Published by Drug Topics:

Direct and indirect remuneration fees have been one of the most contentious issues between retail pharmacists and PBMs and payers, which charge the “clawback” fees months after prescriptions are filled. NCPA members have said DIR fees are the top issue they would like to see resolved in 2017.

“While the proposed CMS guidance will not change existing policy with regard to DIR fees, it does have the potential to require plans to provide greater granularity to CMS on DIR amounts and the types of arrangements they put into place,” said NCPA CEO B. Douglas Hoey, RPh. “The agency has responded positively to many of our previous recommendations, and even issued an analysis showing the financial havoc retroactive pharmacy DIR fees are causing patients, taxpayers, and pharmacies. We urge CMS to consider our latest suggestions on reporting by plan sponsors.”