Pharmacy Payment Challenges in 2024
Featured Partner | SoftWriter's Mark Fulton on decoding the decline in reimbursements amid the complex web of challenges in 2024.
by Mark Fulton, PharmD, MBA, BCNSP, NSC-II
The arrival of 2024 has brought with it a complex web of challenges in the realm of reimbursement. The landscape has shifted dramatically, and the decline in reimbursements is a key concern for pharmacies nationwide. In this article, we will unravel the intricacies behind this decline, exploring the impact of recent CMS rules, the removal of the AMP rebate cap, and the evolving strategies of pharmaceutical manufacturers. We'll also discuss how pharmacies can navigate these challenges and explore potential solutions to safeguard their financial stability.
One major factor contributing to the decline in pharmacy reimbursements is the Centers for Medicare & Medicaid Services (CMS) rule prohibiting retroactive Direct and Indirect Remuneration (DIR) fees, which became effective on January 1st. This rule disappointed many pharmacy advocates, who had initially hoped that CMS would eliminate DIR fees. Previously, pharmacies faced retroactive DIR fees,…
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