From APhA website, May 28, 2019: In its final rule for Medicare Part D, CMS announced that it would not move forward with a proposal to account for pharmacy price concessions—also known as direct and indirect remuneration (DIR) fees—at the point of sale in 2020 Part D plans. The move would not have eliminated DIR fees—it would have only ended the practice of extracting them retroactively. APhA called the news “disappointing, but not discouraging.”
Thousands of pharmacists submitted comments to CMS letting the agency know that applying price concessions at the point of sale was better than retroactive assessment for both patients and pharmacies—and CMS noticed. In the final rule, the agency stated, “CMS is continuing to carefully review these comments as we continue to consider policies that would lower prescription drug costs, address challenges that independent pharmacies face, and improve the quality of pharmacy care.”