A disturbing trend is emerging, one Washington must fix. Local pharmacies continue to be forced to close their doors — one in every five over the last eight years, in fact — making it harder to get medications to senior citizens. This is happening mainly because of a loophole in a Washington regulation that allows health insurers to “claw back” reimbursements to pharmacies for a Medicare Part D prescription. The result is seniors are paying much more, and pharmacies, particularly in rural areas, are being forced to close because they cannot anticipate or keep up with the uncertain costs.
This loophole is called Direct and Indirect Remuneration — otherwise known as “DIR.” These fees are such that pharmacies never know when they will appear and how much they will be. These fees are often charged months after a medication is dispensed to a patient; and even worse, they are assessed without an explanation and can result in a pharmacy being paid less than its cost for a prescription. Not only does Hy-Vee see this, but so does every pharmacy in America that serves Medicare Part D patients.
Due to the lack of oversight, DIR fees have skyrocketed 45,000% since 2010. This practice has pushed many U.S. pharmacies out of business –– leaving many senior citizens with no access to a pharmacy and no personal one-on-one counseling when it comes to their medications. From 2012 to 2018, more than 3,500 pharmacies closed their doors nationwide. This cannot continue.
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U.S. Sen. Chuck Grassley and U.S. Sen. Joni Ernst understand the impact this loophole is creating and have been at the forefront of this issue and we are very thankful for their support; however, it can’t stop there. Federal legislation is our only hope in getting this issue addressed and DIR fees under control before it is too late.
On behalf of myself, Hy-Vee’s more than 80,000 employees, and our more than 1,000 pharmacy professionals at Hy-Vee, I urge lawmakers to address this issue immediately before more pharmacies are forced to close their doors, leaving seniors without the proper personalized care they deserve.