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NEW YORK Like a mythical Hydra that keeps sprouting new heads, the massive, shape-shifting beast masquerading as the U.S. Senate’s compromise health-reform legislation keeps growing in size, reach and complexity as lawmakers tack on amendments that reflect their own philosophy about the role of government and the nature of the healthcare crisis. And in the midst of the debate, retail-pharmacy leaders are doing their best to make their voices heard.
Tuesday’s quick-strike foray on Capitol Hill by leaders of the National Association of Chain Drug Stores was just the most recent of those efforts. But it was certainly one of the most determined and coordinated lobbying campaigns to date in pharmacy’s long battle for recognition and fair compensation for services rendered to a health system in dire need of reform. More than a dozen NACDS board members descended on the House and Senate to appeal in person for a greater stake in whatever healthcare system emerges from the tug of war over health reform.
Among retail pharmacy’s top priorities: that Congress legislate a permanent fix for the cockeyed Medicaid reimbursement system. Under current regulations dictated by the Deficit Reduction Act and the Centers for Medicare & Medicaid Services, both pharmacies and taxpayers will be penalized for dispensing lower-cost generic drugs to patients on Medicaid under a new reimbursement model based on a skewed reading of the average price paid to manufacturers for those drugs.
The most essential element of any health reform package, pharmacy advocates argue, must be a fair reimbursement model for the community pharmacists who dispense medications and patient-care services. That means setting payment standards for a menu of patient intervention and counseling services – all of which could boost wellness and disease prevention, thus saving the health system big sums of money. It also means establishing a reimbursement model for Medicare and Medicaid prescriptions that doesn’t penalize pharmacies for dispensing generics, or force them to dispense those drugs at a loss.
The industry leaders who descended on Washington this week also urged lawmakers and their staffs to ensure a role for community pharmacists in the delivery of medication therapy management in any health reform package – and to keep the from erecting new barriers to the sale by retail pharmacies of durable medical equipment and supplies.
Like most of what pharmacy is after, the latter request shouldn’t even have to be made. It seems obvious enough to those of us who know this industry that pharmacists are already perfectly qualified to sell DME, diabetic supplies and other products without having to jump through a new set of expensive and time-consuming legal hoops to be able to continue doing so. But given the general ignorance of pharmacy’s health care value that still runs rampant among too many lawmakers and health policy “experts,” it’s a battle that must be fought.