NCPA praises CMS’ pursuit of Medicare Part D payments from insurer
ALEXANDRIA, Va. Following an industry group’s collection of Medicare payment complaints, the Centers for Medicare and Medicaid Services reached out to an insurer, reminding the company of its obligations to pay pharmacy precription drug claims.
CMS’ action to contact Fox Insurance — which terminated its Medicare Part D contract in March — followed the National Community Pharmacists Association’s efforts to have CMS aggressively pursue insurance companies and pharmacy benefit managers that do not pay prescription drug claims submitted by pharmacies.
CMS paid Fox some $63 million to cover Part D enrollees for February and March, NCPA said.
“From the perspective of independent community pharmacies and their patients, Fox Insurance now has two strikes against it,” said Bruce Roberts, NCPA EVP and CEO. “The first strike was a result of behavior egregious enough to warrant having its contract terminated by CMS. The second strike has come from Fox’s refusal to honor its commitment to pay [the insurer’s pharmacy benefit manager] ProCare, so that it could reimburse millions of dollars in outstanding pharmacy claims. That behavior has now resulted in CMS demanding payments be made immediately.
“We sincerely hope Fox avoids getting that third strike by paying for these services. It is the right thing to do and the bare minimum that was expected of the company when seniors paid their premiums and pharmacists filled their prescriptions,” Roberts concluded.
Diplomat Specialty Pharmacy, SWON develop support program
SWARTZ CREEK, Mich. Diplomat Specialty Pharmacy on Tuesday announced a joint agreement with Southwest Oncology Network to create SWON-Rx, a comprehensive specialty pharmacy support program to help practices manage oral oncology medications.
SWON is a professional limited liability company whose members are physicians and physician practices whose patients routinely require high-cost, specialty pharmaceuticals specifically for treatment of cancer. SWON currently consists of 65 oncology practices throughout the United States, representing approximately 272 oncologists.
“Diplomat will be SWON’s oral oncology Rx solution,” stated Mark Neville, Diplomat VP sales and marketing. “With the high number of new oral therapeutic options that have been FDA approved over the past few years, Diplomat’s Oncology Navigator has dedicated the required resources to help SWON patients and physicians gain access to these needed medications regardless of the changing reimbursement landscape.”
Added Mark Colangelo, SWON VP, “SWON selected Diplomat because of their patient centric reputation in the industry, their high level of customer service, and their commitment to helping oncology patients get the medications they need to obtain optimal clinical outcomes. Diplomat has unique expertise and dedicated resources that assist patients in reducing the financial burdens associated with these life-sustaining medications. SWON member practices value the support this provides their patients and their staff.”
Pfizer to restructure global plant network
NEW YORK Pfizer plans to lay off 6,000 of its workers and reduce manufacturing or cease manufacturing altogether at 14 plants around the world by 2015, the drug maker said Tuesday.
The plants scheduled for closure are in the United States, including Puerto Rico, and Ireland, while reductions are planned for plants in Germany, Ireland, the United Kingdom and the United States. The company said the reductions would increase manufacturing efficiency and lower costs.
“The restructuring of our global plant network is critical to our efforts to remain competitive so that we can continue to meet patient needs and expand the access and affordability of our medicines,” Pfizer president for global manufacturing Net Ricciardi said. “Nevertheless, today’s announcement is very difficult to make because of its impact on our colleagues.”
Plants scheduled for closure over the next one and a half to five years include tablet and capsule manufacturing plants in Rouses Point, N.Y., originally a Wyeth plant, Caguas, Puerto Rico, and Loughbeg, Ireland. Injectables plants in Dublin, Ireland, and Carolina, Puerto Rico, are scheduled for closure as well. The plant in Guayama, Puerto Rico, will stop manufacturing pills, but will expand its consumer healthcare manufacturing, while pill-manufacturing sites in Newbridge, Ireland, and Illertissen, Germany, will reduce operations. The biotechnology plant in Shanbally, Ireland, will close, and the Pearl River, N.Y., plant will cease biotech manufacturing but will continue operating as a vaccines research center. Biotech plants in Havant, England, Sanford, N.C., and Andover, Mass., will experience reductions.