To better ensure consumers and the Centers for Medicare & Medicaid Services (CMS) have access to drug pricing information relevant to seniors residing in long term care facilities, we believe the Senate Finance Committee-introduced Prescription Drug Pricing Reduction Act (PDPRA) and the Lower Cost, More Cures Act of 2019 (S. 3129/H.R. 19), introduced by Sen. Mike Crapo (R-ID) and…
out-of-control prescription drug pricing is most certainly hurting American seniors and the LTC pharmacies committed to ensuring access to medications and consulting services for Medicare beneficiaries under the Medicare Part D program.
Over just the past few years, the nation’s three largest pharmacy benefit managers (PBMs) – CVS Caremark, Express Scripts and Optum Rx – have come to control more than 80% of prescriptions dispensed in America. For seniors living in the nation’s long term care (LTC) facilities, and served by LTC pharmacies, this percentage jumps to more than 90%- a true oligopoly.
With $9 billion in Budget Relief Act sequester cuts to the U.S. skilled nursing facility (SNF) sector now just weeks away following the latest cut of at least $600 million in Medicare Part B therapy payments after passage of the American Tax Relief Act of 2012 (ATRA), we are making it a priority this month to ensure Congress carefully reviews the cascade of budget and regulatory changes since 2009 that leaves the nation’s second largest health facility employer facing a staggering $65.6 billion in Medicare funding reductions over the next ten years.
Despite the customary complaints about negativity and the avalanche of TV ads, the 2012 campaign was unusually substantive from the standpoint of the entitlement reform discussion because both sides were required to make their best arguments about how we as a nation will protect seniors’ Medicare funding in an era of unprecedented fiscal chaos.
Last week, three reports issued by three separate government agencies made incongruent recommendations — or no recommendations at all — related to skilled nursing facility (SNF) patient care and policy. This spotlights precisely how federal policymaking is hampered by “siloed thinking.”