“For six months, FMI spearheaded an industry task force that worked closely with the White House and leadership in Congress to preserve a competitive and convenient marketplace for seniors,” Hammonds said, noting that the task force helped ensure the resulting law:
- Creates a competitive market to enable seniors to obtain competitive prescription benefits and services from their neighborhood pharmacies — including long-term 90-day prescriptions.
- Prohibits pharmacy benefit managers (PBMs) from requiring retail pharmacies to accept insurance risk as a condition for participating in a PBM-sponsored insurance drug plan.
- Provides seniors local access to pharmacies under the Tricare Standard, which requires that 90 percent of the beneficiaries in urban areas live within two miles of a pharmacy and in suburban areas within five miles; in rural areas, 70 percent must live within 15 miles.
- Requires PBMs to disclose the rebates and discounts they receive from drug manufacturers to the Secretary of the Department Health and Human Services — an incentive for them pass those savings along to beneficiaries and for manufacturers to offer competitive discounts to retail pharmacies.
“We are also pleased that the law calls for the Federal Trade Commission to study PBM practices that may create conflicts of interest,” Hammonds said. “The law’s controls on PBMs help address our long-held concern that Medicare reform would enable PBMs to monopolize the marketplace to the detriment of seniors and retail pharmacies.
“In addition, all prescription drug beneficiaries will benefit from the provisions to speed the introduction of less expensive generic drugs to the marketplace through reforms to the Hatch-Waxman law.
“We look forward to working with the Administration to ensure that these reforms are reflected as Congress intended in the regulations implementing this law.”