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ASCP Announces Recommendations to Insurers and PBMs Regarding IRA Implementation

News Provided by ACCESS Newswire2025-06-25

ALEXANDRIA, VIRGINIA / ACCESS Newswire / June 25, 2025 /The American Society of Consultant Pharmacists (ASCP) has announced its policy recommendations for insurance plans and pharmacy benefit managers (PBMs) concerning implementation of the Inflation Reduction Act (IRA.)

To address concerns, ASCP made four specific recommendations concerning the new, three-party transaction-based relationship for all eligible medications dispensed under Medicare Part D 's Medicare Drug Price Negotiations Program (MDPNP) between the PBM payer, manufacturer and dispensing pharmacy. The recommendations were:

· Payers must reimburse at no less than the negotiated MFP;

· Payers must pay a professional dispensing fee on prescriptions dispensed under the MDPNP program that is reasonable and adequate to provide the highly specialized and highly regulated services necessary to serve residents of long-term care facilities;

· While CMS allows 7-day for claims processing, many payers can and therefore should process claims as quickly possible to facilitate timely reimbursement from manufacturers; and

· Payers should not engage in the relationship between pharmacies and manufacturers, nor require any data or contractual information of the pharmacy-manufacturer relationship

Together with others in the long-term care sector, ASCP has been ringing alarm bells regarding the unintended consequences of IRA implementation, as currently designed by CMS. Without significant improvements to the program before implementation on January 1, 2026, many long-term care pharmacies could be forced to close or reduce services, which will directly and negatively impact the highly vulnerable long-term care patients under their care. A recent industry survey found more than 90 percent of LTC pharmacies would be forced to lay off staff, 85 percent would be forced to limit essential services and more than half would face challenges just continuing to dispense medications.

"The IRA presents unprecedented threats to the survivability of long-term care pharmacy as well as opportunities to build a trusted, transaction-based relationship to promote better care," said Chad Worz, PharmD, Chief Executive of ASCP. "In developing these recommendations, we hope to foster a more transparent and fair medication reimbursement system that benefits patients health outcomes while preserving patient access to critical and specialized long-term care pharmacy services."

These new recommendations to healthcare payers builds off recommendations to IRA-impacted manufacturers issued jointly by ASCP and the National Community Pharmacists Association (NCPA) on June 13, 2025. Since issuing these recommendations, the entities have spoken with all eight of the impacted manufacturers for Implementation Year 2026.

About ASCP:The American Society of Consultant Pharmacists (ASCP) is the only international professional society devoted to optimal medication management and improved health outcomes for all older persons. ASCP 's members manage and improve drug therapy and improve the quality of life of geriatric patients and other individuals residing in a variety of environments, including nursing facilities, sub-acute care and assisted living facilities, psychiatric hospitals, hospice programs, and home and community-based care.

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Contact Information

Melissa Blacketer
Senior Director of Communications
mblacketer@ascp.com
703-739.1311