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Originally intended to incentivize pharmacies to provide high-quality care, they have instead become a source of revenue for PBMs. Between 2010 and 2020, CMS reported (§ 423.100) that retroactive DIR fees increased by an astonishing 107,400%. The increase in DIR fees has had a significant impact on independent pharmacies.
Between 2010 and 2020, CMS reported (§ 423.100) that retroactive DIR fees increased by an astonishing 107,400%. Star Ratings & DIR Fees DIR fees represent a growing issue with unpredictable and arbitrary costs that eat into reimbursement rates, shrink profit margins, and result in patients paying more for their prescriptions.
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