Reimbursement

In a Victory for Patient Access, Administrative Judge Deals Further Blow to Washington State’s Below-Cost Medicaid Pharmacy Reimbursement Plan Pharmacy groups urge federal Centers for Medicare & Medicaid Services to take final action to reject plan, in accordance with Administrative Law Judge’s decision

admin2020-11-24T09:01:05-05:00Categories: Press Release|Tags: Medicaid, Reimbursement, States|

Following the Administrative Law Judge's decision, NACDS, the Washington State Pharmacy Association, and the National Community Pharmacists Association urged the Centers for Medicare & Medicaid Services to bring to an end Washington State’s flawed pharmacy reimbursement plan.

NACDS Asks CMS to Fix State Calculations That Make Medicaid Pharmacy Reimbursement Even Worse Using discount-card drug prices in tally of “usual and customary” pharmacy charges is not lawful, wrongly depresses payments to pharmacies, and ultimately could harm patients

admin2020-08-12T18:34:15-04:00Categories: Press Release|Tags: CMS, Medications, Reimbursement|

NACDS says using discount-card drug prices in tally of “usual and customary” pharmacy charges is not lawful, wrongly depresses payments to pharmacies, and ultimately could harm patients: "For consumers on tight budgets who rely on third-party discount cards to pay for their medications, the potential loss of access to these discounted medications would be devastating.”

More than 240 Patient, Healthcare Groups Urge Congress to Reform Pharmacy “DIR Fees” This Year Congress “should not overlook the clear and present opportunity” to address reforms

admin2020-05-08T14:24:07-04:00Categories: Press Release|Tags: Congress, DIR, Reimbursement|

More than 240 entities urged Congressional leaders to act on a key reform to lower patients’ prescription drug prices at the pharmacy counter and to help prevent pharmacy closures that jeopardize access.

New Indiana Law Vital for Patient Access and Pharmacy Viability, NACDS Says

admin2020-03-26T14:58:16-04:00Categories: Press Release|Tags: Reimbursement, States|

With the enactment of a new law – Senate Bill 241 – Indiana has made great strides to help protect the viability of pharmacies in neighborhoods across the state. The legislation will help ensure that pharmacies are more fairly and properly reimbursed by requiring payers’ pharmacy contracts to have clearly defined drug pricing and reimbursement methodologies and audit practices.

This new law, signed by Gov. Eric Holcomb (R), also prevents payers from retroactively denying pharmacies’ claims for prescriptions that were dispensed, and allows pharmacies to contest changes in their reimbursement. The legislation also requires the maintenance of adequate pharmacy networks and provides beneficiaries with equal access to all network pharmacies.

“Work on this important bill has been underway since well before COVID-19, yet the pandemic shows just how critical it is to maintain pharmacy viability. Pharmacies and pharmacists are on the front lines of healthcare in neighborhoods throughout Indiana and across the country. Access to pharmacies is critical as the COVID-19 pandemic is creating unprecedented stresses on our healthcare system across the nation,” said NACDS President and CEO Steven C. Anderson, IOM, CAE. “This newly enacted law will help patients throughout Indiana continue to receive care from the pharmacy of their choice – which is important at all times and certainly during an emergency.”

NACDS recognizes the legislative leadership of the bill’s primary sponsor, State Senator Liz Brown (R); the House sponsor, State Representative Matt Lehman (R); author and Chair of the Senate Health and Provider Services Committee, State Senator Ed Charbonneau (R); Chair of the House Insurance Committee, State Representative Martin Carbaugh (R); and the distinguished Conference Committee Conferees and Advisors, including two pharmacist legislators: co-author State Senator Ron Grooms (R) and co-sponsor State Representative Steven Davisson (R).

NACDS also acknowledges the leadership of the Indiana Pharmacists Association and NACDS member companies.

Pharmacy Reimbursement Modernization Needed, Report Says NACDS, NCPA and NASP say patient access and fairness to pharmacies merit the attention of policymakers. Their study shows that pharmacies’ cost of dispensing Medicaid prescriptions exceeds the dispensing fee paid by 46 of 47 states. Of note, this is the first national study to evaluate the costs of dispensing specialty drugs.

admin2020-03-03T09:45:42-05:00Categories: Press Release|Tags: Reimbursement|

Pharmacy reimbursement paid by state Medicaid programs requires a fresh look and modernization, according to a new Cost of Dispensing Study commissioned by the National Association of Chain Drug Stores (NACDS), the National Community Pharmacists Association (NCPA) and the National Association of Specialty Pharmacy (NASP).

NACDS: U.S. Supreme Court Precedents Side with Arkansas Move to Regulate PBMs Brief argues for maintaining Supreme Court precedents, reversing Circuit Court decision, and upholding Arkansas law vital for patients, pharmacies

admin2020-03-02T12:54:19-05:00Categories: Press Release|Tags: Legal, Reimbursement|

Brief argues for maintaining Supreme Court precedents, reversing Circuit Court decision, and upholding Arkansas law vital for patients, pharmacies

NACDS Op-ed in Morning Consult: DIR Fees “as Damaging to Patients and Pharmacies as Advertised” Congressional action urged as Drug Channels Institute analysis shows fees “have grown faster than most people realize” and reached a record $9.1 billion in 2019

admin2020-02-26T12:52:02-05:00Categories: Press Release|Tags: Congress, DIR, Public_Relations, Reimbursement|

NACDS' opinion piece cites a Drug Channels Institute analysis that DIR fees “have grown faster than most people realize” and reached a record $9.1 billion in 2019.

Executive Order 13890 Relies on Leveraging Pharmacy, NACDS Says Expansive comments to CMS demonstrate that success of healthcare transformation relies on removing barriers to pharmacy care

admin2020-01-22T08:25:53-05:00Categories: Press Release|Tags: CMS, Medicare, Pharmacy_Value, Reimbursement|

Expansive comments to CMS demonstrate that success of healthcare transformation relies on removing barriers to pharmacy care

U.S. Supreme Court’s Review of Pharmacy Reimbursement Law Lauded by NACDS Arkansas PBM law to cover pharmacy costs has been blocked by Circuit Court

admin2020-01-15T14:59:20-05:00Categories: Press Release|Tags: Legal, PBM, Reimbursement|

The U.S. Supreme Court will review the Eighth Circuit Court’s decision that put the brakes on Arkansas’ PBM law that would ensure that pharmacy reimbursement rates cover pharmacies’ costs of purchasing drugs.