Medicare Part D for LTC Pharmacy: A Refresher

The Medicare Prescription Drug Benefit was passed into law nearly 20 years ago (2003) and implemented in 2006. It’s brought a massive shift from Medicaid as the primary revenue source for LTC pharmacies to Medicare Part D. While the LTC pharmacy industry had concerns about how this change would affect beneficiary access to necessary medications, the outcome was better than the legislation predicted.

During debate over the underlying legislation, we (a coalition of large LTC pharmacies) found members of Congress and the Bush Administration difficult to engage about institutionalized Medicare enrollees. We were a lonely voice, raising our hands during public hearings and in conversation with members, asking how they planned to accommodate the needs of nursing home residents. We were largely ignored – ending up with a requirement for CMS to issue a report on Standards of Practice for Long-Term Care Pharmacy Services.

CMS Engagement with Medicare Part D

While we won few, if any, concessions during the legislative process, we found CMS to be attentive to our concerns and responsive to our suggestions. Industry representatives spent many hours during 2004 discussing the needs of nursing home residents and the current standards of service. Read More >>