ALEXANDRIA, Va. — Characterizing it as a victory for patient care, the National Association of Chain Drug Stores and the National Community Pharmacists Association (NCPA) have reached agreement with the Delaware State Department of Health and Social Services that will restore much of the funding to pharmacies that would have been lost due to rate cuts in Medicaid reimbursement.
The associations joined together in filing a lawsuit challenging Delaware’s April 1 rate reductions for Medicaid reimbursement for brand name drugs, which the trade groups assert result in reimbursement for many drugs at a level that is below a pharmacy’s break-even costs.
As a result of the agreement, the joint lawsuit filed by the associations is no longer considered necessary.
After a voluntary dismissal of the lawsuit, the state agreed to establish reimbursement for brand name drugs at the average whole price (AWP) minus 14.5% — an increase of 1.5% from the original reimbursement structure that led to the filing of the lawsuit.
According to NACDS, Delaware plans to reduce reimbursement for certain generic drugs, but pharmacies will have an opportunity to petition for increased reimbursement if the new rates are below pharmacy acquisition costs.
“We are pleased to have reached this agreement with Delaware, which will result in better reimbursement for pharmacies so they can continue to serve their patients,” comments NACDS president and chief executive officer Steve Anderson. “Patients rely on their neighborhood pharmacies for prescription medications, counseling and other services that enable them to maintain their health and their family’s health.
“We appreciate the state’s cooperation in helping to preserve patient access to pharmacy services.”
NCPA executive vice president and chief executive officer Bruce Roberts calls the agreement a by-product of good-faith negotiations.
“Our No. 1 priority has always been ensuring that we can continue serving Medicaid patients,” relates Roberts. “That relationship was jeopardized by severe cuts to pharmacy
“Thankfully, a better deal was reached to allow the state of Delaware, patients and pharmacies to weather these tough economic times without undermining patient access.”