Medicare Part D delays hit small pharmacists

A dispute between community pharmacists and pharmacy benefit managers over delays in Medicare Part D prescription drug benefit payments has brought some of the administrative challenges of the federal drug program for seniors citizens to light (Marketletters passim).

The National Community Pharmacists Association claims that settlement delays from drug plans for dispensed medicines have forced the average pharmacy credit line to rise from about $250,000 before the Part D launch in January 2006, to about $700,000 at present. Last year, the number of smaller pharmacies dropped by 1,152 to 23,348, a trend blamed largely on the credit squeeze from Medicare plan providers. Politicians on both all sides have expressed concerns, especially given that community pharmacists are often the only source of prescription drugs in the most rural parts of the USA.

A legal proposal (HR1474) to force Medicare private funds to settle prescription bills within 14 days, instead of the 45 days the NCPA alleges is the delay in some cases, is being brought to the House of Representatives. The Pharmaceutical Care Management Association opposes the measure, claiming that it would cost Medicare and patients $9.0 billion over 10 years. The CongressDaily reports that the PCMA has offered to settle with pharmacies in 30 days.