SCPC Provides Comments on CMS Proposed Rule Regarding Medicare Program

DATE: March 7, 2022

Dear Administrator Brooks-LaSure:

The Senior Care Pharmacy Coalition (SCPC) appreciates the opportunity to comment on the CMS Proposed Rule entitled “Medicare Program: Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefits Programs;” Agency Docket Number CMS-4192-P (the Proposed Rule).1 SCPC is the only Washington-based organization exclusively representing the interests of long-term care (LTC) pharmacies. SCPC’s membership includes 80% of all independent LTC pharmacies. Our members serve one million residents daily in skilled nursing facilities and assisted living communities across the country.2 Given the distinct characteristics of the LTC patient population and the enhanced clinical responsibilities of LTC pharmacies, we offer unique perspectives on CMS’ initiatives and proposals, particularly how Medicare Prescription Drug Benefit (“Part D”) policies and requirements impact the pharmacy community. 

SCPC’s comments focus on the CMS “pharmacy price concessions to drug prices at the point of sale” proposal, which would require all “Direct and Indirect Remuneration” (DIR) fees charged to pharmacies by Part D Plans (PDPs) or their Pharmacy Benefit Managers (PBMs) be passed through to beneficiaries at the point of sale. 87 Fed Reg. at 1845, 1909. We believe that CMS should eliminate DIR fees rather than require that PDPs/PBMs pass them on to beneficiaries at point of sale. Should CMS nonetheless proceed with the proposal, the agency should assure that implementation does not inadvertently damage pharmacies and should prevent PDPs/PBMs from shifting any economic losses they sustain to pharmacies. Our comments explain these conclusions. 

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