Preliminary Plan May Force Pharmacies Out Of Business Hurt Patient Care
Texas Insider Report: DALLAS Texas Pharmacy Choice & Access Now (PCAN) - a coalition of consumers local businesses & pharmacists across the nation and Texas -
today called on the Centers for Medicare & Medicaid Services (CMS) to reconsider their preliminary approval of Texas waiver implementing a new Medicaid managed care plan switching pharmacy among other health care services to a managed-care model.
PCAN believes the Centers for Medicare and Medicaid Services (CMS) should reject the State of Texas proposed Section 1115 waiver now pending before the agency citing a precipitous decline in reimbursement rates that will force pharmacies out of business as well as threaten patient services and access to care.
The States proposed implementation of managed care pharmacy services will devastate pharmacies in the state kill jobs and hurt the quality of patient care for the most vulnerable among us. It must be stopped in its tracks" said Tammy Gray RPh owner of a pharmacy in Buda and spokesperson for the Pharmacy Choice and Access Now (PCAN) coalition in Texas.
According to the group the proposed implementation of the managed care model will drastically reduce reimbursement rates for local pharmacies that fill prescriptions and could force some out of business altogether and even more out of the Texas Medicaid program.
Currently pharmacies receive reimbursement for Medicaid prescriptions through the Vendor Drug Program regulated by the state and open to all
pharmacies. Under the new plan they will be subject to rates set by pharmacy benefits managers (PBMs) and managed care organizations for-profit firms that will administer the managed care pharmacy program.
Independent pharmacies across Texas have already begun receiving contracts from at least one PBM that represents an 80 percent reduction in reimbursement rates per prescription dispensed or Medicaid patients. Such drastic cuts are unsustainable for many pharmacies particularly those in underserved rural and urban areas where prescription volume is heavily geared toward Medicaid recipients.
According to a study conducted for PCAN by The Perryman Group proposed reimbursement cuts and the move to managed care would lead to the closure of hundreds of pharmacies the loss of thousands of jobs and the elimination of access to pharmacies in many areas both for the general population and for those receiving Medicaid.
The Perryman Group estimated nearly 43000 job losses 770 pharmacy closures and a $3.1 billion loss to the economy from the move to managed care for pharmacy.
PCAN further stressed that the managed care model is inappropriate for many segments of the Medicaid population including the blind and disabled who rely heavily on special services and counseling provided by pharmacists in addition to prescriptions.
All Texans should be concerned about whats at stake here: quality health care access to their local pharmacy and jobs in their community" concluded Gray.
Gray urged local pharmacists and concerned citizens to
sign the Texas Pharmacy Protection Petition.
Pharmacy Choice and Access Now (PCAN) is a coalition of consumers local business and pharmacists across the nation committed to preserving quality and affordable health care and pharmacy services for patients. We are committed to providing the most cost-effective solutions in the areas of health care and pharmacy services to enable states around the country to help solve their budget woes while maintaining quality care for children families and other Medicaid-served populations.
