WASHINGTON — As the House and Senate health care bills go into the reconciliation process, 16 representatives have urged House Speaker Nancy Pelosi (D., Calif.) to consider a higher federal upper limit (FUL) to determine reimbursements for Medicaid prescriptions filled with generic drugs.
In a December 16 letter to the speaker, 13 Democrats and three Republicans said that while the House and Senate health care reform bills include provisions scaling back the Medicaid reimbursement cuts enacted last year, the rate proposed in the House version does not do enough to remedy the situation.
“We are still concerned that the reimbursement levels proposed will not be sufficient to assure that Medicaid patients will be able to obtain prescription medications through their community pharmacies,” the letter states. “This could reduce Medicaid patients’ access to many pharmacies and negatively impact generic dispensing.”
The lawmakers say the House should be looking at the same 175% multiplier proposed in the health care reform bill that was expected to have passed the Senate on Christmas Eve.
“Community pharmacies play a critical role as primary health care providers in all communities across the United States and often serve as the only resource to millions of lower-income Americans for their daily needs,” the letter says. “Failure to adequately fix Medicaid pharmacy reimbursement would directly impact these patients and the pharmacies that continue to serve them.”
The National Association of Chain Drug Stores says the group’s letter touches on a critical issue for community pharmacies across the country.
“As the face of neighborhood health care, pharmacy is the most convenient and accessible health care provider,” notes NACDS president and chief executive officer Steve Anderson. “[Medicaid] patients should not be penalized due to an unfair reimbursement model.”