Neal Dunn: “I thank Representative Carter, who is a colleague, a friend, and a neighbor, and who also has genuine expertise on this…”

“I thank Representative Carter, who is a colleague, a friend, and a neighbor, and who also has genuine expertise on this subject. The administration recently published two rules that tackle the issues faced by both our Medicare beneficiaries and the pharmacies that serve them. One rule in particular, the ``Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses'' rule, addresses pharmacy direct and indirect remuneration fee reform by instituting that DIR fees will be negotiated at the point of sale instead of the underhanded and retroactive fashion by which the plans and PBMs currently operate. Currently, pharmacies can face these clawback fees after they have already filled and sold a prescription for Medicare part D and Medicare Advantage patients. DIR fees have become a catchall category for pharmacy benefit managers to collect more overhead after prescriptions are sold. Pharmacies are often unaware of what they will owe, and the standards for these fees can be impossible to meet. As a result, many independent pharmacies in my district are forced to provide the drugs at below cost. Imagine that for just a moment. DIR fees are causing pharmacies to operate in the red, all while they are providing lifesaving medication to America's seniors. DIR fees have also led to drastic increases in out-of-pocket costs for our patients, which, in turn, forces seniors into the doughnut hole of Medicare part D even sooner.…”