US pharmacists oppose Medicaid reimbursement rule change

New reimbursement rules to US pharmacists for generic prescription drugs under the Medicaid program have come under fire from members of both major parties in the US Congress. The Centers for Medicare and Medicaid Services (CMS) proposals would mean that pharmacists are reimbursed by the agency at 36% below the price they pay for the copycat drugs from their wholesalers, according to Government Accountability Office figures quoted by House of Representatives Members Marion Berry (Democrat, Arkansas) and Jerry Moran (Republican, Kansas), as well as Senator Max Baucus (Democrat, Montana). The three Congressmen have written to Acting CMS Administrator Leslie Norwalk to query the formula. A further 74 members of Congress signed the letters.

The letter from Representatives said the "proposed payment formula will be devastating to many community retail pharmacies, Medicaid beneficiaries and the financing of the Medicaid program itself."

In December last year, the CMS proposed an $8.4 billion package of budgetary cuts over the next five years. The National Community Pharmacists Association claims that 90% of the savings "are expected to come from slashing pharmacy reimbursement for lower-cost generic prescription medicines." Branded products are not affected by the CMS decision. The NCPA argues that, with 92% of the turnover for its 24,000 members coming from dispensing prescription drugs, the cuts would have a disproportionate effect.