(Washington, DC)— The Pharmaceutical Care Management Association (PCMA) issued the following statement today on pharmacy payment timeframes and the savings and access enjoyed by beneficiaries in Part D. PCMA is the national association representing America’s pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 210 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D:

“PCMA member companies have pledged to pay pharmacies submitting clean Part D claims within 30 days. The 30-day pharmacy claims timeframe is a standard consistent with physician and hospital claims in Medicare Parts A & B, the federal employees’ health benefits plan (FEHBP), and 43 states. Furthermore, last year the Centers for Medicare & Medicaid Services (CMS) found that 18 of the top 20 Medicare PDPs pay pharmacy claims on a twice-a-month billing cycle of 15 days or less. The other two PDPs had contract terms that generally lead to payment within 30 days.

“While the independent drugstore lobby continues to attack Part D, the benefit is enjoying high satisfaction among beneficiaries who are enjoying broad access and robust savings. According a recent analysis conducted by SK&A Information Services, consumers have broad access to pharmacy choices in urban, suburban, and rural areas, as an average of 21 pharmacies are located and compete near independent pharmacies throughout the United States. Along with having a number of pharmacy options, seniors are also experiencing higher-than-expected savings of 29 percent in Part D according to a recent analysis from PricewaterhouseCoopers (PwC).

“PBMs are proud of their track record of success in Part D paying clean claims in timeframe consistent will all other government standards, while also providing savings and access for beneficiaries.”

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PCMA is the national association representing America’s pharmacy benefit managers (PBMs), which lower the cost of prescription drugs for more than 200 million Americans with coverage provided through Fortune 500 employers, health insurers, labor unions, and Medicare Part D

Contact Information:
Charles Coté 202-207-3605