Long-term care pharmacies
are struggling with an Affordable Care Act provision related to short-cycle dispensing of brand name oral solid drugs, according to a recent letter from the Long Term Care Pharmacy Alliance and the National Community Pharmacists Association.
Policymakers must quickly come up with a better definition of “brand name drugs,” the two trade associations urged in their letter to the Centers for Medicare & Medicaid Services last week.
Some generic drugs that were developed decades ago, such as alprazolam, potassium chloride CR and digoxin, are brand-name drugs according to the definition laid out in the ACA. The “inadvertent inclusion” of these drugs in the short-cycle dispensing provision is driving Medicare Part D costs up, contrary to the goal of the healthcare reform legislation, the letter states.
Due to differing interpretations of “brand-name drugs,” there is confusion over audits of the claims filing process for long-term care pharmacies. The trade organizations requested that CMS suspend audit recovery, as “pharmacies
should not be held accountable for inconsistent plan messaging when our members are dealing with hundreds of plans on a daily basis.”
The short-cycle dispensing requirement has stirred controversy among some long-term care providers. They argue that additional dispensing fees and labor costs would offset any savings from reducing the amount of unused drugs.
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