[Congressional Record (Bound Edition), Volume 159 (2013), Part 9]
[Extensions of Remarks]
[Page 12665]
[From the U.S. Government Publishing Office, www.gpo.gov]




                          COMMUNITY PHARMACIES

                                 ______
                                 

                          HON. DAVID LOEBSACK

                                of iowa

                    in the house of representatives

                         Tuesday, July 30, 2013

  Mr. LOEBSACK. Mr. Speaker, I rise today to recognize the important 
role that community pharmacies play in Iowa's Second Congressional 
District and throughout the country. They are the front-line health 
care providers and counselors for many patients who consistently depend 
on their training and expertise to stay informed, healthy, and out of 
the hospital. They also play an incredibly important role in 
strengthening the economies of the areas they serve, particularly in 
rural counties like many of those I represent.
   Like most small business owners, community pharmacists face many 
challenges and compete and negotiate on a day-to-day basis with large 
entities in their business transactions. However, small pharmacy owners 
face an even larger disadvantage than most because of their clear lack 
of leverage they have when negotiating the amount they will be 
reimbursed for filling prescriptions when dealing with pharmacy benefit 
managers (PBMs). PBMs serve as the middleman between the health plans 
and pharmacies, but they also own large mail-order pharmacies 
themselves. As a result, they are in direct competition with the small 
pharmacies with whom they also are called upon to negotiate contracts. 
Also as a note, the largest PBM in the country had nearly $94 billion 
in revenue in 2012.
   PBMs also are charged with auditing pharmacies to detect fraud and 
abuse. This is an important role to ensure that Medicare beneficiaries 
are not taken advantage of, but problems arise when audits are 
conducted over clerical, administrative errors rather than targeted 
toward bad actors who willfully game the system. I have heard from 
several upstanding small business owners in my district who have been 
subject to these unnecessary audits and I think the process needs to be 
reformed so that these audits are as fair and transparent as possible.
   As the federal government is business partners with PBMs in Medicare 
Part D, FEHBP, TRICARE and Medicaid Managed Care, I believe it is our 
duty to take a close look at these practices to ensure our small 
pharmacies have a fair working relationship with these large PBMs and 
that the needs of seniors and all those that depend on community 
pharmacists are met.
   I look forward to continuing to work with the community pharmacies 
throughout Iowa's Second Congressional District to ensure they can 
continue to provide individual, high quality services to Iowans.

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