Pharmacy groups have joined a pending case before the U.S. Supreme Court to determine if cuts to the reimbursement rates paid under Medicaid violate federal law.


Pharmacy groups, U.S. Supreme Court, reimbursement rates, Medicaid, Medi-Cal, American Pharmacists Association, National Association of Chain Drug Stores, National Community Pharmacists Association, National Alliance of State Pharmacy Associations, Douglas v. Independent Living Center of California, reimbursement policies, Medicaid reimbursement cut, Steve Anderson, health care services, Richard Monks






































































































































































































































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Rx groups send Supreme Court brief in Medicaid case

August 29th, 2011

WASHINGTON – Pharmacy groups have joined a pending case before the U.S. Supreme Court to determine if cuts to the reimbursement rates paid under Medicaid violate federal law.

In a brief filed with the Court earlier this month, the American Pharmacists Association, National Association of Chain Drug Stores, National Community Pharmacists Association and National Alliance of State Pharmacy Associations expressed support for pharmacists’ right to challenge the cuts proposed earlier this year for California’s Medi-Cal program.

The filing comes as the Court is getting ready to consider the case of Douglas v. Independent Living Center of California, in which the U.S. Appeals Court for the Ninth Circuit ruled that Medicaid providers can sue states over their reimbursement policies and ask for courts to adjudicate disputes over whether the states were complying with federal law.

The appeals court’s ruling blocked the cutbacks on the grounds that they conflicted with the Medicaid law. The providers argued that if the cutbacks were approved, the state would not provide the level of care required under Medicaid.

In their initial lawsuit California pharmacies and other health care providers that take part in Medi-Cal argued that the state’s 10% Medicaid reimbursement cut violates the federal patient access law, which provides that Medicaid reimbursement rates must be “sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area.”

The four pharmacy groups say that if the cuts are allowed to stand they would threaten Medicaid patients’ access to care.

“This short-sighted proposal is not the solution to cutting spending and reducing costs,” NACDS president and chief executive officer Steve Anderson says. “We have and will continue to urge the state to work with pharmacy and other provider groups to find cost-effective alternatives that do not jeopardize Medicaid beneficiaries’ access to health care services.”

The Supreme Court will begin hearing arguments in the case on October 3 and could issue a decision later this year.

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