Pharmacists in Maine are seeking an end to direct and indirect remuneration (DIR) fees.
Maine’s House and Senate are assessing companion bills to prohibit payers from assessing retroactive DIR fees on pharmacies after the submission of a clean claim. The bills are supported by the Maine Society of Health-System Pharmacists (MSHP) and the Maine Pharmacy Association.
According to an American Society of Health-System Pharmacists news release, Medicare has mandated that Medicare Part D prescription drug plans report DIR received as rebates. However, the drug plans can put their own imprint on DIR through the creation of performance-related assessments charged to pharmacies.
Felicity Homsted, chief pharmacy officer for Penobscot Community Health Care (PCHC) in Bangor and president of the Maine Society of Health-System Pharmacists (MSHP), claims that the fees charged to DIR can be excessive.
According to Homsted, the charges can be applied retroactively, meaning that the pharmacy cannot intervene in real time to resolve issues. Homsted claims that the DIR trend is affecting PCHC’s pharmacies and most often relate to patient’s refill rates.