Battle Lost, But Will Pharmacy Win the War on Medicaid Reimbursements?

DECEMBER 01, 2005
Ken Rankin

A coalition of state and national pharmacy groups, led by the National Association of Chain Drug Stores (NACDS) and the National Community Pharmacists Association (NCPA), this fall called on members of the profession to "fight proposed Medicaid cuts that would hurt poor patients and the community pharmacies that serve them."

Nevertheless, on November 18, the House of Representatives passed the Deficit Reduction Act of 2005 (HR 4241) on a 217-215 roll call. The bill includes $2.1 billion in Medicaid pharmacy reimbursement cuts (down from the $5.2 billion originally proposed). Deep reductions also have been approved by the Senate. Differences between the 2 versions now must be negotiated in a joint House-Senate conference committee.

Bruce Roberts, RPh, NCPA's executive vice president and chief executive officer (CEO), had stated prior to the House vote, "Community pharmacists are in a unique position to help drive down Medicaid prescription drug costs, while at the same time maintaining the health care safety net on which so many people depend. Instead, pharmacy is being targeted for a disproportionate percentage of the proposed budget cuts." Calling the pending Medicare reform legislation an "ill-advised proposal," Roberts warned that if this legislation is enacted, it "will force community pharmacy out of the Medicaid business."

NACDS President and CEO Craig Fuller had voiced similar concerns. "The only way the private sector can provide medication through Medicaid is to be fairly reimbursed for the cost of the products and the professional services pharmacists provide," he said.

Following the vote, Fuller explained, "Our concerns about the Medicaid Reform proposal remain. Even with the concept of a ‘safety valve,'we believe there is much work to be done to achieve a Medicaid program that can actually work."

Mr. Rankin is a freelance medical writer.