Taxpayers Protection Alliance and 60 Plus Endorse Bill to Set Standards for Pharmacy Audits, Strengthen Medicare Program Integrity



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Alexandria, Va. Feb. 7, 2014 - The Taxpayers Protection Alliance (TPA) and the 60 Plus Association (60 +) have sent a letter to members of the U.S. Senate and House of Representatives endorsing S. 867, The Medicare Prescription Drug Integrity and Protection Act. They join groups such as the National Community Pharmacists Association (NCPA) in backing the bill introduced last year by Sens. Mark Pryor (D-Ark.) and Jerry Moran (R-Kan.) that addresses controversial practices by the administrators of Medicare prescription drug plans, pharmacy benefit managers (PBMs).

"We are pleased that the Taxpayers Protection Alliance and 60 Plus Association have lent their weight behind the push to fix some of the most questionable tactics of PBMs in Medicare Part D, by backing S. 867," said NCPA CEO B. Douglas Hoey, RPh, MBA. "The bill would ensure pharmacy audits focus on ferreting out waste, fraud and abuse instead of using minor technicalities as the excuse for PBMs to recoup money. Not only would pharmacy audits go back to embracing their intended purpose, but those recouped funds would go back to the right source—the Medicare program, as opposed to being pocketed by the already very profitable PBMs."

Hoey added, "In addition, S. 867 would provide more privacy protection and choice by forbidding PBMs from transmitting personal patient information to a PBM-owned pharmacy unless the patient has voluntarily elected to fill their prescription at such pharmacy, and ban PBMs from requiring patients to use a retail or mail order pharmacy in which the PBM has an ownership interest."

Key points from the TPA and 60+ letter include:

  • Since PBMs own mail order pharmacies they are also a direct competitor to independent community pharmacies and the audits represent a "potential conflict of interest that could inflate the cost of pharmaceuticals thereby affecting taxpayers and seniors";

  • There is a perverse financial incentive for auditors to find any sort of mistake, no matter how small and unrelated to potential fraud it might be, in order to recoup payments; and

  • The legislation "sets a standard that if the correct patient receives the correct dosage of the correct medication on the correct date as prescribed by a doctor, the pharmacy should not be financially punished."

"This legislation is in the best interest of taxpayers, as it ensures legitimate audit recoupments are returned directly to Medicare and patients," TPA and 60+ wrote in their letter. "We strongly urge you to support this common sense legislation and put the interests of taxpayers above those of multi-billion dollar PBMs."


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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. Together they represent an $88.7 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 300,000 individuals, including over 62,000 pharmacists. To learn more, go to www.ncpanet.org, visit facebook.com/commpharmacy, or follow NCPA on Twitter @Commpharmacy.

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