Senior Care Pharmacy Coalition Provides Second Round of Comments on Legislation to Improve Care for Dually Eligible Enrollees

DATE: July 10, 2023

The Senior Care Pharmacy Coalition (SCPC), the only Washington-based organization exclusively representing the interests of long-term care (LTC) pharmacies, has responded to a Sen. Bill Cassidy (R-LA)-led May 2023 Discussion Draft of legislation to improve care for enrollees dually eligible for the Medicare and Medicaid (dual eligibles) programs. Senators Carper (D-DE), Cornyn (R-TX), Menendez (D-NJ), Scott (R-SC), and Warner (D-VA) joined Senator Cassidy in this effort.

These comments follow SCPC’s detailed response, including specific recommendations, to a Request for Information on the dual eligible subject by this bipartisan group of Senators in January 2023.

SCPC applauds the senatorial group for including in its draft the potential creation of a new Title in the Social Security Act to improve care coordination for dual eligibles, and that this program would be funded by a mix of dollars from the Parts A, B and D of the Medicare program.

SCPC supports that effort, and particularly the recognition that prescription drugs are a key part of care for dual eligibles. However, SCPC urges the group of Senators to add access to LTC pharmacy clinical, consultative, and specialized services as part of the care coordination function.

SCPC strongly recommends that dual eligibles who require long-term services and support (LTSS) have access to LTC pharmacy services, that LTC pharmacy services be delineated in the legislation, and that LTC pharmacies receive separate payment for these services in a manner similar to the ways in which care coordinators would be compensated for their services.

SCPC offers a number of specific changes to the draft legislation, consistent with the organization’s recommendation, including incorporating the definition of “long-term care pharmacy” from the Long-Term Care Pharmacy Definition Act, in its full response.

Affording dual eligibles who need LTSS unfettered access to LTC pharmacy services, regardless of the setting in which they live, will improve their health care outcomes and quality of life, and will reduce Medicare and Medicaid expenditures substantially. SCPC urges the group led by Sen. Cassidy to incorporate its proposed changes into the next iteration of this important legislation and looks forward to a continue dialogue as the Senators refine these policy proposals to improve care for the dually eligible population.

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