May 7, 2010
(Washington, DC) — The Pharmaceutical Care Management Association (PCMA) released the following statement today on H.R. 5234, the PBM Audit Reform and Transparency Act of 2010, legislation championed by the independent drugstore lobby:
“Pharmacy benefit managers (PBMs) have pioneered tools – including incentivizing the use of generic medications, e-prescribing, and mail-service pharmacies – that improve savings, access, and safety for consumers and payers. Since the key to access is affordability, payers and policymakers alike should explore broader use of PBMs’ cost-savings tools and reject approaches that make prescription drugs more expensive.
“The widespread use of proven PBM tools in Medicare Part D has contributed to the program’s total expenditures being 43 percent lower than originally projected.
“Unfortunately, the independent drugstore lobby continues to push an agenda that increases prescription drug costs for consumers and payers and limits efforts to root out fraud, waste, and abuse. Given the increased focus on controlling health care costs, we can’t afford to let anyone, including the independent pharmacy lobby, thwart congressional efforts to fight pharmacy fraud.”
In letters sent to Senate Finance Committee Ranking Member Charles Grassley (R-Iowa) and Health and Human Services (HHS) Secretary Kathleen Sebelius, PCMA outlined several proposals being pushed by the independent pharmacy lobby that could make it more difficult to root out fraud, waste, and abuse, including:
- Mandating that PBMs contract with pharmacies that are currently banned from participating in federal programs.
- Opposing the Office of Inspector General’s ability to prosecute pharmacists charged with a felony.
- Undermining the President’s proposal to enhance Medicaid fraud enforcement.
- Requiring a lengthy waiting period to remove a pharmacy from a network even with irrefutable evidence of fraud.
- Creating unnecessary hurdles that hinder the ability of plans to audit pharmacies thoroughly.
- Exempting independent pharmacies from routine accreditation requirements to sell Durable Medical Equipment (DME).