Reps. Nancy Boyda (D-Kan.) and Jo Ann Emerson (R-Mo.) introduced a bill July 24 to protect rural pharmacies from potential financial disaster.
Medicaid reimbursement for pharmacies is below cost causing small pharmacies to bear the burden of federal cutbacks, Boyda said. The result will be less care provided to rural Medicaid beneficiaries, many of whom rely solely on their pharmacy as a point of contact for healthcare.
According to Boyda at a press briefing July 24, the Patient Access to Medicaid Generic Prescription Drugs Act of 2007 will change the flaws in the final rule for Medicaid pharmacy reimbursement for generic prescription drugs.
Charles Sewell, senior vice president of government affairs at the National Community Pharmacists Association said his organization strongly supports the bill. The bill is joined by 30 bipartisan co-sponsors in the House.
The Centers for Medicare & Medicaid Services issued the a final payment rule on July 6, with an implementation period slated for October 1 through January 30. The Government Accountability Office reports compensation to pharmacies will fall 36 percent below their costs to purchase the medications under the new rule
"The CMS rule is an absolute disaster," Sewell said. "Obviously no business can stay in business very long with reimbursement below cost." Sewell predicts that pharmacies in rural areas will be hit the hardest.
Emerson and Boyda plan to fund the bill through incentives for providers to prescribe generic drugs over brand name drugs. According to Emerson, Medicaid currently has a 50 percent utilization rate for generic drugs.
Boyda claims the CMS rule is aimed at forcing mail order drugs, giving large pharmaceutical companies the edge over small pharmacies.
Emerson said her district in southern Missouri is one of the poorest in the country and has a large Medicaid population. "For many constituents, their healthcare is their pharmacist," Emersons said. "I'm very concerned when I see my rural pharmacies closing their doors or selling out. There's an inherent issue of fairness here."
Paul Kelly, of the National Association of Chain Drugstores said the best way to pass the new bill would be to fold it into current legislation on the State Children's Health Insurance Program (SCHIP).
"If we don't fix pharmacy reimbursement, we're going to have serious access problems in the same communities that SCHIP is meant to assist," Kelly said. 'It is our major concern that the cost of inaction will be greater than the cost of action."