| The Centers for Medicare and Medicaid Services (CMS) recently granted preliminary approval of Texas' waiver implementing a new Medicaid managed care plan switching pharmacy, among other health care services, to a managed-care model. This move would be disastrous to Texas pharmacies, and would hurt the quality of patient care.
Pharmacy Choice and Access Now (PCAN)--a coalition of consumers, local businesses and pharmacists across the nation and Texas committed to preserving quality and affordable health care--believes 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 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% reduction in reimbursement rates per prescription dispensed for Medicaid patients. Such drastic cuts are unsustainable for many pharmacies, particularly those in under-served rural and urban areas where prescription volume is heavily geared toward Medicaid recipients.
Further complicating matters, 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.
Concerned citizens may sign the Texas Pharmacy Protection Petition at www.rxchoiceandaccess.com.
To read PCAN's press release on this issue, and for information, visit http://www.rxchoiceandaccess.c... |
