Sen. Ron Wyden (D-Ore.), chairman of the Senate Committee on Finance, sent a letter to Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure this week asking the agency to increase enforcement of Medicare Part D program requirements for PBMs and to protect pharmacies from unfair PBM practices, specifically PBM violations of the rule that took effect the beginning of this year seeking to rein in DIR fees. He also asked that CMS take a series of concrete steps to address the problem, including enforcement of “any willing pharmacy” requirements by ensuring that PBMs reimburse pharmacies at a minimum of the cost to acquire and dispense covered prescription drugs; implementation of standardized pharmacy measures including the evaluation and reporting of plan performance measures; and reviewing complaints about PBM contracting practices under Part D over the past 18 months. NCPA has been active in seeking relief for our members, having alerted CMS of Express Scripts’ bad practices ... which CMS then confirmed violated the DIR rule and led to ESI terminating its “bonus pool” fee program.
NCPA
