NACDS emphasized the need for Congress to address direct and indirect remuneration (DIR) fee relief as it considers solutions to reduce healthcare costs. In a statement to the Senate Health, Education, Labor & Pensions Committee, NACDS stated that DIR fees are used by Medicare Part D plans and their pharmacy benefit managers to “claw back reimbursement from pharmacies for prescription medications filled for Medicare beneficiaries.”

The statement explains that these fees are often applied several months after the claim has been paid. NACDS pointed out that the Centers for Medicare & Medicaid Services itself said “the use of DIR fees has grown 45,000 percent since 2010.” And that the use of DIR fees has “tripled since just last year in some cases.”

NACDS pointed to the Phair Pricing Act (S. 640) as a way to achieve much-needed reforms in the use of DIR fees in the Medicare Part D program. The bill  will “require Part D plans and their PBMs to pass the savings to beneficiaries by including all pharmacy DIR fees in the negotiated price and the point of sale.”