Enforcement of fair contracts and reimbursement for pharmacies under Medicare drug plans.
This bill establishes a new process allowing pharmacies to report violations of contract terms and reimbursement requirements by Medicare Prescription Drug Plan (PDP) sponsors. The goal is to ensure fair contract conditions and guarantee that independent community pharmacies receive the required total reimbursement amounts. For citizens, this aims to stabilize the local pharmacy network, potentially improving access to essential prescription drugs.
Key points
Pharmacies can now submit allegations of violations regarding unreasonable contract terms and conditions by Medicare PDP sponsors.
The law mandates that PDP sponsors must pay independent community pharmacies the full required reimbursement amount if the initial payment was deficient.
The Secretary of Health and Human Services (HHS) will investigate allegations and can impose civil monetary penalties on non-compliant sponsors.
A standardized, confidential template will be created for pharmacies to submit allegations, protecting the information from public disclosure under FOIA.
Status:
Expired
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