Pharmacy organizations are urging the Centers for Medicare & Medicaid Services (CMS) to “finish the job” of reforming the direct and indirect remuneration (DIR) fee system within Medicare Part D.
“Pharmacy DIR was intended as a payment or fee adjustment after the point-of-sale, with the amount calculated according to pharmacy performance metrics, but instead, PBMs [pharmacy benefit managers] have exploited DIR to create a loophole ... allowing them now to