On the recordMay 9, 2019
I thank the gentleman for his keen insight on this subject. It is very important, and I appreciate his expertise. Madam Speaker, what the gentleman from Kansas was speaking about are two proposals that are before CMS right now. One proposal would do away with DIR fees. Now, let's make sure we understand that DIR stands for direct and indirect remuneration. This is when the PBMs go back months later--in some cases, years later--and recoup, or claw back, reimbursements for what they have already sent to the pharmacies. You can imagine what kind of impact this would have on a business. There is no sustainable business model out there that can absorb that. I get texts all the time from small pharmacy chains that are telling me: I just got a bill from the PBM. Last year, my total DIR fees were $500,000, a half million dollars. That is money they have already paid taxes on, but they are clawing it back. They are taking it back. CMS has proposed that that end. I am in support of that, and I appreciate CMS doing this. The other proposed rule that CMS has come out with has to do with the rebates, or discounts, if you will, that are offered to the PBMs by the pharmaceutical manufacturers--not offered to them, but the PBMs demand them from the pharmaceutical manufacturers. What CMS is proposing is that all of those rebates, or discounts, if you will, be given at the point of sale.…
