COLLINS CHALLENGES INSURER ON BEHALF OF PATIENTS, PHARMACIES
Mr.
Acting Administrator
Dear Acting Administrator Slavitt,
We are writing you in regards to what appear to be deceptive practices being used by
Previously, Symphonix plans have generally been popular with independent and community pharmacies because the plans do not retroactively assess direct and indirect remuneration (DIR) fees. DIR fees negatively impact pharmacies and patients by distorting medication costs and reimbursement rates, increasing community pharmacies' costs by thousands of dollars each month and inhibiting the ability of local pharmacists to provide quality care throughout
However, this is not the first time Symphonix's plans have caused concern for community pharmacies across America. Symphonix's 2016 plan initially promised fair prices and reimbursement rates to seniors and pharmacists during the
Unfortunately, it appears that Symphonix is once again engaging in similar "bait and switch" practices through the inclusion of anticompetitive contractual provisions in their 2017 provider agreements. In 2016, the Symphonix PrimeSaver Rx plan provided coverage at community and independent pharmacies across America. Beneficiaries of this plan recently received a letter informing them that the plan name would be changed in 2017 to AARP[TM] MedicareRX Walgreens and that they would soon be receiving an updated member ID card. However, the letter failed to disclose that patients would be unable to fill prescriptions at community pharmacies unless they were willing to pay a
Under Symphonix's AARP[TM] MedicareRX Walgreens plan, patients are strongly incentivized to use
Throughout
We respectfully request that you look into the behavior of Symphonix as well as the current policies related to Symphonix's decision to change their plan terms at the expense of independent pharmacists and that you share your findings with us. Additionally, we request that you direct Symphonix to immediately notify current beneficiaries about the significant changes to provider networks in 2017 as this information is essential so that beneficiaries--particularly beneficiaries in underserved areas--have the information they need to make an informed decision about their choice of Part D plan and participating pharmacy provider. Thank you for your consideration of our concerns, and those of elderly and rural patients and local pharmacists who provide beneficiaries with access to affordable, quality healthcare.
Sincerely,
Member of
Read this original document at: https://dougcollins.house.gov/press-releases/collins-challenges-insurer-on-behalf-of-patients-pharmacies/
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