PCMA President and CEO Mark Merritt: N.C. bill would raise costs, doesn't solve drug abuse problem | Merritt: Copay coupons bait consumers | House bill would allow OIG to exclude individuals from Medicare
A bill in the North Carolina House would require employers and insurers to cover expensive brand-name opioid pain drugs even when less-expensive generic versions are available, writes Pharmaceutical Care Management Association President and CEO Mark Merritt.
Copayment coupons have long been used by makers of brand-name drugs to "induce patients to use higher cost services like brand name drugs when equally effective generics are available," said Pharmaceutical Care Management Association President and CEO Mark Merritt.
The House introduced the Fighting Medicare Fraud Act of 2016, which would allow the Office of Inspector General to exclude people from participating in any federal health care program if they are affiliated with an organization that has been penalized for engaging in fraudulent activity. The bill, introduced last week, would also allow the exclusion of individuals who left a company or organization before it was penalized.
The CMS generally does not allow health care providers to participate in more than one demonstration project at a time, but an agency document says participants in the Comprehensive Primary Care Plus demonstration may participate simultaneously in certain other projects.
PCMA is the national association representing America's pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 266 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D. PCMA is dedicated to enhancing the proven tools and techniques pioneered by PBMs that generate savings and access for consumers and payors.
Contact PCMA Charles Cote
Vice President, Strategic Communications