Major Start-Up Problems Being Reported
Texas Insider Report: AUSTIN Texas March 1st scores of poor elderly confused Medicaid patients will likely find unprepared pharmacies as they seek to have their prescriptions filled in a system that clearly isnt ready to handle them. With only days left until the start if the states ill-advised managed Rx care program for Medicaid it is clear that no one -- patients pharmacies PBMS or HHSC -- is ready for this monumental change.
We are being inundated with reports from pharmacies around the state concerning major start-up problems:
- Many patients are totally unaware of the impending March 1 start-up of managed Rx care;
- Patients havent received Medicaid IDS;
- Many patients have no idea what prescription drug plan they are in;
- Pharmacies no longer have access to patient data to establish coverage;
- There is no clear idea of who patients are supposed to call for assistance;
- Most PBMs have not given their policies/procedures for early/emergency refills or prior authorizations;
- Many pharmacies have not received a claims procedures manual or claims support/contact information; and
- Many pharmacies are totally unable to get an answer to even routine questions from either their PBMs or HHSC.
It is critical that we quickly document and report as many problems as we can to HHSC and legislators in order to win a postponement of the March 1 start-up date for managed care
Calling or emailing your state legislators and telling them that patients are not ready for managed care pharmacies arent ready the PBMs arent ready and HHSC certainly isnt ready. Be sure to tell them the specific experiences and problems you are having especially if they involve patient fears and confusion.
Tell them what you think your pharmacy will be like on March 1 when scores of poor elderly confused Medicaid patients descend on unprepared pharmacies wanting prescriptions filled in a system that clearly isnt ready to handle them.
The Texas Pharmacy Business Council (TPBC) has created a Medicaid Managed Care Problem Reporting Form that you can use to document the managed care problems you are experiencing. It is critical that we quickly document and report as many of these problems as we can to HHSC and legislators so we can win a postponement of the March 1 start-up date.
Find your House members contact info.
Find your senators contact info.
If you dont know your state representative or senator find out here.
The
Texas Pharmacy Business Council its pharmacy allies and legislative supporters are continuing to work hard daily on the Medicaid crisis especially the all-important reimbursement issue. But with the scheduled start of managed care a little more than two weeks away we need to focus right now on the looming chaos that will descend on a totally unprepared system.
STAY TUNED!
Texas Pharmacy Business Council is a subsidiary of American Pharmacies (APRx) and is a joint financial venture between APRx & the Academy of Independent Pharmacists-Texas.
