NCPA urges Congress to prevent Medicaid pharmacy reimbursement cuts

Sep 2 2009

The National Community Pharmacists Association (NCPA) is urging Congressional action in the next 30 days to preserve the access Medicaid patients have to approximately 23,000 community pharmacies. When the Medicare Improvements for Patients and Providers Acts of 2008 (MIPPA) became law in July 2008, it included a provision delaying the implementation of Medicaid pharmacy reimbursement cuts, based on the Centers for Medicare and Medicaid Services (CMS) regulation from July 2007, using an average manufacturer price (AMP) formula. The moratorium expires September 30, 2009. Congress’ action gave pharmacies and Medicaid patients added protection because a December 2007 court-imposed temporary injunction in a lawsuit brought by NCPA and the National Association of Chain Drug Stores could have been resolved.

For more than a year NCPA officials have worked with Congress to enact a substantive fix. The current health care reform bill in the House (H.R. 3200) offers some relief, but could still force community pharmacies to dispense generic drugs at a loss. Further, no legislation addressing the AMP payment cuts is currently scheduled to be enacted by Congress and the President before the end of the month. In response, National Community Pharmacists Association (NCPA) Executive Vice President and CEO, Bruce T. Roberts, RPh, issued the following statement:

“We urge Congress to act immediately to prevent these Medicaid pharmacy reimbursement cuts from happening. Community pharmacies and, more importantly, our Medicaid patients are vulnerable because our ability to serve them could soon be compromised. Ensuring patient access to community pharmacies prevents far costlier visits to doctor’s offices or emergency rooms.

“Congress must grant another delay as legislators work to adopt a fair Medicaid reimbursement formula. While we appreciate the efforts of Democrats and Republicans to address this in health care reform legislation, clearly any bill that emerges won’t be done soon enough.”