Congressman Griffith's Weekly E-Newsletter 3.1.24

Rural Health Care & Pharmacies

Since coming to Congress, I have worked to find ways to protect and promote access to health care for rural Americans.

One aspect of rural medicine I have tried to help on a federal level is pharmacies. For many in rural areas, visiting pharmacies and interacting with pharmacists is one of the most important points of access for health care in small towns and communities. Pharmacists are trusted members of the community, who help provide relief to those in need.

Pharmacies have faced some tough challenges. Not long ago, UnitedHealth Group (a health care group that operates Optum and United Healthcare platforms) was the victim of a cyberattack. This complicated prescription deliveries for six days as many pharmacies were unable to process prescriptions. Pharmacies have also faced challenges as this country continues to deal with chronic drug shortages, ranging from chemotherapy drugs to antibiotics to ADHD medications. Though wanting to help, some pharmacies have been unable to dispense critical, life-saving medications.

Over the years, I have looked for ways on a federal level to assist pharmacies, while also helping Americans get better access to health care. Below is a summary of bills I recently introduced or co-sponsored that are related to pharmacies.

H.R.5393 - Transparency and Fairness for Pharmacies Act

Pharmacists, including rural pharmacists, have been increasingly charged retroactive fees, known as Direct and Indirect Remuneration (DIR) fees, after prescriptions are filled. These fees hurt, and sometimes destroy, the pharmacists’ business. Imagine you bought a product for resale for $1 and sold it for $1.03. You find out later that without telling you, the company changed the price several months after you sold the product and now has the right to come back and say, “Oh, we really should have charged you $1.20.” You have now lost 17 cents on the transaction. That’s how DIR fees work. Believe it or not, this happens to pharmacists routinely.

To make matters worse, a majority of these pharmacists say they receive no clear information about when and why these DIR fees will be collected. Many also noted that DIR fees can total tens of thousands of dollars each month. In response to this, I introduced the Transparency and Fairness for Pharmacies Act, which takes steps to help rein in and bring more transparency to these DIR fees and all pharmacy fees by Pharmacy Benefit Managers (PBMs).

My bill would require the Centers for Medicare and Medicaid Services to create standardized quality metrics for health plans and PBMs to use when determining payments to pharmacies.

H.R.5400 - Neighborhood Options for Patients Buying Medicines Act

PBMs act as an intermediary between pharmacies, insurance companies, drug manufacturers, etc. whose purpose is to negotiate drug prices. We have seen that PBMs can manipulate drug prices through various ways to enhance their own profits, hurting Americans’ bottom line and the pharmacies who deal with them.

I co-sponsored H.R. 5400, which would modernize Medicare and enhance PBM accountability by preventing them from discriminating against pharmacies that are willing to contract with them, helping seniors seek care closer to home. This will ensure that PBMs do not provide unfair contracts to independent pharmacies where that independent pharmacy wouldn’t accept the contract because the reimbursement rate for medications is so low their patients would lose access to that drug. 

H.R.1770 - Equitable Community Access to Pharmacist Services Act

Pharmacies have the ability to provide a variety of services beyond just filling prescriptions. Currently, certain tests and vaccines administered by pharmacies are not reimbursable by Medicare.

I co-sponsored legislation, Equitable Community Access to Pharmacist Services Act, to establish a federal reimbursement mechanism for pharmacists’ services under Medicare and ensure patients can continue to access essential care and services provided by pharmacists. This will now allow for Virginia pharmacists to test and treat for strep, flu, and COVID-19 and get reimbursed by Medicare for it.

H.R.5526 - Seniors’ Access to Critical Medications Act

Many seniors living in the Ninth District and in other rural areas are not physically able to travel to pick up their much-needed prescriptions, whether it be from pharmacies, doctor’s offices, etc.

I co-sponsored legislation, Seniors’ Access to Critical Medications Act, that would allow for patients to have their caregivers/loved ones pick up the prescription on their behalf, making life easier for seniors.

These bills are just some ways I am currently helping pharmacies and rural Americans. I will continue to explore other ways to promote and protect access to health care.

If you have questions, concerns, or comments, feel free to contact my office.  You can call my Abingdon office at 276-525-1405 or my Christiansburg office at 540-381-5671. To reach my office via email, please visit my website at


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