This service comes at a cost. Does Congress care?
By Kimberly Marselas | McKnight’s Long-Term Care News
For more than two years now, pharmacists who are the sole provider of prescriptions for the nation’s most vulnerable, often chronically ill patients have begged Congress for relief from a devastating pricing change.
There’s a bill on the table. It has bipartisan support. But a solution may not come in time for long-term care pharmacies.
New Medicare prices for 10 drugs — most of them very widely used by nursing home residents — kicked in Jan. 1. While those better prices will be a boon to community-dwelling seniors, those who call nursing homes and assisted living facilities home might actually lose access to pharmacists and, in turn, the drugs they need.
That’s because the much lower prices disrupt the model long-term care pharmacists have long depended on to offset costs of added services (think medication management, safety packaging and more) they essentially provide for free on many low-cost scripts.
Earlier this year, 85% of longterm care pharmacies said they would limit essential services and 60% would close locations if Congress didn’t do something to prop up their businesses.
A group in Congress has proposed a solution that would go a long way to patch the pricing gap: Their bill established a $30 add-on payment to LTC pharmacies for each Part D prescription dispensed in 2026 and 2027. But neither chamber acted.
In mid-December the Senior Care Pharmacy Solution launched a rightfully dark ad campaign, aiming at guilting Congress into action.
“Without urgent action from Washington, millions of America’s most vulnerable seniors could lose access to their prescription medications. Unintended consequences stemming from a recent drug pricing law threaten the viability of long term care pharmacies and could force many pharmacies that serve nursing homes to close,”
a voiceover warns.
Like many healthcare issues, it’s not a simple one to understand. ATI Advisory took a deep dive this fall to deliver policymakers insights on making LTC pharmacists whole. There’s no dearth of information on the issue, but maybe arguments for the service fee have felt too cold or too removed. Now, SCPC is trying to focus lawmakers on the people who will be most impacted by failure to act: frail seniors whose medication regimens are complex and often costly — but also indispensable.
Read the full article on McKnight’s Long-Term Care News here.
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