Report From Congress: 7/2/2007

Letter

REPORT FROM CONGRESS: 7/2/2007

By Congressman Roger F. Wicker

WICKER HOPES FOR ACTION TO ASSIST COMMUNITY PHARMACISTS

Both Houses of Congress are giving serious consideration to legislation I am sponsoring to provide local pharmacies with more timely reimbursement for prescriptions filled through Medicare.

This initiative is designed to ease the financial hardship the Medicare Part D payment process has created. Currently, drug plans sometimes take up to 45 days to pay pharmacies for the prescriptions they dispense. Since most pharmacies must pay their suppliers within 15 days, the delay creates a cash-flow imbalance that has led to the first decrease in the number of community pharmacies in six years. The National Community Pharmacists Association says an average of three businesses a day have been forced to close their doors as a result.

LEADERS RECOGNIZE NEED

Leaders of the committees with jurisdiction over Medicare in both the House and Senate recognize the need to provide relief on this issue and are seeking opportunities to advance this legislation.

Our bill would establish a reasonable time frame for processing claims and providing reimbursement to the hometown pharmacies that provide such an invaluable service in our communities. I offered a similar measure in the last session of Congress, gaining 186 cosponsors.

PAYING CLAIMS IN 14 DAYS

The bill would require Medicare Part D drug claims be paid within 14 days if submitted electronically. Claims processed and filed using standard paperwork would be paid within 30 days. Companies participating would also be required to offer electronic direct deposit of reimbursement to all pharmacies. Many plans currently pay larger drug store chains electronically but do not offer that reimbursement option to community pharmacies.

Another provision in the legislation would require participating drug plans to notify pharmacists promptly if there are problems surrounding the submission of claims. It would also eliminate the confusing practice of "co-branding" on Medicare identification cards and other materials. Guidelines created by the Centers for Medicare and Medicaid Services prohibit favoring one Part D drug plan over another in its marketing activities. The same rule should apply for drug plans, which should not be permitted to steer senior citizens to one pharmacy over another through co-branding on the benefit card. This provision would make the process less confusing for senior citizens.

RURAL COMMUNITIES AFFECTED

We hope the improvements offered in this bill will correct the problem that has created hardship for community pharmacists throughout the country, but particularly in rural areas. Millions of senior citizens depend on the advice and personal service these small pharmacies provide. Speeding the reimbursement process would help keep them operating and ensure broader access to the Medicare Part D drug program.

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