Premier Calls for CMS Action on Long-Term Care Pharmacy at Home

As a member of the Alliance for Long-Term Care Pharmacy @ Home, Premier joined more than a dozen other pharmacies and stakeholders in urging the Centers for Medicare & Medicaid Services (CMS) to help ensure that Medicare beneficiaries have access to essential long-term care (LTC) pharmacy services at home. The Alliance, which represents a coalition of LTC pharmacies, professional associations, and care management groups, has been leading the charge in advocating for policies that support the medically complex patients we serve.

The primary focus of this letter is to address the need for appropriate reimbursement for the specialized services that LTC pharmacies provide. Despite CMS acknowledging the importance of these services in previous guidance, most Medicare Part D plans have not yet implemented sufficient reimbursement rates, which significantly limits access to LTC pharmacy services for Medicare beneficiaries living at home. By calling on CMS to enforce the so-called convenient access standard, Premier aims to ensure that Medicare Advantage and Part D plans fully incorporate LTC pharmacy services into their networks. This expansion of reimbursement is essential for enabling our pharmacies to continue delivering around-the-clock medication management, adherence support, specialized packaging and caregiver consultations, thereby improving patient outcomes and reducing preventable healthcare costs.