WASHINGTON, D.C. – Today, U.S. Sen. Sherrod Brown, along with U.S. Sens. Shelley Moore Capito (R-W.Va.), Joe Manchin (D-W.Va.), and Tom Cotton (R-AR), introduced bipartisan legislation that would expand prescription drug access for seniors living in medically underserved and rural areas. The Ensuring Seniors Access to Local Pharmacies Act of 2015 would require that community pharmacies in medically underserved areas or populations and health professional shortage areas be allowed to participate in Medicare Part D preferred pharmacy networks if they are willing to accept the contract terms and conditions that other preferred providers operate under. This would give seniors more choice, allow community pharmacies to compete, and enhance access to pharmacy services in underserved areas.
“Many Medicare beneficiaries live on fixed incomes and struggle to afford their prescription drugs. Especially for those living in rural and underserved areas, the cost of filling a prescription out-of-network could lead seniors to forgo filling needed medications,” said Brown. “By allowing pharmacies in rural and underserved areas to participate in preferred networks, we can help seniors fill prescriptions and seek guidance on their medications without having to pay more out-of-pocket or travel to a participating pharmacy. This fix would expand access for all seniors regardless of their location, improve competition, and cut prescription drug costs.”
Current law requires plans operating in Medicare’s Prescription Drug Benefit – Part D – to permit any willing pharmacy to participate in the plan’s network. But recently, a majority of Part D plans have created separate preferred pharmacy networks that do not include many community pharmacies, which are critical access points in rural and medically underserved areas. When a senior’s local pharmacy is not included in a preferred network, she is forced to either switch to a preferred network pharmacy or pay a higher copayment at her pharmacy of choice. In rural areas, accessing a preferred pharmacy may require significant travel.
In medically underserved areas, local pharmacies are an important part of the health care delivery system where patients can not only access prescription drugs but can also receive services like preventive screenings and medication therapy management. Excluding community pharmacies from preferred pharmacy networks takes away choices from seniors and could lead to reduced access to medical services.