The Centers for Medicare & Medicaid Services (CMS) yesterday proposed changing Medicare Part D rules to curb plan sponsors and pharmacy benefit managers’ skyrocketing use of direct and indirect renumeration fees (DIR)—PBMs’ controversial practice of clawing back drug payments to pharmacies after the point of sale.
According to CMS, DIR fees have soared from $8.6 million in 2011 to $9.5 billion in 2020. Pharmacy organizations have been lobbying Congress and various administrations to address the matter for years with no success.
The Centers for Medicare & Medicaid Services (CMS) yesterday proposed changing Medicare Part D rules to curb plan sponsors and pharmacy benefit managers’ skyrocketing use of direct and indirect renumeration fees (DIR)—PBMs’ controversial practice of clawing back drug payments to pharmacies after the point of sale.
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