Monday, July 14, 2008

Passage of FAST ACT/Prompt Pay

Over the past couple of weeks BOTH the House and Senate passed of H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008. The Medicare bill, which passed Congress with a veto-proof margin, included my prompt pay bill, H.R. 1474, the Fair and Speedy Treatment (FAST) of Medicare Prescription Drug Claims Act of 2007. The legislation will help keep community pharmacies from going out of business by mandating that insurance companies provide prompt reimbursement under the Medicare Part D prescription drug benefit.

The administration of the Medicare Part D program has been a bad prescription for both patients and community pharmacists. This law put family-owned pharmacies at risk of closing, often leaving patients without their only medical professional available in the area. Congress has finally passed legislation that will provide a remedy to a problem that has crippled community pharmacies for too long.

Since the implementation of Medicare Part D, more than 1,152 community pharmacies have been forced to close their doors. In addition, only 50% of claims are paid by insurers within 30 days. While pharmacists often wait over a month for reimbursement, they must pay their wholesaler every two weeks, putting them in often extreme financial hardship.

This bill mandates that clean claims submitted electronically be paid within 14 days, and all other clean claims will be paid within 30 days. Pharmacists must also be promptly notified if there are problems with submitted claims.

The FAST Act was included as part of the larger bill called the Medicare Improvements for Patients and Providers Act of 2008. This, along with the provisions from my bill, it prevents the 10.1% reduction in Medicare reimbursement rates, enhances Medicare preventive and mental health benefits, improves and extends programs for low-income Medicare beneficiaries, and extends expiring provisions for rural and other providers.

It is no secret that our health care system is broken. As one of the wealthiest countries in the world, it is a shame we cannot provide Americans with better and cheaper health care. Too many Arkansans are living paycheck to paycheck and worry about becoming seriously ill because they know they cannot afford the care they would need – this is wrong.

The passage of this bill is one small step we are taking to remedy our nation's health care crisis. We still have a long way to go, but this is an encouraging sign for more health care reform for all Americans, not just the wealthy or privileged.

President Bush as promised he will veto this bill, but since it passed Congress with a veto-proof margin, I look forward to taking the final vote to override the President's veto and become law.

Learn more about how local Arkansas pharmacists felt about the issue by following the link below to read the transcript from my online town hall with pharmacists, which took place last spring.