Human Services News

From PR Newswire:

With the deadline for the Centers for Medicare & Medicaid Services (CMS) to issue guidelines for the Medicaid prescription drug reimbursement formula fast approaching, the National Community Pharmacists Association (NCPA) today pointed to the release of the Office of Inspector General in the Department of Health and Human Services (OIG) report as further evidence that the proposed policy must be changed.

The OIG report, along with a December 2006 Government Accountability Office's (GAO) report on CMS' proposed Average Manufacturing Price (AMP) for Medicaid reimbursement, provide irrefutable proof as to why patient access to community pharmacies, especially in underserved areas, will be jeopardized.

The OIG report issued last week concludes that the new Federal Upper Limit (FUL) based on AMP for Medicaid reimbursement may force states to underpay pharmacy providers for the generic medicines they dispense under Medicaid.

When you factor in that pharmacies' cost to dispense is not adequately covered by state Medicaid programs, the loss to pharmacists is even greater.

The findings are consistent with the GAO's report that AMP will fall on average, 36 percent below pharmacy acquisition cost.

"The OIG report adds to the overwhelming evidence that Medicaid cuts are threatening consumer access to medications and pharmacy services as a result of the Medicaid pharmacy reimbursement formula," said Bruce Roberts, RPh, NCPA Executive Vice President and CEO. "By underpaying community pharmacies for dispensing Medicaid prescription drugs, initial saving will lead to enormous expenses later on when patients are unable to go to community pharmacies for their medications.

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