Action Alert
Take Action Call for Part D DIR Reform – Write Your Representative TODAY!

The pharmacy community is calling on YOU to join a community-wide effort to flood the U.S. House of Representatives with advocate letters touting the critical need for Part D direct and indirect remuneration (DIR) fee reform. 

We need YOUR help telling the House of Representatives to support a letter crafted by Representatives Morgan Griffith (R-VA) and Peter Welch (D-VT) to the Secretary of Health and Human Services urging the much-needed reforms. Your letter-writing efforts will visibly demonstrate to Representatives this is an issue that matters to constituents.

Although DIR fees began as a fee category to report manufacturer rebates, they are now a Part D Plan catch-all for numerous types of fees, including pharmacy performance-based or preferred network fees. The Centers for Medicare & Medicaid Services (CMS) reported DIR use is growing and has led to increased beneficiary cost-sharing and government costs. Retroactive DIR fees have become increasingly common in Part D, leading to higher out-of-pocket costs for Medicare beneficiaries and leaving pharmacies with little insight into, and too few tools to manage, the resulting risk. Ultimately, as things operate today, uncertainty surrounding retroactive fees has contributed to financial risk that is simply too great and too unpredictable for many pharmacies to manage, increasing chances for closures and preventing new pharmacies from entering communities that need them most. CMS should address DIR so that pharmacy price concessions are reflected at the point of sale – doing so would immediately reduce out of pocket costs for Medicare beneficiaries while ensuring convenient access to community pharmacy.

Tell your Representative to support this letter TODAY by using the NACDS RxIMPACT website to enter your contact information and submit your letter in minutes.Simply scroll down this webpage, enter your contact information and click on the send message button. Our profession, our industry, and our patients are depending on you. If you have any questions about this communication, please contact Heidi Ecker, NACDS Senior Director of Government Affairs and Grassroots Programs via email at or phone at 703/837-4121.

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