WASHINGTON D.C. — Today, the Alliance for Long-Term Care Pharmacy @ Home wrote a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, urging the agency to leverage its existing authority to ensure Medicare beneficiaries have access to long-term care (LTC) pharmacy services at home. This action is seen as crucial for supporting medically complex patients, particularly those in underserved and rural communities The Alliance, representing a coalition of LTC pharmacies, professional associations, and care management groups, emphasizes the critical role of LTC pharmacy services in promoting high-quality healthcare for individuals residing in their homes or communities. These services include providing around-the-clock access to medications, ensuring proper dosage, offering specialized packaging to promote adherence, consulting with caregivers, and administering vaccines. The letter states, "LTC pharmacies have for decades been designed to support medically complex patients by providing around-the-clock access, ensuring that people are on the right medications and at the right dose, providing special packaging, promoting adherence, consulting with family members and caregivers, delivering access to and administering vaccines, and much more." Despite this, a significant disparity exists in the level of support provided to Medicare beneficiaries living in the community compared to those in skilled nursing facilities. In December 2021, CMS acknowledged that Part D enrollees requiring LTC pharmacy services can reside in various settings, including assisted living facilities and their homes. The agency also recognized that Part D prescription drug plans (PDPs) could pay higher reimbursement fees to pharmacies providing these services. However, most PDPs still do not provide adequate reimbursement for LTC pharmacy services at home, significantly impeding access to these essential services for individuals residing at home. As the letter concludes, the Alliance calls on CMS to "utilize the convenient access standard to require Medicare Advantage and Part D plans to expand access to LTC pharmacy at home services," aligning with CMS’s strategic pillars to expand access and drive innovation. About the Alliance for Long-Term Care Pharmacy @ Home The Alliance for Long-Term Care Pharmacy @ Home is a coalition of long-term care pharmacies, professional associations, and care management groups dedicated to increasing access to LTC pharmacy services for medically complex patients living in their homes and communities. For more information about The Alliance for Long-Term Care Pharmacy @ Home and our members, visit www.pharmacyathome.org.
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