Important Blog about 2025 Med Part D Contract
Community pharmacies play a crucial role in providing essential healthcare services to their local communities. One of the key challenges they face is navigating complex contracts with Pharmacy Benefit Managers (PBMs) like Caremark, ESI, Prime, and others.
These contracts often dictate reimbursement rates for medications, dispensing fees, and other services provided by the pharmacy. It is important for community pharmacies to closely analyze these contracts to ensure fair reimbursement that covers the cost of providing quality care to patients.
Accepting contracts that set the pharmacy up for future losses can have a detrimental impact on the sustainability of the business and the ability to continue serving the community. By advocating for fair reimbursements and not accepting unfavorable contract terms, community pharmacies can better protect their financial viability and continue to provide valuable healthcare services to their patients.
On Monday April 29th a major PBM contract deadline arrives with some questionable reimbursement terms regarding a 2025 Medicare Part D plan. IPC Board Member, Mike Deninger has recently released two blog posts discussing the dishonest practices within this 2025 Medicare Part D plan.
We invite you to review both blogs and use these resources as a jump off point before making your decision whether to Opt Out of this contract. Blog 1: Hard Math & Tricky Terms discusses the reimbursement math behind the 2025 contract and how it can be potentially detrimental to your pharmacy. Blog 2: What to do When Faced with a Bad Contract covers the finer points of what actions you should consider when a less than favorable contract is presented. As these contracts affect your business it is important to have all the necessary information to make an informed decision.
*The views expressed in these posts may not reflect the views of IPC – contact Health Mart Atlas or your PSAO with any questions regarding the impact of provider contracts to your pharmacy.
We hope these blogs help provide some insight into the importance of analyzing PBM contracts and advocating for fair reimbursements in community pharmacies!
