Press Releases
Senators Roberts/Lincoln/Salazar offer Medicaid Pharmacy Reimbursement Amendment to SCHIP
Jul 19 2007
WASHINGTON, DC – Continuing efforts on behalf of community and retail pharmacists to oppose a recently proposed rule which threatens to restrict access to prescription drugs for millions of Medicaid beneficiaries, U.S. Senators Pat Roberts, Blanche Lincoln (D-AR) and Ken Salazar (D-CO) today introduced an amendment to the State Children’s Health Insurance Program (SCHIP) reauthorization bill during Finance Committee Mark-up.
“American families rely on their pharmacists, and this new formula for Medicaid reimbursement will create significant economic hardships for our local pharmacies, which ultimately threatens patient access to their needed drugs,” Senator Roberts said. “This rule particularly affects rural areas, and I am taking a stand against it to help our Kansas pharmacists.”
While not seeking to upset the compromise on SCHIP, the Senators asked for, and received, a commitment from the Chairman, Senator Max Baucus (D-MT) and Ranking Member Senator Chuck Grassley (R-IA) to find a more appropriate legislative vehicle to address the issue later in the year.
The Senators have concerns over the new formula that defines how pharmacies will be reimbursed under what is called Average Manufacturer Price (AMP). Congress mandated AMP under the Deficit Reduction Act. It was intended to bring pharmacy reimbursement in line with actual costs. Recently, the Centers for Medicare and Medicaid Services (CMS) issued a rule to further define AMP, which causes serious concerns for pharmacies across the country.
Just last month the Office of Inspector General found that the new AMP formula may result in reimbursements to pharmacies that are below pharmacy acquisition costs. The General Accounting Office also found similar results. Both agencies expressed concerns that this situation could adversely affect access to pharmacies for Medicaid patients.
The Senators’ amendment seeks to get the definition of AMP right and changes it to a more reasonable level. Their efforts are supported by both the National Association of Community Pharmacies, the National Association of Chain Drug Stores, and the Healthcare Distribution Management Association.
“Many of my pharmacies in Kansas have contacted me and said they will either be forced out of business or forced to stop serving Medicaid beneficiaries if this new formula is not changed,” Senator Roberts said. “This is clearly not acceptable.”
In March, Senator Roberts and Senator Salazar sent a letter to the Centers for Medicare and Medicaid Services (CMS) on behalf of community and retail pharmacists to address the proposed rule.
Senator Roberts is a senior member of the Senate Health, Education, Labor and Pensions (HELP) Committee and a new member of the Senate Finance Committee.
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“American families rely on their pharmacists, and this new formula for Medicaid reimbursement will create significant economic hardships for our local pharmacies, which ultimately threatens patient access to their needed drugs,” Senator Roberts said. “This rule particularly affects rural areas, and I am taking a stand against it to help our Kansas pharmacists.”
While not seeking to upset the compromise on SCHIP, the Senators asked for, and received, a commitment from the Chairman, Senator Max Baucus (D-MT) and Ranking Member Senator Chuck Grassley (R-IA) to find a more appropriate legislative vehicle to address the issue later in the year.
The Senators have concerns over the new formula that defines how pharmacies will be reimbursed under what is called Average Manufacturer Price (AMP). Congress mandated AMP under the Deficit Reduction Act. It was intended to bring pharmacy reimbursement in line with actual costs. Recently, the Centers for Medicare and Medicaid Services (CMS) issued a rule to further define AMP, which causes serious concerns for pharmacies across the country.
Just last month the Office of Inspector General found that the new AMP formula may result in reimbursements to pharmacies that are below pharmacy acquisition costs. The General Accounting Office also found similar results. Both agencies expressed concerns that this situation could adversely affect access to pharmacies for Medicaid patients.
The Senators’ amendment seeks to get the definition of AMP right and changes it to a more reasonable level. Their efforts are supported by both the National Association of Community Pharmacies, the National Association of Chain Drug Stores, and the Healthcare Distribution Management Association.
“Many of my pharmacies in Kansas have contacted me and said they will either be forced out of business or forced to stop serving Medicaid beneficiaries if this new formula is not changed,” Senator Roberts said. “This is clearly not acceptable.”
In March, Senator Roberts and Senator Salazar sent a letter to the Centers for Medicare and Medicaid Services (CMS) on behalf of community and retail pharmacists to address the proposed rule.
Senator Roberts is a senior member of the Senate Health, Education, Labor and Pensions (HELP) Committee and a new member of the Senate Finance Committee.
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