of outcomes based on pay-for-performance programs.

“We are extremely proud to be associated with our growing roster of partners which includes many of the healthcare industry’s foremost technology innovators,” stated Doug Johnson, vice president of business development for technology partners at RxHub. “Their collective vision not only helped shape Rx 4 Success but provides the foundation for ongoing market driven performance analysis and improvement.”

Rx 4 Success will become a participation requirement for technology partners connected to the RxHub network as of July 31, 2008.

keyboard_arrow_downCOMMENTS

Leave a Reply

No comments found

TRENDING STORIES

Polls

Which area of the industry do you think Amazon's entry would shake up the most?