Latest Updates

This important legislation, which is slated to go into effect January 1, 2024, establishes much needed protections for community and independent pharmacists, as well as specialty physicians practicing in Michigan.

Independent pharmacists – please take action today! NCPA recently provided its members with an adaptable template letter to CMS, urging the agency to revise its proposed Medicare Advantage / Part D rule to more accurately reflect real-world conditions in terms of negotiate price and DIR fees.

Knowing the role community and small chain pharmacies play for patients across Maryland and the country, pharmacy services administrative organizations (PSAOs) likewise continue stepping up to the plate. As administrative intermediaries, PSAOs were created to help small, community pharmacies navigate the ever-changing, ultra-competitive pharmacy reimbursement landscape. Now, more than ever, their roles are critically important to the livelihood of the pharmacy community.

On January 6, CMS issued a proposed rule that would reduce unpredictability for pharmacies created by PBMs and health plans taking post point of sale “clawbacks” of uncertain amounts up to several months after the pharmacy counter transactions.

CMS Administrator Brooks-LaSure committed that CMS will use its regulatory authority to address DIR post-claim-adjudication fees imposed by PBMs upon pharmacies and providers.