Tester, Capito Encourage Action to Improve Drug Pricing Transparency in Medicare Part D

CMS proposal would protect beneficiaries and community pharmacies, lower costs for seniors

WASHINGTON, D.C. – Jon Tester (D-Mont.) and U.S. Senators Shelley Moore Capito (R-W.Va.) yesterday led a bipartisan group of senators in expressing support for a proposal from the Centers for Medicare and Medicaid Services (CMS) that would help increase the transparency and accuracy of prescription drug costs in Medicare Part D.

“Pharmacy price concessions account for real differences between the listed prices of prescription drugs and those drugs’ final, actual costs,” the senators wrote in a letter to CMS Administrator Seema Verma. “By requiring that all of these pharmacy price concessions be reflected in the negotiated price at the point of sale, CMS’s proposal will help increase the transparency and accuracy of prescription drug costs in Medicare Part D, and help significantly lower American seniors’ out of pocket drug costs.”

A current lack of transparency in pharmacy price concessions in Medicare Part D often negatively affect beneficiaries, lead to higher costs for seniors, and create uncertainty for the community pharmacies who serve them. Senators Capito and Tester previously introduced legislation-the Improving Transparency and Accuracy in Medicare Part D Drug Spending Act-to address this issue. The bill would prohibit Medicare Part D plan sponsors and pharmacy benefit managers from retroactively reducing payments on accurate reimbursement claims submitted by pharmacies.

“Thanks to the strong leadership of Senators Capito and Tester, a bipartisan coalition of senators has endorsed CMS’ fix for the problem of retroactive pharmacy DIR fees,” said National Community Pharmacists Association CEO B. Douglas Hoey, Pharmacist, MBA. “Patients, taxpayers, and pharmacies will all benefit from the agency’s transparent, common-sense proposal.”

Others signing yesterday’s letter include: U.S. Senators John Boozman (R-Ark.), Bill Cassidy, M.D. (R-La.), Thad Cochran (R-Miss.), Susan Collins (R-Maine), Tom Cotton (R-Ark.), Steve Daines (R-Mont.), Joni Ernst (R-Iowa), Chuck Grassley (R-Iowa), Heidi Heitkamp (D-N.D.), John Hoeven (R-N.D.), John Kennedy (R-La.), Angus King (I-Maine), James Lankford (R-Okla.), Joe Manchin (D-W.Va.), Jerry Moran (R-Kan.), David Perdue (R-Ga.), John Thune (R-S.D.), Thom Tillis (R-N.C.), and Roger Wicker (R-Miss.).

The full letter is available HERE.