Know the Lowest Price Act


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Some regulations get great fanfare while others seem to fall into place quietly, organically. Here is one those regulations that, for as extremely beneficial it is for everyone onMedicare, does not seem to be getting much airplay. It’s called the “Lowest Price Act”.

This act was signed into law on October 10, 2018, and will become effective either on or after January 1, 2020. The act blocks Medicare Advantage plan providers or providers of a Medicare Part D prescription drug plan from using gag clauses that prohibit pharmacists from alerting Medicare customers of differences between their insurance copay and what the patient would pay without using health insurance coverage, says Ken Majkowski, PharmD, chief pharmacy officer at FamilyWize.

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The act was implemented to increase price transparency for consumers covered under Medicare or Medicare Advantage. “Many consumers don’t know to ask if a lower prescription price is available,”Majkowski says. “When a pharmacist knows that a patient is overpaying but can’t share this information, the patient loses a chance to save and pharmacists feel like they aren’t performing to the best of their abilities. Consumers aren’t given the opportunity to make educated choices surrounding healthcare costs.”

Pharmacists can help patients find better pricing by advising that there are options available to them, Majkowski says. Pharmacists may also want to remind patients that if they don’t use their Medicare benefit, they may not be able to apply that purchase to their deductible if one exists.1

Price Transparency is What We Know

RX VALET is and has been at the forefront of price transparency for years. In fact, it’s baked into our website. When members search for their medication, the prices are shown immediately.

Whether it’s a retail pharmacy, home delivery, international pharmacy, ora Prescription Assistance Program (PAP), if there is a cheaper price, members see it right away. Not only does RX VALET have price transparency, but we also take it a step further and will reach out to our members that have made a more expensive choice just to see if they were aware of their potential costsavings!

So, for all those on Medicare Advantage or Part D, keep this act top-of-mind. Because when we all save, we all win.

 

1 https://www.drugtopics.com/regulatory/5-new-pharmacy-rules-and-regulations-2019/page/0/3

July 23, 2019