Pharmacy Groups File Brief for Right to Challenge Medicaid Cuts

Reps from APhA, NACDS, NCPA, and NASPA argue that argues that a 10% Medicaid reimbursement cut in California violates the federal patient access law.

Pharmacy groups filed a legal brief on August 5 with the US Supreme Court supporting the right of pharmacies to challenge Medicaid cuts that they said violate a federal patient access law. The brief was filed by the American Pharmacists Association (APhA), National Association of Chain Drug Stores (NACDS), National Community Pharmacists Association (NCPA), and the National Alliance of State Pharmacy Associations (NASPA) in the case of Douglas v. Independent Living Center of California.

The initial lawsuit—filed by pharmacies and other health care providers—argues that a 10% Medicaid reimbursement cut in California violates the federal patient access law, which provides that Medicaid reimbursement rates must be “sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area.” The proposed cuts would threaten access to care for Medicaid patients, the organizations said.

The joint legal brief filed by the 4 pharmacy groups also contents that a long line of Supreme Court decisions support the right to challenge state actions that are inconsistent with federal laws, and challenges to inadequate Medicaid reimbursement rates must be allowed if they threaten patient access to pharmacy care.

Comments from each organization are as follows:

“APhA is pleased to join with our colleague pharmacy organizations in challenging the actions of states that threaten to deprive patients of access to medications and pharmacists services that they desperately need. While we recognize the budget constraints that states face, these proposed Medicaid cuts will exacerbate our medication use crisis by forcing more pharmacies out of Medicaid and disrupting patient/pharmacist relationships that are critical to effective medication use. The data show that poor medication use leads to higher costs in the form of Emergency Department visits and hospitalizations.”

-Thomas E. Menighan, BSPharm, MBA, ScD, APhA executive vice president and CEO

“Patients rely on their local pharmacists for expert medication counseling and advice on controlling healthcare costs, such as through the appropriate use of generic drugs. Independent community pharmacists in particular are often located in underserved rural and urban areas where there may be few, if any, other pharmacy options. These cuts clearly jeopardize pharmacy access for underserved patients and could ultimately increase costs.”

-B. Douglas Hoey, RPh, MBA, NCPA executive vice president and CEO

“We are deeply troubled about the impact that such a drastic cut in Medicaid pharmacy reimbursement will have on patient access to pharmacy care. This short-sighted proposal is not the solution to cutting spending and reducing costs. We have and will continue to urge the state to work with pharmacy and other provider groups to find cost-effective alternatives that do not jeopardize Medicaid beneficiaries' access to healthcare services.”

-Steven C. Anderson, IOM, CAE, NACDS president and CEO

“We share our colleagues' deep concern with Medicaid cuts that will dramatically impact patient access. Arbitrarily implementing reductions in Medicaid reimbursement without consideration of federal law, is a disservice to its beneficiaries who rely and depend on these services. Ultimately, these drastic cuts will put their health and lives at risk.”

-Rebecca Snead, RPh, NASPA executive vice president and CEO

The Supreme Court will hold a hearing in the case on October 3, and may issue a decision later this year.