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
“allow seniors to maintain access to Part D prescription
medications and qualify for the potential cost savings from preferred
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.
Summary by Eric Revell
(Photo Credit: Flickr user dno1967b)