Cuts in Medicaid Pharmacy Reimbursements Will Prompt Pharmacy Closures and Reduce Access to Vital Medications

Nov 28, 2011, 13:13 ET from A coalition of Texas pharmacy groups

AUSTIN, Texas, Nov. 28, 2011 /PRNewswire/ -- As the House Human Services Committee held an interim hearing today, Texas pharmacy groups and other industry stakeholders voiced concern about the devastating impact the current implementation of a Medicaid managed care model for pharmacy services will have on their customers and businesses. Pharmacy owners traveled from across the state to testify that a dramatic reduction in reimbursement rates for pharmacy services to Medicaid patients will result in pharmacy closures and lost jobs, thus restricting access to vital medications and pharmacies for Medicaid patients and other Texans.

"The Texas Department of Health and Human Services needs to understand that such severe cuts in reimbursement rates will reduce access to vital medications and other pharmacy services for Medicaid patients," said Dorinda Martin, R.Ph., owner of Lamar Plaza Drug Store in Austin and Dripping Springs Pharmacy, and president of the Texas Pharmacy Association. "Today's testimony shows firsthand the terrible impact that the move would have on Medicaid beneficiaries, pharmacies and all Texans."

Legislation passed by the Texas Legislature in 2011 authorized the move of pharmacy services into managed care in 2012. Under the managed care model, pharmacy reimbursements could be cut by as much as 80 percent, making it impossible for some pharmacies in Texas to continue servicing Medicaid patients or to stay in business. Pharmacy owners, their patients and allies are pushing for solutions to lessen the impact of the implementation of the move, including fair reimbursement rates for pharmacies.

"Seventy-five percent of the prescriptions we fill are for Medicaid and 10 percent are for Children's Health Insurance Program, so 85 percent of our customers will be affected," said Louis Rumsey, R.Ph., owner of Elam Road Pharmacy in Dallas, Texas. "The prescription reimbursement cuts that come with the move to Medicaid managed care will force me to close my business and my customers will be left without good options for their pharmacy services."

As currently implemented, the move of pharmacy services to this model would cause widespread pharmacy closures resulting in a loss of access for many patients and thousands of job losses in the state. Texans in rural areas will be particularly impacted by this loss of access, as numerous patients will be forced to travel long distances to the nearest pharmacy.

Texas Lieutenant Governor David Dewhurst recently expressed his support for helping pharmacists in Texas continue to service Medicaid patients in response to a question asked by Martin during a November 17th Texas Tribune/TribLive event in Austin. Click here to listen to the conversation between the pharmacist, Dorinda Martin, and Dewhurst.

Martin asked Dewhurst, "We are very concerned about the implementation of Medicaid managed care. We would like to know, as a group of pharmacists in the State of Texas employing about 40,000 people, how you can help us in your present and future position to continue to service the Medicaid patients of this state?"

Dewhurst responded to Martin, "That is an excellent, excellent question … Our independent pharmacists play a huge role, and I want to make sure that we are containing costs, but we're not driving people out of business. At the end of the day, you've got to be able to make a profit."

The discussion surrounding this move comes at a time when pharmacies in other states across the country are experiencing the negative impact resulting from Medicaid managed care for pharmacy services. For example, Kentucky pharmacies are already seeing job loss and economic distress only weeks after moving from a state-run Medicaid prescription program to managed care.

"It is clear that this move would significantly threaten Texas pharmacies and all Texans," said Tammy Gray, spokesperson for the Pharmacy Choice and Access Now (PCAN) coalition in Texas and owner of Buda Drug Store. "Our leaders must act to prevent the loss of thousands of jobs and the closure of numerous pharmacies, resulting in the loss of access to local pharmacies for patients who need it most."



SOURCE A coalition of Texas pharmacy groups