Clear Messaging Is Key to Facilitating DIR Fee Reform

Ron Lanton III, Esq., executive director and senior counsel for Frier Levitt Government Affairs, explains the most effective way to facilitate DIR fee reform on a state and federal level. 


Well there are a lot of things that can be done to move along this DIR debate and to get more PBM transparency. I think the first thing, really, is to get the message straight. Because when you talk to state legislators about DIR, anything with reimbursement, you get that glaze over effect in the eyes, because they’re just like ‘Look I don’t understand health care, it’s too confusing,’ but it’s really not. When you really break it down for them in a simple to understand way, they do get it and they do want to help because this is impacting their constituents. So I think that if you’re bringing them a clear message and just telling them the problem, I think that’s a good thing.
One problem I do want to take note of though is that when I did handle DIR in some of the states, they talked a lot about ‘well this is a federal issue’. One of the arguments that I countered with that, and it’s working because they do want to take the debate into the next session, is that if you have a dual eligible patient that’s on Medicare and Medicaid, because with Medicaid the state does have jurisdiction, that’s a way for them to actually involved in the process. So I think the messaging is key. I think that you can also, if you’re looking for ways to get better messaging, go to NASP, a great organization to tell you about what’s going. NCPA is another organization that’s put out a lot on DIR fees. Your state pharmacy association would be great. And I know there’s a bill, we talked about a little bit earlier, that’s already in Congress right now that’s talking about DIR. So, taking those same messages, using those different avenues to channel that messaging and get Congress especially involved, because they are saying it’s a federal issue, let’s get that bill moving. I think that’s more effective and a good way to do this.

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