LEADERS PRESSURE CMS ON ANTI?GENERIC RULES

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Responding to objections raised by community pharmacies, congressional leaders are pressuring federal Medicaid officials to justify their controversial proposal to slash pharmacist reimbursement for generic drugs. In a letter citing evidence that the pending rule changes will discourage pharmacists from dispensing generics, House Energy and Commerce Committee Chairman John Dingell (D, Mich) and House Energy and Commerce Subcommittee on Health Chairman Frank Pallone Jr (D, NJ) called on Health and Human Services (HHS) Secretary Michael Leavitt to rethink the controversial new Medicaid changes.

Under the rule proposed by the Centers for Medicare & Medicaid Services (CMS), federal payments to state Medicaid programs for generic medications would be subject to new limitations linked to the lowest Average Manufacturers Price (AMP). A recent analysis by the Government Accountability Office (GAO) determined however, that, under this new formula, ?retail pharmacies will be reimbursed on average 36% lower than their costs to purchase generic medications dispensed to Medicaid beneficiaries,? Dingell and Pallone said.

?What evidence does CMS have that this approach will not negatively affect access to lower-cost generic drugs for Medicaid beneficiaries?? they asked Leavitt. The 2 congressional leaders further suggested that Leavitt consider basing Medicaid payments for generic drugs on a ?weighted AMP? rather than on the lowest AMP.

Officials at the National Community Pharmacists Association (NCPA) welcomed the stepped-up congressional concern over the controversial anti-generic plan. Bruce Roberts, RPh, executive vice president and chief executive officer of NCPA, said, ?We are heartened that Chairmen Dingell and Pallone are asking the tough questions of Secretary Leavitt regarding Medicaid pharmacy cuts that we believe will be so disastrous for independent pharmacies and the Medicaid patients they serve.?

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