Dear Michigan Pharmacy Owner,
We are proud to announce that Sav-Mor Pharmacy Services & Michigan Independent Pharmacy Association (MIPA) have worked diligently with Blue Cross Complete (PerformRx) to remove transaction/transmission fees for approved pharmacy claims for ALL Michigan Pharmacies! Additionally, Blue Cross Complete has agreed to refund any transaction/transmission fee pharmacies may have occurred in the first quarter of 2024 (this is expected to happen in the coming weeks).
MI House Bill 4348, which was made effective 1/1/2024, prohibited pharmacies from being charged a transaction fee or a fee to transmit a prescription claim electronically. Sav-Mor was able to successfully negotiate these transmission fees out of our contract with PerformRx in 2021. However, through our reconciliation program we were able notice these transmission fees to other Michigan pharmacies who happen to belong to various other PSAOs, even after the House Bill 4348 effective date of 1/1/2024. Because Sav-Mor is constantly monitoring claims for our members and working with state and federal legislators, Blue Cross Complete (PerformRx) will make these adjustments across all Michigan Pharmacies regardless of PSAO/Contracting entity!
We are proud to highlight this small victory and continue to work with other payors & the Department of Insurance and Financial Services (DIFS) to regulate the payors/PBM’s according to the guidelines of HB4348. Sav-Mor and MIPA will continue to work alongside the Michigan Pharmacists Association to further introduce key legislation that provides protection for pharmacies across Michigan. We already have complaints and communication out to other payors to try to resolve the transmission fee issue.
What should I do now? How can I review these transactions/transmission fee’s?
The average transmission/transaction fee was $0.18 cents per approved claim. If you would like to see the financial impact for your pharmacy in 2024, ask your pharmacy reconciliation system to identify transaction adjustment fees for PerformRx (BIN#019595). If they cannot supply this information or you do not currently work with a company for your claims reconciliation, Sav-Mor would love to show you how we provide pharmacy reconciliation for over 150+ pharmacies. To learn more, reach out to [email protected].
Michigan Independent Pharmacy Association
A community of Michigan Independent Pharmacies
MIPA in Washington DC, (MIPA will be attending the NCPA Fly-In on April 17th & 18th, 2024)
- NCPA Pharmacy Fly-In (April 26-27, 2023)
- MIPA and Michigan Independent Pharmacy Owners were proud to meet with congressional representatives from the State of Michigan at the NCPA Fly-In. We are very appreciative of NCPA for providing facetime with staff members to allow our MIPA members and additional Michigan Pharmacies to discuss PBM reform, provider status and other topics. We hope to have more representation from our great state next year!
- In attendance were the following Michigan Pharmacy Representatives.
- John Gross (Director of MIPA) - MIPA MEMBER
- Steve & Emily Jensen (Jensen's Community Pharmacy) - MIPA MEMBER
- Marwan Isa (Lincoln Rx Pharmacy) - MIPA MEMBER
- Stefan Miller (Benson Drug) - MIPA MEMBER
- Nashwan Algumaei (Arbor Lakes Pharmacy)
- Brandon Peiffer (Vice President, Operations - Sav-Mor)
Our Mission
The Michigan Independent Pharmacy Association was formed in 2019 to provide a unified voice for independent pharmacies in public policy discussions.
Our Role
The Michigan Independent Pharmacy Association has an aggressive political agenda to protect independent pharmacies by educating state legislators, congressional leaders, and the public on the importance of independent pharmacies.
Join Us
If you are an independent pharmacy owner, you need to join this organization and begin fighting back. Only through a unified voice can we be heard.
Advocacy
Medicare Part D DIR Fees
MIPA is currently working in collaboration with the National Community Pharmacists Association (NCPA) and others on a national platform to eliminate or significantly reduce DIR fees in the Medicare Part D program.
MIPA supports S. 127 PBM Transparency Act of 2023 & S.113 The Prescription Pricing for the People Act
Please reach out to your senators to urge them to cosponsor both bills here!
Pharmacy Benefit Managers (PBMs)
MIPA aggressively opposes the unfair practices of PBMs that lack transparency and lead to unfair pharmacy reimbursement, claw backs, adjustments, and fees after the point of sale.
Former Speaker of the House Jason Wentworth stated “We were fortunate to have the opportunity to team up with the Michigan Independent Pharmacy Association and find success with this important legislation." See Press Release Here
For a detailed overview of HB 4348 and what changes will be in effect in 2024, please login to the members portal.
Audits
MIPA will continue to advocate for fair and reasonable PBM audits that will protect pharmacies from unreasonable audit practices and recoupment methodologies.
Reimbursement
MIPA will continue to advocate for adequate pharmacy reimbursement from all payors, including Medicaid, Medicare, and others. All pharmacies deserve to be reimbursed at or above cost, with reasonable dispensing fees, and without "clawbacks."
Membership
MIPA members are provided access to the latest developments in Michigan health care policy, updates to news that affect independent pharmacy businesses and a voice at the table where pharmacy policy decisions are made.
Michigan independent pharmacies should join MIPA to form a strong, unified network to increase pharmacy reimbursement, combat non-transparent practices of PBMs, protect pharmacies from unfair audit practices, and more.
MIPA is fighting for pharmacy transparency, fair reimbursement, and improved access and quality for patients.
This organization was founded by like-minded independent pharmacy owners to have an impact and fight for community pharmacies.
We need all independent pharmacies to join us!