Lower drug prices are good for consumers. And Congress certainly did not intend lower prices to harm LTC pharmacies, much less threaten access to LTC pharmacy care and services for seniors. But now Congress must act to avoid the unintended consequences these drug pricing policy changes have created.
Most importantly, Congress must ensure that Medicare Part D payments for LTC pharmacy services reflect the actual cost of essential and legally required services and must account for cost increases over time. Any solution must also address both the problem of inadequate dispensing fees and the problem of unfair contracts and predatory market practices driven by disproportionate PBM market power.
PDPs must fairly reimburse the costs LTC pharmacies incur to comply with the Medicare and Medicaid pharmacy services requirements, including the Part D LTC pharmacy service criteria. And PDPs must offer LTC pharmacies contract terms that would allow efficient LTC pharmacies to remain viable businesses.
Congress must act to protect LTC pharmacies and the millions of Medicare beneficiaries they serve before January 1, 2026, when the first negotiated Medicare drug prices take effect.
