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senate Bill S. 1190

Opening Medicare's Pharmacy Network to Independent Pharmacies in Underserved Areas

Argument in favor

Seniors need affordable access to prescription drugs — enabling more rural pharmacies to participate in Medicare Part D’s pharmacy network will help seniors get their medications close to home at reduced prices.

AndrewGVN's Opinion
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01/14/2016
Wow, I can't believe a Republican created a bill that involves a social program. Besides that, I believe that this would be an excellent way to help people in small communities receive the proper medication that they need, for most likely a lower price than other competition.
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eagle's Opinion
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02/03/2016
If this bill actually reduces pharmacy costs, I would be in favor. However, if medications end up to cost the elderly more, the bill should be rescinded.
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Alis's Opinion
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10/11/2015
Big Pharma has such a strangle hold on the US. Anything that would help people get needed medication is a no-brainer! Just do it.
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Argument opposed

Forcing Medicare's prescription drug plans to work with any willing pharmacy will weaken a plan's ability to get price discounts (based on promises of increased patient volume) — making it harder to negotiate the best prices with pharmacies.

Elinor's Opinion
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10/14/2015
Medicare had one purpose: to provide healthcare-based fiscal assistance for elderly. Congress is, as it has with Social Security, adulterating the Medicare bill's original intent and stealing the funding from it for another purpose.
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John's Opinion
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01/13/2016
I have an idea lets get government out of the health care system
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John's Opinion
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10/15/2015
Regrettably, no. On the surface this sounds good, but it will surely increase the cost of the program by decreasing the benefit of becoming a preferred provider when "analysis of HRSA data indicates that 94.77 percent of all Medicare Part D enrollees reside in counties meeting at least one of the 'underserved area' criteria established in this legislation." WE ARE 18 TRILLION IN DEBT AND WE CANNOT AFFORD TO INCREASE SPENDING!!!
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What is Senate Bill S. 1190?

This bill aims to help seniors enrolled in Medicare prescription drug plans (Part D) get access to pharmacies in: 

  • Medically underserved areas (MUAs), 
  • Medically underserved populations (MUPs), 
  • Or health professional shortage areas (HPSAs). 

Under this bill, independent pharmacies in these areas could participate in Medicare Part D’s preferred pharmacy network — as long as they are willing to accept the terms and conditions that preferred providers operate under.

Impact

Seniors enrolled in Medicare Part D who have difficulty accessing pharmacies in the Part D network, local pharmacies that are willing to participate, and Medicare administrators.

Cost of Senate Bill S. 1190

A CBO cost estimate is unavailable.

More Information

In-Depth:

Under current law, Medicare Part D plans allow any willing pharmacy to participate in its preferred network — but not all Part D plans have preferred pharmacy networks. This can force seniors in rural areas to choose between traveling out to pharmacies in their "preferred network" OR pay higher co-payments/co-insurance to continue using their local pharmacy. It's important to note that many small local pharmacies are independent.

The National Community Pharmacy Network points out that Medicare could implement the so-called ‘pharmacy choice policy’, but hasn't — motivating bills like this one.  

According to this legislation’s sponsor, Sen. Shelley Moore Capito (R-WV), the Ensuring Seniors Access to Local Pharmacies Act of 2015 would: 

“allow seniors to maintain access to Part D prescription medications and qualify for the potential cost savings from preferred pharmacies.”
On the other hand, this bill's critics contend that it addresses a problem that doesn't exist, while the threatening to raise prices for seniors — not help them
"A July 2014 report by the Moran Company analyzed legislation similar to [this bill] that was introduced in 2014 and found that these requirements "might appear... to be limited in geographic scope," but an analysis of HRSA data "indicates that 94.77 percent of all Medicare Part D enrollees reside in counties meeting at least one of the 'underserved area' criteria established in this legislation." ... Requiring prescription drug plans to contract with any willing pharmacy would reduce the ability of plans to obtain price discounts based on the prospect of increased patient volume and thus impair the ability of prescription drug plans to negotiate the best prices with pharmacies."

This bill was introduced on a bipartisan basis by two Republican and two Democratic Senators, after similar legislation was introduced in the House during the 113th Congress but failed to progress.


Media:

Summary by Eric Revell
(Photo Credit: Flickr user dno1967b)

AKA

Ensuring Seniors Access to Local Pharmacies Act of 2015

Official Title

A bill to amend title XVIII of the Social Security Act to ensure equal access of Medicare beneficiaries to community pharmacies in underserved areas as network pharmacies under Medicare prescription drug coverage, and for other purposes.

bill Progress


  • Not enacted
    The President has not signed this bill
  • The house has not voted
  • The senate has not voted
      senate Committees
      Committee on Finance
    IntroducedMay 5th, 2015
    Wow, I can't believe a Republican created a bill that involves a social program. Besides that, I believe that this would be an excellent way to help people in small communities receive the proper medication that they need, for most likely a lower price than other competition.
    Like (5)
    Follow
    Share
    If this bill actually reduces pharmacy costs, I would be in favor. However, if medications end up to cost the elderly more, the bill should be rescinded.
    Like (4)
    Follow
    Share
    Medicare had one purpose: to provide healthcare-based fiscal assistance for elderly. Congress is, as it has with Social Security, adulterating the Medicare bill's original intent and stealing the funding from it for another purpose.
    Like (3)
    Follow
    Share
    I have an idea lets get government out of the health care system
    Like (3)
    Follow
    Share
    Seniors shouldnt be experiencing hardships getting meds. It wasnt a hardship collecting their taxes!
    Like (2)
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    Big Pharma has such a strangle hold on the US. Anything that would help people get needed medication is a no-brainer! Just do it.
    Like (2)
    Follow
    Share
    Regrettably, no. On the surface this sounds good, but it will surely increase the cost of the program by decreasing the benefit of becoming a preferred provider when "analysis of HRSA data indicates that 94.77 percent of all Medicare Part D enrollees reside in counties meeting at least one of the 'underserved area' criteria established in this legislation." WE ARE 18 TRILLION IN DEBT AND WE CANNOT AFFORD TO INCREASE SPENDING!!!
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    This promotes free market health care. Although rather than amending the Social Security act, we should repeal it.
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    In principle, I believe in opening up participation to any pharmacy who wants to participate. In reality, what pharmacy would want to deal with Medicare's ridiculously low reimbursement rates?
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    This is a step in the right direction. I would however like to this expanded to all pharmacies, not just those who have lobbied! :)
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    Reading through the bill, I find nothing to disagree with. Rural Americans currently experience great difficulty in getting medication at a reasonable cost or convenience. This bill would reduce that difficulty.
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    Yes help the poor
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    Government butt out of medical care
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    Who are they fooling? We don't get best possible prices anywhere. Congress is incompetent to get a deal. They get paid by the pharmaceutical companies who screw us.
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    .
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    There are sufficient coverage of mail order pharmacies that can cover the country.
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    Medicare should be allowed to negotiate all drug prices with pharmaceutical companies
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    Seniors keep on getting squeezed. Allow any pharmacy in to the network!
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    We need more coverages in rural areas
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    BEST PRICES ARE MAIL ORDER--NOT LOCAL PHARMACIES, THIS IS MOOT.
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