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Username: RxChoiceandAccess
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Texas Pharmacy Community Applauds Bills to Expand Access to Critical Immunizations

by: RxChoiceandAccess

Thu Mar 28, 2013 at 02:35 PM CDT

Poll Shows 87 Percent of Texans Agree Pharmacists Should Be Allowed To Give Immunization Shots to Children

Major Texas pharmacy groups recently announced their support for vital legislation filed by Senator Larry Taylor (R-Friendswood), Representative Jodie Laubenberg (R-Parker) and Representative Gene Wu (D-Houston) - Senate Bill 1013, House Bill 2938 and House Bill 2222 - that would increase access to critical and cost-effective immunizations for Texas children by expanding immunization authority for Texas pharmacists.

When it comes to immunization rates, Texas ranks below the national average. Expanding immunization authority for pharmacists would encourage more childhood immunizations given the cost-effective and convenient nature of pharmacy-administered immunizations.

"Pharmacists are highly qualified and trusted health care providers who are in the best position to help meet the growing immunization demand and reduce the number of vaccine-preventable diseases for thousands of Texas children," said  Joe DaSilva, chief executive officer of Texas Pharmacy Association. "Unfortunately, there are still many immunizations that Texans do not have easy access to, including the highly contagious Pertussis (whooping cough). Expanding immunization authority for Texas pharmacists will increase access to vital immunizations for children across our state, helping to prevent diseases and reduce health care costs in  the long run."

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Texas Vaccine Bills Would Allow Pharmacists to Administer Vaccines for Children

by: RxChoiceandAccess

Thu Mar 14, 2013 at 04:01 PM CDT

Three bills that were recently introduced in the Texas legislature (Senate Bill 1013, House Bill 2938 and House Bill 2222) would expand immunization laws to allow Texas pharmacists to administer vaccines for children. The news is great for kids in Texas, as the state ranks below the national average for immunizations.

According to Texas Pharmacy Association CEO Joe DaSilva, "Pharmacists are highly qualified and trusted health care providers who are in the best position to help meet the growing immunization demand and reduce the number of vaccine-preventable diseases for thousands of Texas children. Unfortunately, there are still many immunizations that Texans do not have easy access to, including the highly contagious Pertussis (whooping cough). Expanding immunization authority for Texas pharmacists will increase access to vital immunizations for children across our state, helping to prevent diseases and reduce health care costs in the long run."

The Cypress Creek Mirror reports:

Texas' more than 10,000 licensed pharmacists are of critical importance for preventative care within their communities, especially in areas where patients have limited access to a doctor's office. For many Texans living in Medically Underserved Areas and Health Provider Shortage Areas, their local pharmacist is their closest health care provider. In addition, pharmacists offer more convenience in that they do not require a scheduled appointment and many are open extended hours.

Permitting pharmacists to administer vaccines is likely to mean more children get childhood vaccinations since it would be more convenient and cost-effective to administer these vaccines in a pharmacy.

For more information, please visit Pharmacy Choice and Access Now!

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South Texas Pharmacy Closes Due To Medicaid Cuts

by: RxChoiceandAccess

Thu Jan 24, 2013 at 01:46 PM CST

And another one bites the dust... A pharmacy in South Texas that has been struggling to keep its doors open since Texas cut Medicaid pharmacy reimbursements in the name of managed care will close its doors on Friday.

The Med-Aid Pharmacy in Mission, Texas has been serving customers for the last seven years. They were growing and expanding steadily until the state turned responsibility for setting reimbursement rates over to managed care organizations.

The Texas Tribune reports:

Until March of last year, reimbursement rates were the same throughout the state. After the state expanded managed care, pharmacists signed contracts with multiple managed care organizations and agreed to accept the reimbursement rates for medications set by each organization's pharmacy benefit manager. Pharmacists were unable to find out how much they could be reimbursed or how reimbursement rates compared before signing the contracts.

Sadly, many independent pharmacies have found that those undefined reimbursement rates are not sufficient to allow them to keep their doors open.

Apparently the leaked memo from a CVS pharmacy supervisor that pointed out that reduced reimbursements might "put many independent pharmacy owners in a pinch that they have never before felt" and also saying that the change "poses a huge opportunity for us to grow our company and the scripts and patients that we service" was very much a foreshadowing of the dangers to come for independent pharmacies in Texas.

To find out more about how managed care is devastating pharmacies in Texas, visit Pharmacy Choice and Access Now today!

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Texas Pharmacy Association PAC Chair: Managed Care Hurts Patients

by: RxChoiceandAccess

Wed Dec 12, 2012 at 10:51 AM CST

This post originally appeared at Pharmacy Choice and Access Now.

