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The Dose

More Members of Congress Pressure Medicare on DIR Fees

by Michael Rule | Aug 10, 2016

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In June, due to NCPA advocacy efforts and widespread grassroots activity from independent pharmacists, 30 members of the House of Representatives wrote to the Centers for Medicare & Medicaid Services (CMS) urging the agency to finalize its guidance on DIR fees. NCPA members and staff continued advocacy efforts, and as a result, three more members of Congress have contacted CMS to voice support for their DIR proposal.

Congressman Ralph Abraham (R-La.) highlighted the lag time in assessing fees and the importance of CMS finalizing its guidance, writing in part, "Through discussions with multiple independent pharmacies in Louisiana's Fifth Congressional District, I learned of situations in which pharmacies have been waiting for as long as five months to find out the dollar amount in DIR fees that PBMs are taking from them. This is no way for an industry to run. CMS finalizing guidance on their DIR rules would be a positive step toward consistent and fair reporting."

In a separate letter, Congressmen William Keating (D-Mass.) and Seth Moulton (D-Mass.) reiterated the support of their colleagues for CMS' proposal, noting "As Congressmen Scott, Loebsack, Welch, and Carter noted in their letter to you dated June 14, 2016, and as many other Members of Congress concurred, your agency's proposed guidance should be successful because: (1) it prevents PBMs and plan sponsors from manipulating drug prices by withholding market information; and (2) it ensures that Medicare beneficiaries have access to the most accurate data available as they assess the costs of their prescriptions."

These letters are further evidence of growing momentum in Congress for addressing DIR fees, however, it's vital to continue to communicate with elected officials on the impact DIRs have on local small business pharmacies. A recent post on NCPA's The Dose entitled "Turn Up the Heat on Congress this Summer" highlighted a toolkit of resources available to independent pharmacists to help make their voice heard, and the NCPA Legislative Action Center can be utilized to send messages to your legislators urging action on DIRs. Continuing to engage legislators with a coordinated and unified voice and raising awareness of the local impact of DIRs will help sustain the momentum.