The legislation will protect independent pharmacists from going out of business by ensuring that insurance companies provide adequate and timely reimbursements under the new Medicare Part D prescription drug benefit.

The bill also promotes greater use of generics, saving taxpayers an estimated $94 for every generic prescription dispensed.

“The Medicare prescription drug benefit continues to place an overwhelming and unnecessary burden on our pharmacists,” Abercrombie said. "If Congress does not act soon, Hawaii independent pharmacists may have no choice but to close their doors, leaving patients without access to a critical health care source. Our bill is a simple reform that will make sure pharmacists are treated fairly and not held hostage by insurance companies."

According to surveys conducted by the NCPA, more than 90% of responding pharmacists say their cash flow is worse since the Medicare Prescription Drug Benefit began on January 1, 2006, and more than 60% have sought outside financial assistance from banks, wholesalers, credit unions or family members to cover the financial shortfalls.  

Abercrombie is supporting the FAST Claims Act because of the difficulties experienced by independent Hawaii pharmacists like Carl Mudrick, Pharmacist-Manager of City Pharmacy Kapahulu.

Every day, Carl Mudrick fights the Part D bureaucracy to try to ensure his customers have the medications they need.  But for some of his Part D customers, he is currently being paid a fee of less that $1 per prescription.  At this rate, Mudrick cannot keep his pharmacy open, and as a result, he is rethinking his decision to operate an independent pharmacy. 

The FAST Claims Act seeks to ensure that:

Ø      Pharmacists are paid for their services in a timely manner by requiring Medicare Prescription Drug Plans (PDPs) to offer electronic direct deposit of reimbursements to participating pharmacies;

Ø      Claims submitted electronically will be paid within 14 days, and all other claims will be paid within 30 days;

Ø      Pharmacists are promptly notified if there are problems with submitted claims;

Ø      Generic dispensing fees are set at a minimum level to ensure pharmacists can afford to provide cost-saving drugs to their communities; and

Ø      Co-branding is prohibited on cards issued by a prescription drug plan.

The FAST Claims Act also builds on a provision in the 2003 Medicare bill by establishing guidelines for Medication Therapy Management (MTM) programs offered by drug plans. Such programs are critical in promoting the proper use of medications and reducing adverse events in high-risk seniors.

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