CCAGW slams proposed amendments to Medicare Part D

The Council for Citizens Against Government Waste says controversial proposed bills on Capitol Hill would interfere with the market dynamics that have helped keep down costs while raising beneficiary satisfaction with Medicare Part D.

Specifically, CCAGW opposes the Ensuring Seniors Access to Local Pharmacies Act of 2015, H.R. 793, and its companion version in the Senate, S. 1190, as well as the MAC Transparency Act, H.R. 244, all of which are an attempt “to fix something that is not broken,” says CCAGW President Tom Schatz.

In particular, CCAGW is concerned that H.R. 793/S. 1190 -- the so-called “any-willing pharmacy policy” -- would force prescription drug plans to accept any independent pharmacy to participate in their preferred network if one or more of their stores is located in a “medically underserved area.” For the most part, those are urban or rural areas that lack primary medical and dental care and mental health providers, but not pharmacies, according to CCAGW.

By requiring prescription drug plans to contract with any willing pharmacy in such a way would threaten their ability to negotiate the best prices with pharmacies, reduce cost savings for consumers, and increase Medicare spending, Elizabeth Wright, director of CCAGW’s health and science division, told American Pharmacy News.
CCAGW has similar concerns regarding H.R. 244.

The MAC (maximum allowable cost) process was created by public and private payers, such as health insurance companies, to stop them from having to pay significantly higher prices for drugs than the average acquisition cost paid by pharmacists, Schatz explained in a May 11 letter to senators.

“The system has increased both competition and the dispensing of generic drugs, as well as encouraging pharmacists to shop around for the best deal,” Schatz writes. “The cost savings are passed onto consumers and taxpayers.”

However, H.R. 244 would force participants in these negotiations to increase the disclosure of sensitive financial information, in turn increasing both direct costs and litigation costs, a move that Wright said would ultimately end up hurting the Part D program.

“We’re against (all of these amendments) because they’ll interfere with the negotiations with Medicare Part D, which is already a pretty successful model for other entitlement programs,” Wright said.

On the same page is the Pharmaceutical Care Management Association, which this week released a new ad campaign -- We Love our Preferred Pharmacy Plan -- highlighting the popularity and convenience of lower cost preferred pharmacy plans in Medicare.

“Lower cost preferred pharmacy plans have become the very foundation of Medicare Part D,” PCMA President and CEO Mark Merritt said in a statement. “It makes little sense for lawmakers to put these plans at risk.”

H.R. 244 and H.R.793 have been referred to the House Subcommittee on Health, and S. 1190 has been referred to the Senate Finance Committee.