How to Manage DIR Fees

DIR stands for “direct and indirect remuneration” and are also referred to as “network to plan rebates.” DIR was initially coined by the Centers for Medicare and Medicaid Services (CMS) related to the Medicare Part D benefit to address price concessions (e.g. drug manufacturer rebate). Essentially, rates are established in which corresponding fees are often taken out of pharmacy reimbursements. Unfortunately, these fees can be very confusing and have a history of hurting independent and/or retail pharmacies’ income. CPhA partnered with the National Community Pharmacists Association (NCPA) to develop this one-hour course that covers everything pharmacists need to know about DIR fees and how to manage them.

Learning Objectives

At the completion of this activity, the participant will be able to learn and understand:

  1. Define Direct and Indirect Remuneration (DIR) fees.
  2. Describe the purpose and settings in which DIR fees apply to pharmacy services.
  3. Identify the organizations involved in calculating and applying DIR fees to pharmacy services. Determine the impact of DIR fees on the participant’s pharmacy and how to mitigate DIR fees to the extent possible.
  4. Determine the impact of DIR fees on the participant’s pharmacy and how to mitigate DIR fees to the extent possible.


The following executives from the National Community Pharmacists Association will be leading the discussion and presentation on DIR Fees:

  • Ronna Hauser, Vice President, Pharmacy Affairs
  • Matt Diloreto, Senior Director, State Government Affairs
  • Susan Pilch, Vice President, Policy & Regulatory Affairs

Continuing Pharmacy Education

The California Pharmacists Association (#0113) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. Upon completing an evaluation form, participants will be awarded 1 hour (0.1 CEUs) of Continuing Pharmacy Education Credit. A statement of credit will not be issued. Participants may log onto the CPE monitor website using their individual log in to download their statement of credit. Please allow 4 weeks for processing of CPE credits to the CPE monitor. UAN: 0113-0000-16-032-H04-P, 0113-0000-16-032-H04-T

Activity Type:  Knowledge-based
Target Audience:  Pharmacists, pharmacy technicians
Release Date: August 4, 2016
Expiration Date: August 4, 2019

What to Expect After Registration

After registration, you will receive a confirmation email containing instructions on how to access this course.

Registration Fees**      
CPhA/NCPA Member $49
Non-Member $99

***No cancellations or refunds will be issued once user login information has been sent. Unfortunately, due to the online format of this program we are unable to offer exceptions to this policy. It’s recommend that each registrant review the course content prior to submitting payment to ensure the content meets individual educational needs. User has 30 days to complete the on-demand program from registration. If you have questions regarding course content or cancellation policy please contact CPhA at (916) 779-4524.

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