Managed care for Medicaid pharmacy services has only been in place in Texas for nine months, but it has already done great harm to patient access and the viability of community pharmacies in the Houston area and around the state. Without corrective action by state leaders, many of these pharmacies will not survive - much to the detriment of the patients and communities they serve.

Since March, when the state's Medicaid pharmacy patients were transferred from a 'fee-for-service' to a managed-care program run by private sector pharmacy benefit managers (PBMs), dozens of pharmacies have closed and many more are struggling to avoid the same fate.

Simple economics explain why. The PBMs-with the state's blessing-have dropped reimbursement rates to pharmacies filling Medicaid prescriptions by as much as 80 percent. PBMs have also dramatically cut the reimbursement for the drugs dispensed to rates that are often times well below a pharmacy's actual cost to fill a prescription. The results are both unfortunate and predictable: reduced services, job cuts and for some, closing their doors.

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Medicaid Cuts Mean Lots Services For Some Texas Patients

by: RxChoiceandAccess

Thu Dec 06, 2012 at 02:07 PM CST

2012 has marked a year of great change for Texas Medicaid participants. The state has been moving from a traditional fee-for-service Medicaid system to a managed care one in hopes of saving money, clamping down on Medicaid fraud, and improving coordination of care. So far, the track record for managed care in reaching those goals has been less than stellar.

The Liberty County Vindicator reports that one major issue has been that "new providers have too much leeway in cutting promised services after signing up new patients. Thousands of recipients fled one HMO in south Texas after the company cut certain services and reimbursement rates." How's that for saving money and clamping down on fraud? As a result, State Representative Armando Martinez, is looking to create a consumer-protection bill that would stop providers from changing terms after signing up new customers.

Another issue has been with coordination of care. Trelisha Brown of the Texas Legal Services Center's Health Law Program believes that coordination of care has gotten worse in some ways as she now has to field questions from patients who say they now have to "jump through multiple hoops" when they need to see specialists, order equipment or request testing and medical supplies.

And the reduced reimbursement rates have also impacted Medicaid patients looking to get their prescriptions filled. The new pharmacy system has ushered in an era of pharmacies turning away Medicaid patients or closing their doors altogether because the reimbursements aren't covering the cost of acquiring and dispensing patient medications.

The Texas Health and Human Services Commission has estimated that the new managed care system will save $1 billion over the next two year, but we can't help but wonder what it's really going to cost in the long run.

To learn more about how managed care is hurting patients and health care providers, visit Pharmacy Choice And Access Now today!  

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Mis-managed Care

by: RxChoiceandAccess

Wed Nov 07, 2012 at 04:24 PM CST

Managed care systems for Americans on Medicaid, when executed incorrectly, don't benefit anyone. And considering the level of mismanagement taking place in some states, others, including Texas, should seriously reconsider implementing managed care for Medicaid patients.

Take what's happening in Kansas. One managed-care company, Passport, has filed a formal complaint because the state miscalculated the amount of patients the company would receive under the new program, dropping it from 41 percent down to 27 percent. As a result, Passport is formally complaining that the state has violated its own bidding process.

On top of that, Passport claims that if the state were to assign them an even larger share, an astonishing 80 percent of the region's population, the state would save an estimated $80 million.

Instead of focusing on providing quality health care for patients, Kansas and its managed care companies are fighting each other over who gets assigned the largest patient load. This simply will not work.

Texas needs Medicaid reform that makes sense, and helps patients. Visit Pharmacy Choice and Access Now to find out more.

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Texas State Rep. Candidate Laments Managed Care Impact On Pharmacies

by: RxChoiceandAccess

Fri Oct 12, 2012 at 09:08 AM CDT

Managed care for Medicaid patients has been a disastrous turn for Texas pharmacies. With reimbursements slashed to levels that few independent pharmacists can afford, dozens have been forced to make the toughest decision: refuse to service their Medicaid patients, or shut their doors for good?

For some pharmacies in low-income areas, this hasn't been any choice at all. Some pharmacies have so many Medicaid patients that they have been forced to close down no matter what, cutting off access for thousands of patients to their trusted community pharmacist.

It's a problem that's been noticed by pharmacists and other health care providers, and now is getting attention of candidates for office. Bobby Guerra, who is running for the Texas House of Representatives, gave an interview this week to the Texas Tribune in which he raises concerns about the effect of managed care for pharmacies.

