PDP Balance Billing?

BlueD here is what you are referencing

https://www.medicare.gov/part-d/costs/coverage-gap/part-d-coverage-gap.html

The price for the drug is $20, and there's a $2 dispensing fee that gets added to the cost. Mr. Evans will pay 65% of the plan’s cost for the drug and dispensing fee ($22 x .65 = $14.30). The $14.30 amount he pays will be counted as out-of-pocket spending to help him get out of the coverage gap.

It also seems the CMS has contorted rules regarding dispensing fees as indicated by this report

CMS Bans Prorated Pharmacy Dispensing Fees In Final Rule On Part D, MA - Senior Care Pharmacies

Also note that dispensing fees are normally built in to PBM pricing and are hidden from the consumer. It may be that if a pharmacy can get away with it, as in the case with CVS cited above, they will do so operating on the theory it is better to ask forgiveness than permission.

Dispensing fees are common in Canada and other parts of the world.
 
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