Pharmacies throughout California are sharing the pain of receiving fewer dollars for filling certain prescriptions in the aftermath of last month’s implementation of 10% reimbursement reductions by Medi-Cal, the state’s health coverage program for low-income residents.


Medi-Cal, reimbursement reductions, pharmacies, California, Medicaid, dispensing fees, California Pharmacists Association, Jon Roth, reimbursement rates, California’s Medicaid program, Toby Douglas, California HealthCare Foundation, AB 1805, Nancy Skinner, Gov. Jerry Brown


































































































































































































































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Medi-Cal cuts hit pharmacies

March 17th, 2014

SACRAMENTO, Calif. – Pharmacies throughout California are sharing the pain of receiving fewer dollars for filling certain prescriptions in the aftermath of last month’s implementation of 10% reimbursement reductions by Medi-Cal, the state’s health coverage program for low-income residents.

Some pharmacies have warned they will stop stocking the drugs rather than take a financial loss with the lower dispensing fees — a position that has generated concern for patients with conditions ranging from cancer to HIV to mental illness.

In response to those fears, the state has formed a list of about 2,600 drugs (about 60% of all medications that are reimbursed each month) that are now excluded from the cuts. Those exemptions, remarked California Pharmacists Association chief executive officer Jon Roth, make the reductions “more palatable.’’

Nevertheless, the state plans to retroactively collect payments on remaining drugs dating nearly three years ago, when the cuts were signed into law.

A California Assembly bill introduced earlier this year would restore reimbursement rates to California’s Medicaid program. Whether or not AB 1805, by assembly member Nancy Skinner (D., Berkeley), is approved, Gov. Jerry Brown and the state’s department of health care services (DHCS) have the discretion to exempt specific providers from the cuts.

They have exempted several types of providers in order to maintain access to care, but the state feels disinclined to exempt many more of them, DHCS director Toby Douglas told the California HealthCare Foundation.

“We have continued to refine our reductions,” he said. “But at this point, we don’t see any need to make further changes to legislators’ decision on the 10% reduction.”

California is among the lowest in the nation in Medicaid payments to providers, according to a 2009 study funded by the foundation.

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