Congressman discusses Tricare transparency and low Medicare dispensing fees
What happened
Congressman Kevin Hern met with owners of Broken Arrow Family Drug and Oklahoma Deputy Attorney General Micheal Leake. Attendees discussed the need for greater transparency in Tricare and other federal programs. Hern was also educated on low dispensing fees for Medicare transactions and how Pharmacy Benefit Managers claim federal preemption when states attempt to enforce reimbursement or audit laws.
From ncpa.org
Why it matters
The meeting highlighted concerns regarding transparency within Tricare and the low dispensing fees for Medicare transactions. This discussion raises questions about Pharmacy Benefit Manager reimbursement practices and the scope of federal versus state oversight in major health care programs.
From ncpa.org
Who's involved
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The entities involved
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Tricare
health care program of the United States Department of Defense Military Health System
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Medicare
US federal health insurance
Related events
- Proposed updates to the Medicare fee schedule are currently under review for modernization.
- Sentara Health is losing money due to disputes over payment rates with Medicare while serving patients in the Hampton Roads area.
- Tricare and Medicare are now requiring that all services they reimburse must be medically necessary.
- Backing legislation to strengthen Medicare payments.