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New Survey Reveals Pharmacists Are Increasingly Struggling to Care for Patients Amid Predatory Audits, Unfair Reimbursement Practices

Wed, 08/03/2011 - 11:38am
Bio-Medicine.Org

ALEXANDRIA, Va., Aug. 3, 2011 /PRNewswire-USNewswire/ -- A new survey of 1,850 members of the National Community Pharmacists Association (NCPA) released today has identified two rising problems that are increasingly undermining the trusted, cost-saving patient care that millions of seniors and other Americans rely on from independent community pharmacists.

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NCPA asked community pharmacists about their experiences with pharmacy audits and generic-drug reimbursement limits (known as "maximum allowable costs" or MACs). Employers and health plans often contract audit and MAC-setting responsibilities to controversial, middlemen known as pharmacy benefit managers (PBMs), which also operate mail order facilities that compete with local pharmacies.

The survey produced two main findings. First, the pharmacy audits, rather than concentrating on true fraud, often punish pharmacies severely for trivial issues (e.g., a busy physician misspelling a patient's name or writing the incorrect date). Second, pharmacies are not privy to basic reimbursement (MAC) methodology prior to signing contracts with health plans and find that, during the life of contract, those MAC limits are both lowered arbitrarily and raised belatedly in

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