The Issue: Private insurers participating in the Medicare Part D prescription drug program offer reduced cost-sharing to enrollees who agree to patronize a limited number of “preferred pharmacies.” Insurers say they can negotiate price concessions from pharmacies that want to join the narrow preferred networks, providing savings to Medicare beneficiaries and the federal government. But independent druggists say their pharmacies are often excluded from the preferred networks, which have been dominated by national drug chains. The Centers for Medicare & Medicaid Services (CMS) has increased oversight of preferred pharmacies, saying its data indicate some Part D plans do not always offer lower drug prices at preferred pharmacies, or do not have a sufficient number of preferred retailers in certain geographic areas, potentially violating federal rules.
For more information see CRS Report R40611, Medicare Part D Prescription Drug Benefit Medicare Part D Prescription Benefit.
Date of Report: January 6, 2015
Order Number: IF10037
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