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Lawmakers involved about shrinking pharmacy community for TRICARE sufferers, their households.
On Thursday, U.S. Senator Cindy Hyde-Smith (R-MS) joined Senate colleagues in a letter to Seileen Mullen, the Performing Assistant Secretary of Protection for Well being Affairs, in search of solutions about TRICARE beneficiaries’ capacity to keep up entry to native pharmacies.
The letter raises questions on Categorical Scripts lowering reimbursements for prescriptions distributed at in-network retail pharmacies for 2023, which can drive many retail pharmacies out of the TRICARE Pharmacy Program and disrupt service for beneficiaries who depend on impartial group pharmacies.
“It has been delivered to our consideration that Categorical Scripts has decreased reimbursements for prescriptions distributed at in-network retail pharmacies for 2023. These reductions could go away many retail pharmacies unable to take part within the TRICARE Pharmacy Program, thus considerably impacting 9.6 million TRICARE beneficiaries’ entry to native pharmacies,” the senators wrote.
“Most lately, Categorical Scripts notified pharmacies and beneficiaries that present 2022 pharmacy contracts will expire October 24, 2022, moderately than the tip of the 12 months,” the lawmakers continued. “This can solely additional cut back the pharmacy community for TRICARE sufferers and their households, and will drive beneficiaries to alter pharmacies at a time when many obtain annual vaccinations.”
The Senators state that pharmacists proceed to be some of the accessible well being care suppliers in america.
Over 90% of People reside inside 5 miles of a group pharmacy, and 76.5% of pharmacies in rural areas are impartial group pharmacies.
“As you realize, along with allotting medicines and vaccines, group pharmacies present providers that result in higher well being outcomes, decrease general administrative charges, and worthwhile in-person consultations with a healthcare supplier,” the senators wrote.
The group of lawmakers ask solutions to the next questions to make sure TRICARE beneficiaries keep entry to native pharmacies:
- How is DHA monitoring present and future retail pharmacy participation within the TRICARE Pharmacy program?
- If future in-network pharmacy participation decreases, what steps will DHA take to make sure sufficient entry to in-person pharmacy providers for TRICARE beneficiaries?
- Terminating the 2022 pharmacy contracts two months forward of schedule will possible result in a disruption of look after TRICARE beneficiaries. What causes has Categorical Scripts given DHA for terminating the 2022 contracts early? Please define what oversight DHA has over Categorical Scripts, in addition to what authority DHA has given Categorical Scripts to make these contract adjustments.
Click here to view the full letter.
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