NCPA expresses concerns over restricted-network plans

Group urges changes to Medicare Part D plan-finder tool

ALEXANDRIA, Va. — Many so-called restricted-network Medicare Part D prescription drug plans don't give adequate pharmacy access to rural residents and are deceptively marketed to patients, the National Community Pharmacists Association said Monday.

The plans include those offered by a number of national retail chains and health insurers.

The NCPA said the plans were being marketed to patients and featured on Medicare's Plan Finder without making clear that the lowest advertised drug prices were available only at a relatively few, selected pharmacies. Second, the group said, patients in rural areas may not have full access to them.

"From day one, these overly restrictive drug plans have raised questions about ensuring adequate access to pharmacy care, which is why NCPA has opposed them," NCPA CEO B. Douglas Hoey said. "We urge Medicare officials to consider these marketing and patient access concerns and take action in the interest of seniors."

The group recently sent a letter to the Centers for Medicare and Medicaid Services, asking it to change the Plan Finder tool to clarify that lower-cost prescription drug cost sharing is only available at the preferred pharmacy and require restricted-network plans to state in all communications that patients must go to the preferred pharmacy in order to obtain the lower drug costs.

"We encourage every Medicare beneficiary to talk to a community pharmacist about choosing the right Medicare drug plan," Hoey said. "Pharmacists can be a tremendous resource to Medicare patients by educating them about the enrollment process and helping them 'plug in their drugs' using Medicare's Plan Finder tool at Medicare.gov."

 


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