Over the next few weeks, you will be receiving service contracts from one or more Prescription Drug Plans ("PDP"s) trying to build networks for the Medicare Part D benefit. Some may propose reimbursement rates that are financially unacceptable to your personal business. In the past, many of you have signed on to network contracts that were financially unfair because rejecting those contracts meant that their customers could no longer receive benefits at your store(s).
Under Medicare, group enrollments will no longer be solely controlled by PBMs. Some seniors can change plans on 30 days notice. After the Centers for Medicare and Medicaid Services announces the approved PDPs in September and the enrollment process begins in November, you can educate your customers about the plans you have accepted. You can express your appreciation to them for your trusted provider-patient relationship and the desire to continue it under the Part D benefit. We believe many patients will choose from the set of plans accepted by their current pharmacists.
If you receive unfavorable contract offers from one or more PDPs, NCPA wants you to know that you have a choice. (Some of these contracts from prospective PDPs may be "opt-outs." You could find yourself in a network you don’t want to be in if you don’t decline to participate in writing.)
You have a choice to reject unfair agreements. The Medicare enrollment process empowers you to keep your customer base without accepting unfair contracts.