Google+ When the CMS Changes PPN Rules - Are Seniors The Biggest Losers? google0234ed6cc8d24af6.html
Zero Plan Disruption for Retirees
Zero Plan Disruption for Retirees
EGWP's allow plan retiree's to keep the same pharmacy benefits without interruption or additional costs, while the plan provider realizes significant cost savings.
Retiree Prescription Drug Plans
Retiree Prescription Drug Plans
Under an EGWP the PDP handles main administrative requirements, manages all federal interaction, collects federal Part D plan subsidies and assumes compliance responsibilities.
Employee Group Waiver Plans
Employee Group Waiver Plans
EGWP's are commonly referred to as Egg Whips and provide generous cost savings combined with improved cash management.

CMS Changes PPN Rules

Is the CMS neglecting its own report that Preferred Pharmacy Networks (PPN’s) have costs from 3.5 to 24.1 percent less than non-preferred pharmacies.Where branded drugs worked out to be 3.3 percent less expensive, on a claims-weighted average basis; generics prescriptions were 11 percent cheaper.

The small community pharmacies have lobbied for these changes. Namely that they be given access to the pricing that the preferred networks get. Only 11% of Part d recipients would benefit from this expansion, while at the same time the change acts as a disincentive for PPN’s to exist. The economics and competition that spurs lower costs for large networks, will be lost by the changes the CMS has made.

It will result in increased costs for plans and higher premiums for seniors.

Read the entire story in Forbes

Part D Enrollment Figures for 2014

For more on the latest Part D enrollment numbers released by the CMS this January that shows more than 75% of all Medicare Part D enrollees participate in a preferred pharmacy plan, read here.

About The Author

Employer group waiver plan consultant helping Medicare Part D eligible retiree pharmacy benefit plan sponsors and brokers select the best medicare part d prescription drug products for their plan enrollees with no plan interruption, higher benefit payouts, substantial administrative burden reductions, faster cash flow and more.

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