ESI blinked and vows to accelerate reimbursement for bonus pool fees

NCPA June 12, 2024

medicare performance network bonus pool update

Many of you may have received a message from Express Scripts, Inc. yesterday announcing that it is giving up on its “bonus pool” fee program that NCPA believes violated CMS’ DIR regulation. Of course, ESI pretended in its message that it was abandoning the scheme “in response to a challenging pharmacy environment and feedback from providers.” But the truth is that ESI would never have reversed itself, and it would certainly never have agreed to refund the fees it has taken from you, without pressure from NCPA and independent pharmacy.

We’re grateful to CMS for listening to your concerns, and then acting on them. And we would like to thank all of you who made us aware of the problem and helped us develop a strategy. This big win is proof of what we can accomplish together. Stay tuned to qAM for more on this developing story. 

NCPA