News Release
Congressman Bob Etheridge
North Carolina

May 23, 2006

                                       Contact: Joanne Peters
                                       Phone: (202) 225-4531

Etheridge Calls for Prompt Reimbursements to N.C. Pharmacists Under Medicare Part D

WASHINGTON - U.S. Rep. Bob Etheridge (D-Lillington) today called for the prompt reimbursement to pharmacists for prescriptions filled under Medicare Part D prescription medicine plans. Etheridge is an original cosponsor of H.R. 5182, the Fair and Speedy Treatment of Medicare Prescription Drug Claims Act of 2006.

Pharmacists across America are struggling with the implementation of the new prescription medicine benefit, and it has been particularly burdensome for rural pharmacists. Under Medicare Part D, pharmacists are reimbursed by insurance companies, however many of the payments have been delayed. Some rural pharmacists fear they may soon have to close their doors.

"As Co-Chair of the Rural Working Group, I am particularly concerned about the impact of Medicare Part D on rural America and our local pharmacies. In many parts of my district, community pharmacies are the only place for seniors to go to fill their prescriptions and get medical advice," said Etheridge.

"Medicare Part D has been an unjust burden on the backs of our nation's pharmacists and our vulnerable senior citizens. Congress cannot stand to the side as these small businesses continue to shoulder the burden of faulty policy. We have been told that improvements are being made in the system each day, but pharmacists and states cannot afford to pay for deficiencies in this system while the administration 'figures it out.'"

The Fair and Speedy Treatment (FAST) of Claims Act of 2006 seeks to ensure that:

  • Pharmacists are paid for their services in a timely manner by requiring Medicare prescription medicine plans to offer electronic direct deposit of reimbursements to participating pharmacies;
  • Claims submitted electronically will be paid within 14 days, and all other claims will be paid within 30 days;
  • Pharmacists are promptly notified if there are problems with submitted claims;
  • Generic dispensing fees are set at a minimum level to ensure pharmacists can afford to provide cost-saving drugs to their communities; and
  • Co-branding is prohibited on cards issued by a prescription drug plan.

Etheridge is also a cosponsor of the Medicare Informed Choice Act, which extends the enrollment deadline from May 15, 2006, to December 31, 2006, and allows seniors to change plans one time if they are unhappy with their choice. The bill also protects retirees from being dropped by their former employer's plan during the first year of the implementation of the plan.

Without these changes, beneficiaries who enroll after May 15, 2006 will face a late-enrollment penalty , could lose employer-provided retiree health benefits if they enroll in some Part D plans, and could be prohibited from switching plans until 2007.


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