By Barbra Golub - May 13, 2011
American Pharmacies, a member-owned independent pharmacy cooperative operating in Texas, Arkansas, Louisiana, Oklahoma, New Mexico, Missouri, Mississippi and Tennessee, has asked CMS to rescind regulations allowing preferred pharmacy networks in stand-alone Prescription Drug Plans (PDPs). According to the cooperative, these regulations allow Part D plans “to discriminate among pharmacies” and create “different classes of in-network pharmacies.” For example, the Humana-Walmart Preferred Rx plan “improperly provides strong financial incentives for patients to choose Walmart-owned pharmacies over other of the plan’s in-network retail pharmacies,” it asserted.
The group also contended in a letter to the agency that the plan runs contrary to the “any willing pharmacy” provision of the Part D regulations, allowing participation of any pharmacy that meets the terms and conditions of the Part D plan. Under the Humana-Walmart plan, beneficiaries pay more for prescriptions purchased at a pharmacy other than Walmart.
This is not the first time this plan has come under fire. Last year the National Community Pharmacists Association (NCPA) complained to CMS that the agency should not have approved the plan because it “violates the spirit and intent of the rules and regulations surrounding the Part D program” and specifically Part D marketing guidelines. It appeared, based on NCPA comments, that the association had concerns with some of the larger Part D plans that it sees taking up a huge market share and hurting community pharmacies.
Is this just concern on the part of American Pharmacies that their members will lose business, or do they have a valid complaint?
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