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Pharmacy Associations join forces to advocate for pharmacists during change healthcare outage

Washington, D.C.
Monday, March 4, 2024, 17:00 Hrs  [IST]

As the Change Healthcare outage is now in its second week, the pharmacy community continues to be challenged and frustrated by the significant impact this has on pharmacies, pharmacy teams, and patients—from both an access to care and an economic perspective. Pharmacies are struggling or—in some cases—unable to process prescription claims, some have not received e-prescriptions for a full week, and many cannot process manufacturer patient assistance copay cards, which patients rely on.

Despite this chaos, pharmacies and pharmacists are making good faith efforts to provide continuity of patient care and, in many cases, working with no or little information about a prescription’s coverage details. This is creating backlogs, workflow disruptions, and an inability to provide patient care.  

Association executives from the American Pharmacists Association (APhA), the National Community Pharmacists Association (NCPA), the National Alliance of State Pharmacy Associations (NASPA), and the American Society of Consultant Pharmacists (ASCP) released an open letter to pharmacy benefit manager (PBM) executives and other insurance payers whose systems may have been impacted by the Change Healthcare outage. Pharmacists and pharmacies are asking for assurances that claims fulfilled during this outage will be paid, and paid in a timely manner, considering the challenges faced by pharmacies and pharmacists with predicting co-payments and determining eligibility and coverage.  

As always, pharmacies and pharmacists acted in good faith with patient care at the centre of their decisions and met the needs of patients in accessing their medications and treatments. These frontline health care providers must be made whole when services are restored.  This emergency has been ongoing since Wednesday, February 21, and has yet to be resolved.

The pharmacy organizations also asked Change Healthcare to work with the appropriate partners to expeditiously implement less onerous means for all willing pharmacies to process impacted manufacturer patient assistance programmes.

It is unclear when systems will be back to pre-outage functioning and fully recovered, so this needs to be addressed urgently.  APhA, NCPA, NASPA, and ASCP stand ready to work with all organizations to disseminate information about the status of the outage as a whole, as well as their efforts related to impacted manufacturer patient assistance programmes.

The American Pharmacists Association (APhA) leads the pharmacy profession by supporting pharmacists, student pharmacists, and pharmacy technicians in their role optimizing medication use and patient health outcomes and ensuring patients have access to pharmacists’ care.

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 programmes, and home and community-based care.

The National Alliance of State Pharmacy Associations (NASPA), founded in 1927 as the National Council of State Pharmacy Association Executives, is dedicated to enhancing the success of state pharmacy associations in their efforts to advance the profession of pharmacy. NASPA’s membership is comprised of state pharmacy associations and over 70 other stakeholder organizations.

Founded in 1898, the National Community Pharmacists Association is the voice for independent pharmacy, representing over 19,400 pharmacies that employ more than 230,000 individuals nationwide. Independent pharmacy is a $94 billion marketplace.

 




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