Senior Care Pharmacy Coalition (SCPC) to CMS: Development of Long Term Care (LTC)-Specific Quality Metrics Essential to Accurate Star Ratings Assessment of LTC Patient Care

Washington, DC – Commenting in detail regarding the Centers for Medicare and Medicaid Services’ (CMS) recently Proposed Rule (“Advance Notice of Methodological Changes for Calendar Year (CY) 2021 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies – Part II”), the Senior Care Pharmacy Coalition (SCPC) says developing long-term care read more…

SCPC Member Alert: Recent FDA Requirements on Dispensing Create Conflict with Department of Justice Fraud Concerns and Payer Practices

As you may know, many Part D Plans/PBMs and other government payers (Medicare, Medicaid and TRICARE) recently began seeking audit recoupments from pharmacies that do not dispense insulin pens in multi-dose packaging as provided by manufacturers.  SCPC understands that this payment policy change is causing confusion in the marketplace and could be disruptive to effective read more…

Senior Care Pharmacy Coalition (SCPC) Suggests Two PBM Transparency Refinements to Senate Finance Committee Drug Pricing Bill

Washington, DC – In previously noting that capping Medicare beneficiaries’ out-of-pocket costs as low as possible is a primary long-term care (LTC) pharmacy advocacy priority as Congress debates drug pricing reform legislation, the Senior Care Pharmacy Coalition (SCPC) also recommended two pharmacy benefit manager (PBM) transparency provisions be included in the pending Prescription Drug Pricing read more…

To Protect Seniors, Modernize Regulations by Passing LTC Pharmacy Definition

Morning Consult | February 28, 2020 By Alan G. Rosenbloom  When it comes to the “alphabet soup” of three- and four-letter federal agencies, one’s eyes can glaze over in confusion about what they do, why they do it and how average citizens benefit from their federally funded oversight. In the realm of health policy and our read more…

National LTC Pharmacy Advocacy Group: Capping Seniors’ Out of Pocket Costs as Low as Possible Remains Key Drug Pricing Reform Objective

Washington, DC – With media attention increasingly focused upon the “inflationary rebate” facet of the Senate Finance Committee’s Prescription Drug Pricing Reduction Act of 2019 (S. 2543), the Senior Care Pharmacy Coalition (SCPC) today said capping Medicare beneficiaries’ out-of-pocket costs as low as possible remains a top long-term care (LTC) pharmacy advocacy priority. “Capping Medicare read more…

Bill to eliminate third-party pharmacy benefit managers could save state millions

Fox 25 Oklahoma – January 24, 2020 By Destiny Washington OKLAHOMA CITY (KOKH) — Oklahoma could soon join the growing number of states backing away from using Pharmacy Benefit Managers (PBM’s) to administer prescription-drug programs. A PBM is a third-party administrator of prescription drug programs for state and federal government employee plans, self-insured employer plans, commercial read more…

SCOTUS Can Rein in Middlemen Who Are Gaming Local Pharmacies, Patients

Morning Consult– January 23, 2020  By B. Douglas Hoey Very few people know what pharmacy benefit managers do. The three biggest rival the largest corporations in the world in terms of market capitalization, revenue and profits. The CVS Health pharmacy service segment, for example, reported $134 billion in revenue last year. The PBMs exert enormous influence on read more…

More Than Half Of Voters Say Health Care, Drug Costs Are Top 2020 Concern

Inside Health Policy – January 08, 2020 By Emily Martin More than half of voters consider out-of-pocket costs for prescription drugs and other aspects of health care as top concerns ahead of the first primaries, according to a recent poll from Morning Consult and Bipartisan Policy Center. Nearly half also say use of illicit drugs and read more…

Outpatient settings need pharmacists, but lack of reimbursement makes that tough

Modern Healthcare– December 14, 2019 By Maria Castellucci About three years ago it became clear to the leadership team at RWJBarnabas Health that pharmacists were needed in its 68 ambulatory clinics. Its providers—and the system overall—are increasingly participating in value-based contracts with payers that involve metrics related to medication adherence, adverse drug events and other read more…

Trump administration pushing new drug spending cap

Axios– November 24, 2019 The Trump administration is pushing for a monthly cap on what seniors pay out-of-pocket for drugs through Medicare’s pharmacy benefit to be added to a bipartisan drug pricing bill in the Senate, a senior administration official told Axios’ Caitlin Owens and me. The big picture: The cost of prescription drugs is still a read more…

Twitter   LinkedIn