Pharmacists Press Conference Urging Senate Majority Leader Harry Reid to Fix Flawed Medicaid Drug Reimbursement Rule

Tuesday, November 6, 2007 General News J E 4

CARSON CITY, Nev., Nov. 5 The following was issued by the National Community Pharmacists Association:

Pharmacist press conference to discuss new Medicaid generic prescription drug reimbursement rule and need for Senate Majority Leader Harry Reid (D-Nev.) to use his power to make sure the legislative fix is considered before Congress adjourns for the year. The rule, scheduled to be fully implemented in early 2008, will grossly underpay pharmacists and puts patient access to their services at risk.

WHO: Kirk Wentworth, RPh, Owner of MedCare Pharmacy in Carson City, Nev. Dennis Gailey, RPh, Owner of Medicine Shoppe #1413 in Fallon, Nev. Julie Gabica, MedCare Pharmacy long-time customer Barbara Friedman, Patient of MedCare long-time customer WHEN: November 8, 2007, at 1:30 p.m., Pacific Time WHERE: MedCare Pharmacy 1851 N, Carson Street Carson City, Nev. 89701 775-885-8881 WHY: The Centers for Medicare and Medicaid Services published the Medicaid reimbursement rule on July 17, and the implementation process will be complete January 30. At that time, community pharmacies will be faced with a burden that could not only cause difficulty in participating in the Medicaid program, but sustainability in the business community. These challenges will be due in part to low reimbursement rates based on an inaccurate Average Manufacturer Price (AMP) formula. According to a Government Accountability Office report, on average, pharmacies will be paid 36 percent below their acquisition costs for the generic prescriptions of Medicaid patients. The legislative fix is S.1951, the Fair Medicaid Drug Payment Act of 2007. The bill removes discounted mail order and pharmacy benefit manager prices that are unavailable to community pharmacies and unfairly lower the overall AMP formula; requires Medicaid payment be calculated using the weighted average of the Medicaid generic drugs based on their actual utilization; restores the practice of using three available generic products for the calculation; increases the maximum allowable reimbursement from 250 percent of the AMP to 300 percent; and encourages more inexpensive generic drug usage by requiring prior authorization of brand name drugs. Each measure is aimed at bringing fairness to the reimbursement system and preserving patient access to prescription drugs.

SOURCE National Community Pharmacists Association


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