[20160405]IF10037_医疗保险首选药房网络.pdf

https:/crsreports.congress.gov Updated April 5, 2016Medicare Preferred Pharmacy NetworksOverview The Issue: Private insurers that participate in the Medicare Part D prescription drug program offer reduced cost sharing to enrollees who agree to patronize a limited number of “preferred pharmacies.” Insurers say they can negotiate price concessions from pharmacies that want to join the narrow preferred networks, providing savings to Medicare beneficiaries and the federal government. But independent druggists say their pharmacies have been excluded from the preferred networks, which have been dominated by national drug chains. The Centers for Medicare & Medicaid Services (CMS) has increased oversight of preferred pharmacies, saying its data indicate some Part D plans do not always offer lower drug prices at preferred pharmacies or do not have a sufficient number of preferred retailers in certain geographic areas, potentially violating Part D rules. Current Status: In January 2014, CMS proposed rules that would have required Part D insurers to have consistently lower drug prices and cost sharing in preferred networks and to contract with any pharmacy willing to meet such pricing terms.