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SACRAMENTO, Calif. — The National Association of Chain Drug Stores, California Pharmacists Association (CPhA) and several other health care organizations are hailing a recent decision by a federal court to block California officials from proceeding with a 10% Medi-Cal reimbursement rate cut that had been approved by the federal government.
“We commend the court’s final ruling in favor of preserving and protecting patient care,” said NACDS president and chief executive Steve Anderson. “Drastic cuts are not in the best interest of patient care or the state’s finances.
Last spring the California legislature passed and Gov. Jerry Brown signed AB 97, which included a 10% reimbursement rate reduction for pharmacists, doctors, dentists and other providers for Medi-Cal, California’s Medicaid program. Federal approval was needed for the state could implement the cuts.
The information that the Centers for Medicare and Medicaid Services relied on to approve the state’s cuts did not measure whether and how patients’ access to care would be impacted or otherwise take into consideration — as required by law — the costs to provide the care, according to NACDS and other groups that had opposed the original decision.
Opponents of the cut argued that Medi-Cal rates are already extremely low and that many prescription medications are reimbursed at break-even rates — resulting in many providers being unable to afford to participate in the program.
“Community pharmacies help to reduce health care spending and improve patient health through pharmacy services including medication counseling, vaccinations, education and screenings as well as the utilization of generic medications,” Anderson said. “Jeopardizing patient access to community pharmacy would diminish health and increase the reliance on more costly forms of care.”
Jon Roth, CPhA’s CEO, said the group fought against the state’s action “on behalf of patients and the pharmacists who serve them.”
“The legislature needs to realize that using the Medi-Cal program to close the budget is bad medicine for California,” said Roth. “When the legislature asked, we provided them with cost-effective solutions that would have helped close the budget gap. However, they effectively slammed the door on our proposed solutions when they voted to reduce reimbursement to providers by 10% and in turn have ensured that access to care for California’s most vulnerable citizens is put in jeopardy.”
The lawsuit was filed against the California Department of Health Care Services and the U.S. Department of Health and Human Services on November 21. Judge Christina Snyder issued a 25-page order finalizing an injunction.
CPhA, the California Medical Association and the California Dental Association successfully sued in the past to enjoin prior Medi-Cal reductions.
