CMS issued a final rule that eliminates PBMs’ retroactive application of direct and indirect remuneration (DIR) fees, requiring they be reflected in the negotiated price the patient pays at the pharmacy counter. This creates greater transparency for patients and pharmacies and increases consistency for Part D plans.
The final rule merely moves the fees to the point-of-sale negotiated price. It does not eliminate them. The final rule includes all price concessions (including all DIR fees) in the negotiated price, at the pharmacy counter, beginning January 1, 2024 (contract year 2024).
Although the entire pharmacy community has pushed to eliminate retroactive DIR fees, how the final rule is implemented could still create some financial uncertainty. It’s important pharmacies critically analyze the details of PBM contracts to evaluate the financial impact to their business and stay alert to how PBMs will implement the requirements of the final rule.
Our national pharmacy organizations and pharmacy leaders have done a great job bringing light to the dark business practices of many PBMs. However, more must be done to address their harmful and anticompetitive business practices. A 2024 implementation date gives PBMs ample opportunity to ensure the final rule does not negatively impact their financials.
CMS Increases Medicare Part B Reimbursements for Vaccines
Even though there’s still a lot of focus on COVID vaccines, don’t forget about administering vaccines for influenza, pneumococcal, and hepatitis B. CMS has nearly doubled the administration of these vaccinations under Medicare Part B, with an increase from $16.94 to $30 per dose. So, not only will you be compensated more for services rendered, but you will also be helping your customers avoid contracting these infectious diseases.
Alert: Microsoft® is Disabling Basic Authentication
DocuTrack® users that import from an email service mailbox please be aware that effective October 1, 2022, Microsoft will begin disabling Basic Authentication for Outlook, EWS, RPS, POP, IMAP, and EAS protocols in Exchange Online. SMTP Auth will also be disabled if it is not being used.
Basic Authentication is an outdated industry standard. Security threats posed by it have only increased since Microsoft originally announced in September 2021 the plan for turning off Basic Authentication in Exchange Online, citing better and more effective user authentication alternatives.
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