House Ways & Means Committee Members Urge CMS to Expand Access to LTC Pharmacy at Home Services9/30/2024
Washington, D.C. – In a significant bipartisan effort, members of the House Ways & Means Committee have called on the Centers for Medicare and Medicaid Services (CMS) to ensure that Medicare beneficiaries have greater access to long-term care (LTC) pharmacy services at home. In a letter addressed to CMS Administrator Chiquita Brooks-LaSure, Representatives Adrian Smith, Lloyd Doggett, Nicole Malliotakis, Terri Sewell, Brian Fitzpatrick, and Gregory Murphy, M.D., highlighted the critical role of LTC pharmacies in supporting medically complex patients who choose to reside in their homes or communities rather than in institutional settings The letter emphasizes the urgent need for CMS to leverage its existing authority to close the gap in care for beneficiaries living at home who require specialized LTC pharmacy services. The authors note that this underserved population often includes individuals from marginalized communities, dual-eligible beneficiaries, and those facing cognitive impairments or multiple chronic conditions. “Despite CMS recognizing that Part D enrollees requiring LTC pharmacy services can reside in various settings, including their own homes, most Part D plans still fail to provide adequate reimbursement for these vital services,” the letter states. The Representatives point to disparities in healthcare outcomes and expenditures between beneficiaries living in skilled nursing facilities and those living independently. Without proper access to LTC pharmacy services at home, community-dwelling beneficiaries face higher risks of adverse drug events, emergency room visits, and preventable hospitalizations. The letter underscores the cost-saving potential of these services, noting that Medicare Part A and Part B spending is more than twice as high for beneficiaries requiring LTC services in the community due to higher hospitalization rates and emergency department visits. Expanding access to LTC pharmacy services would not only reduce these costs but also help beneficiaries manage their conditions safely at home. The House Ways & Means members urged CMS to act by utilizing the convenient access standard, provided by Congress, to encourage Medicare Advantage and Part D plans to expand access to LTC pharmacy at home services. About the Alliance for Long-Term Care Pharmacy @ Home The Alliance for Long-Term Care Pharmacy @ Home is a coalition of LTC pharmacies, professional associations, and care management groups advocating for increased access to LTC pharmacy services for medically complex patients living at home. Our mission is to promote equitable access to healthcare services that allow patients to remain safely in their homes and communities. For more information, visit www.pharmacyathome.org. 
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