The wheels are starting to move in the healthcare oversight arena, with major changes coming to Direct and Indirect Remuneration (DIR). In this blog, we’ll fill you in on what is changing and how to prepare for the future impact on independent pharmacists
CMS eliminates retroactive DIR fees
Starting January of 2024, the Centers for Medicare & Medicaid Services will begin implementing changes in how DIR fees are collected. CMS will:
1. Remove retroactive application of DIR fees.2. Reduce beneficiary cost sharing on drugs.
3. Address clawback fees imposed on pharmacies at the time of transaction.
4. Establish new systems based on standardized, evidence-based measures that reward and improve quality of care provided by pharmacists.
All of these changes allow for better drug-cost transparency for both pharmacists and consumers. Patients will have reduced out-of-pocket costs, while pharmacists will benefit from increased predictability. The change to clawback fees in particular makes it easier for independent pharmacies to manage costs and remain financially stable.
Preparing for future impact of DIR fees
Pharmacies will need to be prepared for the changes it will bring at point of sale and the immediate cash flow issues that may be encountered within the first month of the DIR fee ruling. Use the next 18 months to develop strategies and build new relationships, services, and contracts to make up for downturns in prescription dispensing revenue.
The first few months of implementation may be rocky for member pharmacies as they adjust, but in the long-term this adjustment will allow for better financial planning for independent pharmacies.
To help pharmacies manage the upcoming changes, Health Mart Atlas has developed an opt-in DIR Assist program that allows customers to set aside funds for possible cash flow challenges during the first few months of 2024. Visit myhealthmart.com to enroll now.
We want our member pharmacies to hit the ground running on January 1, 2024. AAPA will be here to bring our member pharmacies tips and strategies throughout 2023 to better help them prepare for this upcoming change. For more information about the change to DIR fees, check out this video.
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