From the interview:

We need to slow the train down on the managed health care that has impacted so negatively our area. When the managed care hit this area, as an example, we had over 20 small pharmacies close overnight. Many of them are in smaller communities, and they cannot compete with the big chain pharmacies. They provide unique services like delivery of medication for people on dual enrollment - Medicare and Medicaid. This area is probably one of the fastest-growing areas in the nation, and along with that comes growing pains. We have a big population of folks that are at or below the poverty line. We need to focus on the elderly's needs, the dual enrollment situation. Many physicians are having a very hard time with what's happened with managed care. I'd like to see the train slow down a bit, and hopefully I can help build those relationships with fellow legislators in helping them understand as best we can the negative impact this has had on our communities.

PCAN applauds Mr. Guerra for stepping up and speaking out on this important issue.

Click here to read the entire article, and visit Pharmacy Choice and Access Now to find out more about how managed care is impacting community pharmacies, and how you can help.  

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Texas Lawmakers Get An Earful On Managed Care

by: RxChoiceandAccess

Thu Sep 20, 2012 at 03:40 PM CDT

Texas lawmakers may have gotten a little more than they bargained for at Monday's hearing in how the Medicaid managed care implementation is going in South Texas. Members of the House Human Services Committee were treated to concerns that sticking with the last legislative session's budget decisions would "erode our state's safety net of care."

Carlos Cardenas, a gastroenterologist testifying on behalf of the Texas Medical Association, argued that under managed care, physicians are being forced to complete more paperwork and receive lower reimbursement for their services, particularly for dual-eligibles (elderly patients on both Medicaid and Medicare). As a result, many physicians have been forced to lay off staff and see fewer of those patients.

While the new commissioner of Health and Human Services has claimed that the managed care rollout was a qualified success, he will be asking for an emergency appropriation of $4.7 billion to cover Medicaid expenses when the legislature reconvenes in January.

Read more: Medicaid Woes Subject of House Committee Hearing

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San Antonio Express News: Pharmacies Lose Under Texas Medicaid Plan

by: RxChoiceandAccess

Tue Sep 11, 2012 at 11:00 AM CDT

In an opinion piece in the San Antonio Express News this week, the president of the Bexar County Pharmacy Association expresses concern about the future of community pharmacies under Texas' new Medicaid plan.

Chris Alvarado, a pharmacy manager from San Antonion, argues that the state has shifted to a managed care plan for Medicaid patients as part of a budget cut, and pharmacies are losing out. Many have been forced to shut their doors, or make the difficult decision to stop serving Medicaid patients, many of whom live in rural areas with few other options for prescription drugs.

From his op-ed:

Imagine trying to run a business where you lose an average of $14 on each product sold. Few businesses could stay open under circumstances like these. Yet, that is exactly the absurd system the state's health department has recently put in place for Texas pharmacies, such as the pharmacy I manage, when filling Medicaid prescriptions.

As a result, many pharmacies throughout the state are being forced to lay off employees, reduce salaries, stop serving Medicaid patients altogether or even close their doors, in some cases. This threatens access to pharmacy services for the state's 3 million Medicaid patients, including lower-income children, seniors and Texans with disabilities.

This unacceptable! To find out more about the situation community pharmacies are facing in Texas and other states visit Pharmacy Choice and Access Now!

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Dallas Business Journal: Payment system stymies DFW independent pharmacies

by: RxChoiceandAccess

Thu Aug 30, 2012 at 04:12 PM CDT

A new payment system in Texas is squeezing independent pharmacies with reduced dispensing fees and lower reimbursements for prescription drugs. The effects of this system could have dire consequences for pharmacy owners, employees, and patients.

The Dallas Business Journal reports that with pharmacy benefit management companies (PBMs) are now setting reimbursement rates and dispensing fees, Texas Medicaid dispensing fees have been cut by 80 percent, from $7 to less than $2.

According to independent pharmacist Ronald Barrett, "Every day, I have to make a decision about whether to fill a prescription because frequently the reimbursement - the cost of the drug and our dispensing fee - is actually less than we pay for the cost of the medicine. That's not on every single drug, but it happens enough that it's scary."

Barrett goes on to explain that he'll typically take a loss on one drug if he's making a profit on another drug the customer is buying. But if the loss-inducing drug is the only prescription the customer is filling, he'll decline the business and suggest that they go elsewhere.

There's an inherent conflict of interest in this system because PBMs are frequently both paying claims and filling prescriptions. The fear is that PBMs are setting unrealistically low prices to force many independent drug stores out of the program and in some cases, force them out of business altogether.

The sad fact of the matter is that it's frequently in the best interests of PBMs to follow these practices, or as Glenn Staley, partner in Acorn Pharmacy in Dallas, puts it: "They have a built-in incentive to destroy their competition."

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