Pharmacists Ask McConnell to Fix Flaws in Medicaid Generic Prescription Drug System
FRANKFORT, Ky., Dec. 6 /PRNewswire-USNewswire/ -- Today Kentucky community pharmacy owners held a press conference at Capital Pharmacy and Medical Equipment urging U.S. Senate Minority Leader Mitch McConnell (R-Ky.) to help ensure S.1951, the Fair Medicaid Drug Payment Act of 2007, is brought to the Senate floor for a vote before they adjourn this year. The bill fixes the Medicaid generic prescription drug pharmacy reimbursement cuts scheduled to take effect early next year that threaten the economic viability of community pharmacy, as well as patient access to pharmacy services.
"Community pharmacy owners like myself are being put in a terrible bind because of the coming cuts to Medicaid reimbursement," said Mac Bray, owner of Capital Pharmacy and Medical Equipment. "My options will be to either turn my back on my Medicaid patients by limiting or dropping my services, or suffer huge financial losses by continuing to participate in the Medicaid program. Senate Minority Leader Mitch McConnell can spare myself and other pharmacists from making that Hobson's Choice by pushing for the Senate to pass S.1951 before they go home for the Holidays."
In 2005, the Deficit Reduction Act cut Medicaid pharmacy services by over $8 billion, causing the Centers for Medicare & Medicaid Services (CMS) to create new rules for Medicaid generic drug reimbursement based on an Average Manufacturer Price (AMP) formula. A December 2006 Government Accountability Office report found that, on average, pharmacies would be paid 36 percent below their acquisition costs using this new formula, therefore forcing patients without access to community pharmacies to seek services from expensive emergency rooms and doctors' offices.
S.1951 seeks to rectify the pricing discrepancies and preserve the beneficial relationship between community pharmacists and patients by:
-- Removing discounted mail order and pharmacy benefit manager prices that are unavailable to community pharmacies and unfairly lowers the overall AMP formula.
-- Requiring Medicaid payment to be calculated using the weighted average of the Medicaid generic drugs based on utilization.
-- Restoring the previous practice of using three available generic products in calculating the Federal Upper Limits that are used for setting adequate pharmacy reimbursements.
-- Increasing Medicaid reimbursement from 250 percent of the AMP to 300 percent in order to ensure pharmacies are not reimbursed below their acquisition costs.
-- Encouraging more inexpensive generic drug usage by requiring prior authorization of brand name drugs.
"Who can stay in business at 36% below cost?" said Brad Hall, executive director of the Kentucky Pharmacists Association. "The federal government's AMP formula does not properly measure retail acquisition costs for community pharmacies like Capital Pharmacy and Medical Equipment here in Frankfort. The real world consequences of this disastrous federal policy will be felt most profoundly by patients, who will see their access to prescription drugs and the valued expertise of their trusted local pharmacists undermined. When that happens these patients will be forced to more expensive options such as visiting emergency rooms. This can all be avoided if Congress acts before the rule is fully implemented on January 30, 2008."
Also in attendance was Larry Hadley, co-owner of Wayne's Pharmacy, which is also in Frankfort, Ky. He provided additional insight into the fallout his business and patients would experience if Congress doesn't act to change or at least delay the AMP rule. "After five years of working to build up my business, I am very concerned about what the future holds," said Hadley. "All you have to do is a little math to understand the numbers don't add up under AMP. Hopefully, Sen. McConnell will make a concerted effort to change AMP before patients in the city of Frankfort, the state of Kentucky, and our nation as a whole are hurt."
To learn more about this issue go to:
The National Community Pharmacists Association, founded in 1898, represents the nation's community pharmacists, including the owners of more than 23,000 pharmacies. The nation's independent pharmacies, independent pharmacy franchises, and independent chains dispense nearly half of the nation's retail prescription medicines. To learn more go to http://www.ncpanet.org.
|SOURCE National Community Pharmacists Association|
Copyright©2007 PR Newswire.
All rights reserved