Political Quotes

“Madam President, many Iowans rely on pharmacists who operate independently or as part of a small community pharmacy chain. This is especially true in rural Iowa, but I will bet it is true in a lot of other rural States as well. In Iowa, we have over 300 independent pharmacists, and many work in multiple rural communities. These pharmacies are small businesses serving Iowa communities like Muscatine and Sioux City. These pharmacies want a level playing field to compete with anyone whether that is a big chain or whether it is another independent pharmacy. Yet the pharmacists I hear from are being hurt by retroactive direct and indirect remunerations. I am going to refer to them as ``DIR'' fees. They have to work with pharmaceutical benefit managers in regard to those fees, and there are conflicts between them that I hear about all the time. This all deals with Part D Medicare plans. What I am talking about with regard to direct and indirect remunerations and these negotiated fees with PBMs are what are sometimes known as clawbacks. Every day, seniors go to the drug store, and they probably always pay a copay. These seniors then rightfully believe that they are paying the lowest amount possible, but that is not always the case. After the patient pays and leaves the pharmacy, the Part D Medicare plan or a PBM, a pharmacy benefit manager, contacts the local pharmacist to claw back a certain amount paid. That is where this DIR fee comes in.…”