Medicaid AMP battle heats up
WASHINGTON —With a deadline looming later this year for a big cut in Medicaid prescription reimbursements and the shape of health reform efforts still unclear, pharmacy and healthcare groups are redoubling their efforts to reshape the Medicaid payment system and turn aside a serious threat to the economic viability of many community pharmacies.
A growing sense of urgency dominates those efforts. Spurred by congressional approval of President Obama’s federal budget for fiscal 2010—and by alarm over the potential damage wrought by the new system for Medicaid pharmacy payments set to take effect in October—a broadly based coalition of pharmacy organizations is urgently appealing to Congress for relief.
The National Association of Chain Drug Stores, National Community Pharmacists Association and six other prescription drug supply chain organizations co-authored a letter to Senate and House leaders May 1. The purpose: to urge the most powerful lawmakers in Congress to reform the average manufacturer price reimbursement system for generic drugs in Medicaid before the new system is set to take effect in early fall.
The letter marks an effort by “all segments of the prescription drug supply chain” to speak with a united voice in urging Congress to overturn the plan by the Centers for Medicare and Medicaid Services to establish the new, controversial payment method. Implementation of the new plan was delayed last year by congressional action until Sept. 30, 2009, and pharmacy organizations—aided by supporters in Congress—are scrambling to pass legislation that would replace CMS’ new Medicaid reimbursement plan with a more equitable payment system.
“The urgency of moving quickly has become more evident with the approval of the FY 2010 Budget Resolution,” the letter noted. “The budget resolution calls for the committees of jurisdiction to report healthcare reform legislation by Oct. 15, 2009—a full two weeks after the expiration of the delay in the AMP cuts.”
Besides NACDS and NCPA, the letter’s co-authors include the American Pharmacists Association, the Food Marketing Institute, the Generic Pharmaceutical Association, the Healthcare Distribution Management Association, the National Alliance of State Pharmacy Associations and the Pharmaceutical Care Management Association.
Together, those groups issued a stark warning to House and Senate leaders of both parties. “Without action before the end of the current fiscal year, Medicaid patients’ access to neighborhood pharmacies, pharmacists and affordable medications could be put at risk,” they asserted. “The AMP system will result in unsustainable cuts to pharmacy reimbursement, distortions in the prescription drug marketplace, and, most important, could very well curtail Medicaid patients’ access to pharmacies and cost-effective generic drugs.”
The AMP issue is also playing out at the state level. Last month, NACDS president and CEO Steve Anderson and Jeff Rochon, CEO of the Washington State Pharmacy Association, made a direct appeal to pharmacy consumers in that state with a guest column in The Seattle Times. In their article, the two condemned the state’s plan to cut Medicaid pharmacy reimbursements and asked consumers for their support in overturning the plan.
On May 14, in response to a lawsuit filed by retail pharmacies, including Walgreens and Bartell Drugs, Washington state rescinded its plan to lower the reimbursement rate.