Political Quotes

“You have hit something. You have led into a great example. This is highlight. And if there are problems, let's fix them. You hit on that issue. We have heard of DIR fees tonight. We have heard about reimbursements. Let me leave you an example from a little company called Humana. I had a pharmacist call me about proposed amendments to their Pharmacy Provider Agreement. Humana decided to withhold $5 per prescription from initial reimbursements to the pharmacy. Now, you understand what is happening. They are withholding $5 of what they should be sending to the pharmacy. The return of the reimbursements was conditional on the pharmacy meeting certain patient adherence metrics. This is essentially a fee conditional on meeting certain performance standards, and Humana would withhold reimbursements from poorly performing pharmacies. That sounds good, doesn't it? It has got a great twang to it. Somebody in the marketing office there thought, This is going to be pretty cool. It sounds so good, but let's talk about it. Humana's criteria, however, had little to do with patient care and more with driving community pharmacists out of the market. Many of the metrics used, including patient adherence, are beyond the control of the pharmacist. Humana's amendment unduly burdens small pharmacists and protects large chain pharmacies, many of which they own.…”