When you fill a Medicare Part D prescription that has a generic equivalent, you
must indicate the price differential between the price of that brand name drug
and the price of the lowest-priced generic version of that drug available at
your pharmacy. This requirement is not voluntary and cannot be provided on an
“as requested” basis.
The Centers for Medicare and Medicaid Services
believes that generic pricing disclosures will provide enrollees – many of whom
may not know that less expensive generic equivalents are available – with
valuable information that will save money for beneficiaries. The Medicare
Modernization Act requires that Part D prescription drug plans (PDPs) ensure
that pharmacies inform enrollees of any price differential between the brand
name price and the lowest priced generic version of a covered Part D drug
available at the pharmacy . It is the PDP’s responsibility to verify that
community pharmacies are complying with this requirement.
It is
important that your pharmacy have policies and procedures in place to adhere to
this requirement by Jan. 1, when Part D takes effect. Since enforcement of
this provision is in the hands of the PDPs, you will need to safeguard your
pharmacy to avoid audit-like penalties from them.