NCPA Statement on Medicare Rule Requiring Shorter Drug Cycles in Long-Term Care Facilities

Alexandria, Va. - Nov. 16, 2010

National Community Pharmacists Association (NCPA) Executive Vice President and CEO Kathleen Jaeger issued the following statement today on a proposed rule recently issued by the U.S. Centers for Medicare and Medicaid Services (CMS) to require pharmacies to dispense brand name drugs in long-term care (LTC) facilities in seven-day cycles instead of the traditional 30-day cycle:

"Community pharmacists fully support efforts to reduce pharmaceutical waste in our health care system and have demonstrated that commitment, such as by referring patients to lower-cost generic drugs wherever appropriate.

"This year NCPA created a Long-Term Care Division to advocate for patients and the independent pharmacies that serve them in LTC settings. The LTC Division's staff met with Medicare representatives to share the perspective of community pharmacists and also outlined those views in a letter to CMS.

"NCPA appreciates the efforts of Medicare officials to take our views into account and to adjust the regulation to somewhat mitigate the proposed rule's impact on independent pharmacies. For example:

  • "First, the rule only applies to brand name drugs and exempts low-cost generics and certain other products. This should help avoid forcing pharmacies to spend more resources on preventing the dispensation of excess product than these particular products are actually worth.
  • "Second, while the rule does not exempt independent pharmacies, it does grant selected pharmacies an extra year to grapple with the expected compliance costs.

"Despite these positive aspects, this well-intentioned initiative could be an unfunded mandate for some small pharmacies. This new policy is an opportunity to utilize community pharmacists to produce real savings for Medicare, beneficiaries and Part D plan sponsors and allow pharmacists to be recognized for the value of those services to patients and the overall system. As currently written, the proposed rule only provides guidance to Part D plan sponsors to ensure that the dispensing fees paid to pharmacies take into account the additional time that will have to be taken. There is no firm requirement to adjust dispensing fees to reflect pharmacists' expert counseling services, much less recoup their costs like new technology, workflow and staffing arrangements.

"NCPA's LTC Division looks forward to continuing to work with Medicare officials and will provide formal comments to CMS on the proposed rule in hopes that some of these remaining issues can be positively addressed to make this rule more workable for small pharmacies. More detailed compliance guidance for community pharmacies is available to NCPA Long-Term Care Division members at"

The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 23,000 independent community pharmacies, pharmacy franchises, and chains. Together they represent a $93 billion health-care marketplace, have more than 315,000 employees including 62,400 pharmacists, and dispense over 41% of all retail prescriptions. To learn more go to or read NCPA's blog, The Dose, at

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