On Thursday, IPA members and staff met with the Centers for Medicare & Medicaid Services (CMS) and Senator Chuck Grassley's [R-IA] office to present data on Iowa pharmacy access and urge CMS to take action to prevent pharmacy closures in Iowa as a result of new Medicare Part D contracts and the upcoming DIR hangover or DIR ‘cliff.' Senator Grassley's office coordinated the meeting in direct response to outreach from IPA and members who voiced concerns of expected pharmacy cash flow and access issues.

“Throughout my 99 county meetings in Iowa, I've heard firsthand from rural pharmacies about the looming cash flow challenges created by Medicare Part D reimbursement changes. I've brought Iowa pharmacies' concerns up directly with the Centers for Medicare and Medicaid Services Administrator by phone and letter. I've also spoken on the Senate floor and in the Finance Committee about steps we must take to protect seniors' access to rural pharmacies. I continue to insist that powerful PBMs who benefit from publicly-funded Medicare and Medicaid programs step up to help rural pharmacies, and CMS needs to do its part too. I'm glad CMS took the time to speak with the Iowa Pharmacy Association at my request and learn from their valuable insights. CMS, PBMs and rural pharmacies must work together to smooth out the cash flow problems rural pharmacies are set to face through next year.” – Senator Chuck Grassley

Senator Grassley first became aware of the DIR cliff in April during a visit to Medical Associates Pharmacy in Boone. Between April and July, the Senator and his team regularly met with Iowa pharmacists to learn about the expected financial strain and impact on access to care. In July, the Senator sent a letter to the CMS Administrator explaining the issue and requesting action to prevent pharmacy closures. Over separate advocacy visits in Washington D.C. in mid-September, IPA CEO Kate Gainer, staff, and members emphasized the need for urgent action. This prompted the following remarks by the Senator on the Senate floor on September 28th and the meeting between IPA staff and members, Senator Grassley's office, and CMS. IPA thanks Senator Grassley and his team for their unwavering support for Iowa pharmacies.

During the meeting, CMS heard personal impact stories from Leslie Herron, Owner of Sumpter Pharmacy; Lindsey Ludwig, Executive Director of CPESN-Iowa; Randy McDonough, Owner/CEO of Towncrest Pharmacy; and Charlie Hartig, Owner/CEO of Hartig Drug.

IPA illustrated the current and future state of community pharmacy in Iowa with data from the “Pharmacy Access in Iowa” study and the “Iowa Pharmacy Association State of Community Pharmacy – 2024 Expectations Survey.”

The Pharmacy Access in Iowa Study exhibits an alarming decrease in pharmacy access from 2008 to 2022, most notably in rural communities. Michael Andreski, RPh, PhD, faculty member at Drake University College of Pharmacy and Health Sciences, conducted this study in collaboration with The Health Professions Tracking Center at the University of Iowa Carver College of Medicine.

IPA conducted the Iowa Pharmacy Association State of Community Pharmacy – 2024 Expectations Survey between October 6-11th to illustrate expectations of community pharmacies in Iowa with the upcoming 2024 DIR rule changes, Medicare Part D contracts, and PBM challenges. This survey includes responses from 97 independent and small regional chain community pharmacies serving over 333,000 patients across Iowa.

Attendees from CMS included Cheri Rice, Deputy Director, Parts C and D, the Center for Medicare; Jenn Shapiro, Director of the Medicare Plan Payment Group, the Center for Medicare; Maria Martino, Director, Congressional Affairs Group, Office of Legislation; Alex Winters, Congressional Affairs Group, Office of Legislation; and Olivia Gomez, Congressional Affairs Group, Office of Legislation.

IPA continues to work with Iowa's lawmakers and federal regulators toward solutions for pharmacies impacted by these issues. Contact your Member of Congress today to explain the issues facing your practice, provide data quantifying the impact, and share personal stories of how your community will be impacted.