ALEXANDRIA, Va. – The National Community Pharmacists Association (NCPA) told a Senate committee today that reimbursements to local pharmacies should be no lower than the Medicaid fee-for-service program.

National Community Pharmacists Association Logo. (PRNewsFoto/National Community Pharmacists Association)

In a letter to the New York State Senate Committee on Health, NCPA threw its weight behind SB 6603. The bill, introduced by Sen. James Skoufis (D), would require reimbursements to be no lower than the Medicaid fee-for-service program. Passing the legislation is critical, said NCPA, because it’s important that taxpayer-funded programs be transparent. The group said Skoufis’ legislation would bring transparency and fairness to pharmacy reimbursements in the state’s Medicaid managed care program.

Anne Cassity, NCPA vice president, Federal and State Government Affairs, pointed out that at least six other states have adopted nearly identical reimbursement floors in their respective Medicaid managed care programs. That allows those states to know exactly how their tax dollars are being spent because they establish the reimbursement rates for pharmacy services in their Medicaid managed care programs. In those states, PBMs must reimburse pharmacies at the same rates established under the fee-for-service program.

Under the proposed bill, what a PBM reimburses a pharmacy must be based on the national average drug acquisition cost, or NADAC, plus a professional dispensing fee. NADAC is a simple average of the drug acquisition costs submitted by retail community pharmacies. The professional dispensing fee is established by the state and is supported by New York-specific data.

“These two benchmarks are evidence-based and accurately reflect a pharmacy’s true cost of dispensing a drug,” Cassity wrote. “By basing pharmacy reimbursements on NADAC plus the state- established professional dispensing fee, this bill will allow the state, taxpayers, and patients to rest assured that the amount they are paying for their medications is an accurate reflection of the true cost of those drugs.”

NCPA represents the interest of America’s community pharmacists, including the owners of more than 21,000 independent community pharmacies across the United States and 2,482 independent community pharmacies in New York. These New York pharmacies filled over 142 million prescriptions last year, including 25 million Medicaid prescriptions, impacting the lives of thousands of patients in your state.

On Wednesday, the bill was voted out of committee without opposition, and is now headed to the Senate Finance Committee. Assemblyman Richard Gottfried (D), chairman of the Assembly Health Committee, has introduced a companion bill, A7598.