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Washington, D.C. --- After hearing from New Jersey independent pharmacists about the problems they are encountering with the new Medicare prescription drug plan, U.S. Sen. Frank R. Lautenberg (D-NJ) and U.S. Rep. Frank Pallone, Jr. (D-NJ) today introduced legislation that will expedite drug reimbursements to pharmacists and abolish the practice of co-branding that unfairly benefits large chain pharmacies.
New Jersey pharmacists have complained to the two lawmakers that they have not received prompt payment for the prescriptions they dispense under the new plan. Previously, under State Medicaid programs, participating pharmacies were reimbursed twice a month. Now, under the new Medicare prescription drug program, private drug plans have between 60 to 90 days to reimburse a pharmacist. This leaves pharmacists responsible for all the costs associated with dispensing the drugs.
The Pharmacists Medicare Relief Act of 2006 requires private drug plans to reimburse pharmacists in a timely fashion. The legislation mandates that claims submitted electronically by pharmacists be paid within 14 days, while claims submitted through the mail must be paid within 30 days. If drug plans do not reimburse pharmacists within the required time, they would be charged interest which would accrue until payment is finally made.
Independent pharmacies are also facing the issue of "co-branding" under the new plan, which puts them at a unique disadvantage. The Bush administration allows the private drug plans and large chain pharmacies such Wal-Mart and Walgreen's to "co-brand", or collaborate on marketing materials that are sent to beneficiaries. For example, a beneficiary's membership card often has the name of the prescription drug plan on it and the chain that it has co-branded with.
As a result, Lautenberg and Pallone said that many beneficiaries are under the assumption they can only get their prescription drugs at those pharmacies. They are unaware that in most cases, their community pharmacist, who they have been going to for years, also participates in the prescription drug plan's preferred provider network.
Lautenberg and Pallone's legislation prohibits private drug plans from distributing marketing materials that include the name or brand of any pharmacy, and allows those who continue to engage in the practice to be charged as a felon facing a maximum fine of $25,000 and a maximum prison sentence of five years.
"Pharmacists are paying a price for the failures of the Bush Administration. They should be paid in full, and on time," said Senator Lautenberg. "This legislation will level the playing field for independent pharmacists who were ignored when the plan was created."
"New Jersey pharmacists should not have to risk losing their business in order to help seniors receive the prescription drugs they were promised under the new drug plan," Pallone said. "Our legislation provides much needed relief to pharmacists who deserve to be reimbursed in a timely fashion and who should not lose business because of unfair marketing." |
