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There's Still Time for Drug Payment Legislation, but It's Not on the Schedule

By Alex Wayne, CQ Staff

September 6, 2007 -- Supporters of legislation that would speed up insurer payments to pharmacies under Medicare's new drug benefit are hoping to pass their bill by Thanksgiving.

But so far, House leaders haven't placed the popular measure (HR 1474), which has 199 cosponsors, on the fall schedule.

"Really, more than anything else, it's just been hard to get the leadership focused on it," said Rep. Marion Berry, D-Ark., a former pharmacist who sponsored the bill.

Independent pharmacists complain that while insurers and drug companies profit from Medicare's drug benefit, the program is causing them financial pain because the insurers don't pay them quickly enough.

As a result, the National Community Pharmacists Association says, independent pharmacies have been forced to take out loans averaging $70,000 to pay drug suppliers while waiting for payments from insurers. The association says 1,152 community drugstores closed last year, some because of problems related to the new drug benefit.

The Pharmaceutical Care Management Association, which represents insurers, says all "clean" claims are paid within 30 days. But a new study by the University of Texas found that independent pharmacists were reimbursed within 30 days on just half of their 2006 claims.

Berry's bill would require insurers to pay pharmacists as quickly as 14 days.

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