Icky
01-26-2007, 09:54 AM
Just check out what's going on in Pharmacy... As if Medicare Part D wasn't bad enough (and believe me!!! It's awful!!!), now they are going after MEDICAID.
I urge you to call you Congressmen/women and Senators and tell them to FIX the Pharmacy Reimbursement Rates on BOTH Medicare Part D AND Medicaid... Let them know that with Medicaid, any reimbursement formula that uses AMP (Average Manufacturer Price) will all but destroy independent pharmacy! Tell them this is not acceptable to you! Tell them they must fix this ASAP!
Thank you
GAO Report Bad News for Patients and Pharmacies NCPA is reporting that an analysis dated December 22, 2006, yet only released publicly earlier this week by the Government Accountability Office (GAO), reveals that a new formula for reimbursing pharmacies that serve Medicaid recipients will result in pharmacists losing, on average, 36 percent on every Medicaid prescription they fill. According to the report from GAO which was based on a sample of the most prescribed and highest cost prescriptions used by Medicaid recipients, “estimated AMP-based FULs were, on average, 36 percent lower than average retail pharmacy acquisition costs.” “The Centers for Medicare & Medicaid Services (CMS) is effectively putting community pharmacies out of the Medicaid business,” said NCPA Executive Vice President and CEO Bruce Roberts, RPh. “It will be the nation’s poor—in particular women and children who make up the majority of Medicaid recipients—who will suffer when they no longer have access to community pharmacies for the medicines they need.” Although Medicaid is a state-administered health program for the nation’s poor and disabled, the federal CMS is implementing a new congressionally-mandated formula for the maximum amount states may pay pharmacies in order to continue receiving federal matching funds. The Deficit Reduction Act of 2005 redefined these maximums, known as Federal Upper Limits (FULs), to be based on 250 percent of the lowest Average Manufacturer Price (AMP). In concluding its report to Congress, the GAO noted that “[Medicaid] savings should be achieved while ensuring that reimbursements to retail pharmacies are adequate.” NCPA is currently working with Congress to redefine AMP so that it fully covers pharmacies’ costs, and ensures Medicaid recipients’ access to pharmacy services. APCI and NCPA continue to warn members of Congress that inadequate reimbursement will not only hurt independent pharmacies, but could be catastrophic to Medicaid health care, especially in rural areas of the country. APCI, in conjunction with others, is working at the state level to move toward dispensing fees that would allow for AMP pricing and keep pharmacy reimbursements at least at adequate levels. The APCI Legislative Affairs Division staff has been in Kentucky, Mississippi, Tennessee, and Alabama within the last few weeks working on this issue. And as always, APCI is communicating with state associations and others in the other states for the membership regarding Medicaid dispensing fees.
I urge you to call you Congressmen/women and Senators and tell them to FIX the Pharmacy Reimbursement Rates on BOTH Medicare Part D AND Medicaid... Let them know that with Medicaid, any reimbursement formula that uses AMP (Average Manufacturer Price) will all but destroy independent pharmacy! Tell them this is not acceptable to you! Tell them they must fix this ASAP!
Thank you
GAO Report Bad News for Patients and Pharmacies NCPA is reporting that an analysis dated December 22, 2006, yet only released publicly earlier this week by the Government Accountability Office (GAO), reveals that a new formula for reimbursing pharmacies that serve Medicaid recipients will result in pharmacists losing, on average, 36 percent on every Medicaid prescription they fill. According to the report from GAO which was based on a sample of the most prescribed and highest cost prescriptions used by Medicaid recipients, “estimated AMP-based FULs were, on average, 36 percent lower than average retail pharmacy acquisition costs.” “The Centers for Medicare & Medicaid Services (CMS) is effectively putting community pharmacies out of the Medicaid business,” said NCPA Executive Vice President and CEO Bruce Roberts, RPh. “It will be the nation’s poor—in particular women and children who make up the majority of Medicaid recipients—who will suffer when they no longer have access to community pharmacies for the medicines they need.” Although Medicaid is a state-administered health program for the nation’s poor and disabled, the federal CMS is implementing a new congressionally-mandated formula for the maximum amount states may pay pharmacies in order to continue receiving federal matching funds. The Deficit Reduction Act of 2005 redefined these maximums, known as Federal Upper Limits (FULs), to be based on 250 percent of the lowest Average Manufacturer Price (AMP). In concluding its report to Congress, the GAO noted that “[Medicaid] savings should be achieved while ensuring that reimbursements to retail pharmacies are adequate.” NCPA is currently working with Congress to redefine AMP so that it fully covers pharmacies’ costs, and ensures Medicaid recipients’ access to pharmacy services. APCI and NCPA continue to warn members of Congress that inadequate reimbursement will not only hurt independent pharmacies, but could be catastrophic to Medicaid health care, especially in rural areas of the country. APCI, in conjunction with others, is working at the state level to move toward dispensing fees that would allow for AMP pricing and keep pharmacy reimbursements at least at adequate levels. The APCI Legislative Affairs Division staff has been in Kentucky, Mississippi, Tennessee, and Alabama within the last few weeks working on this issue. And as always, APCI is communicating with state associations and others in the other states for the membership regarding Medicaid dispensing fees.