Charlotte Observer: Pharmacies in Peril
(Regarding underpayment to pharmacists on Medicare Plan D covered medications)
Responding to complaints, Leslie Norwalk, deputy administrator of the Centers for Medicare and Medicaid Services, recently told a congressional committee that most Part D plans pay pharmacies “well within the industry standard of 30 days from the time a clean electronic claim is submitted.”
Norwalk said Medicare discovered some cases where drug plans “printed checks that were held several days before mailing,” but the plans “quickly remedied any problems.”
The agency surveyed insurance plans and found that 18 of the top 20 pay pharmacy claims twice a month, Norwalk said.
Emilio Ruocco, a spokesman for Caremark Rx Inc., a pharmacy benefit manager, said his company follows the “current prompt-pay rules and the normal 30-day time frame.”
He said the 30-day rule starts after the prescription “has been verified,” not when it’s issued. In January and February, he acknowledged there were delays in verifying Part D enrollments. But he said he had not heard of two-month delays.
From Phil Law Weblog, “Caremark Rx in Class Action Lawsuit”
A lawsuit seeking class action status has been filed in the United States District Court for the district of Arizona alleges that Caremark Rx Inc. intentionally concealed revenue to avoid paying commissions.
Caremark Stock Options Draw Subpoena
From PlanetFeedback.com – Caremark, Do you not get it? (Be sure to read the comments too)
“Time and time again, PBMs’ business tactics financially enrich the PBMs and contrary to their slogans offer no real healthcare savings to patients or plan providers,” said Mike James, pharmacy owner and Director of Governmental Affairs, Association of Community Pharmacists Congressional Network (ACP*CN). “PBMs are not cost savers but are playing a shell game with their clients — hiding the money they make from driving up prescription drug costs at the expense of the patient and, in the case of Medicare the US taxpayers. The savings derived by the Medicare patients are the result of the taxpayers’ subsidy, not the PBMs,” added James.
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