The National Community Pharmacist Association (NCPA) met recently with TRICARE leadership. Issues discussed included the new mail order pilot program, mail order waste, pharmacist services, disposal of controlled substances, and coverage for compounds (TRICARE’s earlier decision regarding non-coverage for compounds is now on hold) . Regarding the new mail order pilot program for TRICARE for Life beneficiaries for certain brand medications, we relayed multiple concerns, especially the impact on LTC patients. While there is a waiver process available for nursing home residents to be exempted, it is currently on an individual patient basis and could be cumbersome, as it requires the resident or their caregiver to call Express Scripts to try and resolve.
We are hopeful there can be a more streamlined approach to granting such waivers, and TRICARE assured us they are working on such a process. Aside from our one-on-one discussions with TRICARE, NCPA also joined a LTC stakeholder letter asking for a broader exemption from the pilot for both skilled and assisted living patients.
For more information, please contact CARE Pharmacies.