Medicaid News in the States

By John Coster, RPh., Ph.D.

Economic downturns like the current one produce a double-whammy for federal and state Medicaid budgets: enrollment in the program grows as there’s less money to pay for it. That means more potential for provider reimbursement cuts – something NCPA is trying hard to avoid. Pharmacies can simply not withstand any more Medicaid reimbursement cuts, especially in light of last year’s AWP rollback. Here’s a rundown of some related state activity NCPA’s monitoring, along with federal efforts.

Getting that Medicaid AMP Fix Right in Health Reform

By Kevin Schweers

On Capitol Hill it’s crunch time for health care reform as negotiations between House and Senate leaders pick up speed. A top priority for community pharmacies is getting an adequate fix to Medicaid’s reimbursement formula for generic drugs. So we held a briefing today to update reporters on where things stand and to demonstrate the strong, bipartisan support there is in Congress for an equitable reimbursement formula. Here’s a quick recap; a recording of the call is available here.

GAO to Congress: Pharmacies Face Major Medicaid Cuts without Congressional AMP Fix

By John Coster

A new government study affirms that community pharmacies would, on average, be significantly underpaid for dispensing generic prescription drugs to Medicaid recipients under an existing Average Manufacturer Price (AMP) reimbursement formula that was created through the 2005 Deficit Reduction Act. 

Medicaid AMP ‘Fix’ Moves Closer to Finish Line

By John Coster

In the wake of Senate passage of health care reform legislation on Christmas Eve morning, momentum on Capitol Hill is continuing to build for a Medicaid AMP “fix” that is fair to community pharmacies. The support is bipartisan and spans the political spectrum from liberal to conservative and from members of the Congressional Black Caucus to the Congressional Rural Caucus.

Pressing Phamacy Issues Covered In Opinion Pages

By John Norton

(NOTE: To read all NCPA opinion pieces go to the following link.)

As the health care reform efforts kicks into overdrive, NCPA recently had three opinion pieces published advocating for patients and community pharmacies on three major issues: mandatory mail order; durable medical equipment (DME) accreditation; and Medicaid’s Average Manufacturer Price (AMP) based cuts.

New Ad Makes the Case for Medicaid AMP Fix in Health Reform

 By Kevin Schweers

Two years ago this week something significant and positive happened for Medicaid patients and their community pharmacists. This December, we’re working for more of the same. 

Health Reform Bill Could Include Cost of Dispensing Study

By Kevin Schweers

Senator Michael Bennet (D-CO) today filed an amendment to the health care reform bill that would require the Government Accountability Office to conduct a Medicaid cost of dispensing survey. It’s been more than a decade since the feds last examined this issue in detail. Since that previous study there have been a variety of federal and state pushes to cut pharmacy reimbursement again and again without government data to fully know the impact of such reductions.

What the Latest Senate Health Care Reform Proposal Means for Community Pharmacy

We’re still reviewing the 2,000+ page health reform proposal released by Senate Democratic leaders Wednesday night, but here’s what our initial read shows:

Community Pharmacy Issues Raised in Drug Topics Profile

By Kevin Schweers

For an insightful and succinct look at the issues facing community pharmacy today, check out the interview our friends at Drug Topics recently did with Jon Copeland and Bruce Semingson, two longtime NCPA allies and staunch supporters of independent community pharmacy. Mr. Copeland and Mr. Semingson are, respectively, CEO and COO of American Associated Pharmacies, an influential buying group cooperative.