PHARMACISTS BRACE FOR MEDICAID GENERIC CUTS
Dispensing fees for Louisiana pharmacists participating in the Medicaid drug program could rise as high as $15 per prescription under new legislation enacted in that state to address the effects of pending federal cutbacks in pharmacy reimbursement for generic drugs under the program. Louisiana's action, the latest of several state moves to raise Medicaid reimbursement for pharmacists in response to the federal belt-tightening, was adopted on the heels of a new report from the Department of Health and Human Services Office of Inspector General (OIG), which confirmed pharmacists? worst fears about the generic drug payment cuts.
For 12 of the 19 generics studied by government researchers, the average pharmacy acquisition costs "would have been more than double the new reimbursement limit," the OIG said. Those findings echo earlier research by the US Government Accountability Office, which found that the Centers for Medicare & Medicaid Services' (CMS) reimbursement cuts are so deep that pharmacists dispensing generics to Medicaid patients would be paid an average of 36% less than their acquisition costs for those drugs.
A new timeline for implementation of the plan schedules the generic reimbursement cuts to begin September 1, 2007. Unless reversed by Congress, the courts, or the administration, the reduced generic payments will "result in the demise of thousands of independent community pharmacists and the loss of pharmacy access for millions of Medicaid patients," officials at the National Community Pharmacists Association (NCPA) said.
According to Bruce Roberts, RPh, NCPA executive vice president and chief executive officer, "The NCPA is left with no alternative but to pursue litigation to prevent the government from implementing this flawed policy."