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In Illinois, coalition takes aim at Rx reimbursement cuts

Pharmacy Choice and Access Now (PCAN), a coalition of pharmacists, consumers and local businesses, has set up shop in Illinois as the state mulls cuts to Medicaid pharmacy reimbursements.

SPRINGFIELD, Ill. — Pharmacy Choice and Access Now (PCAN), a coalition of pharmacists, consumers and local businesses, has set up shop in Illinois as the state mulls cuts to Medicaid pharmacy reimbursements.

PCAN said Monday that the Illinois Department of Healthcare and Family Services (HFS) in mid-July proposed a reduction to the reimbursement that community pharmacies receive for the cost of drugs while serving Medicaid patients. The group noted that such a cutback would jeopardize Medicaid patients’ ability to access pharmacy care.

According to PCAN, the proposed reducation also comes as 20% of seniors and people with disabilities are set to lose state-sponsored prescription drug coverage through Illinois Cares Rx on Sept. 1.

"Community pharmacies and other Medicaid providers have already withstood the brunt of cuts made to the Illinois budget. We understand times are tough, but the way back to fiscal health for Illinois should not come at the expense of the health of Illinois’ most vulnerable," Todd Evers, president-elect of the Illinois Pharmacists Association, said in a statement. "The proposed Medicaid reductions add insult to injury for Illinois’ citizens currently served by the program and come at a time when Medicaid is on the verge of a nationwide expansion."

PCAN said it’s urging legislative leaders and elected members of the Joint Committee on Administrative Rules (JCAR) to reject the state’s proposed rule before its implementation hurts the Illinois economy and limits access to care for people with the greatest need.

"Community-based pharmacies like me employ over 35,000 in Illinois and contribute nearly $400 million in tax revenue to the state of Illinois, and now the Department of Healthcare and Family Services is proposing a cut of nearly $50 million," stated Anthony Sartoris, president of Doc’s Drugs, a Braidwood, Ill.-based pharmacy operator with 17 drug stores in Illinois. "These cuts may impede the ability for me to provide prescription drugs to Medicaid patients in our communities who rely on our services."

A national coalition aimed at safeguarding the quality and affordability of health care and pharmacy services, PCAN recently took its efforts to other states wrestling with Medicaid issues.

Last month, for example, PCAN called on the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) to reject a California state plan amendment that would reduce reimbursement rates for Medi-Cal, the state’s Medicaid program, by 10%.

Also in July, PCAN urged that key pharmacy protection provisions recently passed by the Texas legislature (Senate Bill 7) be incorporated into Medicaid reforms enacted by the state. The safeguards included such measures as open access pharmacy networks within a managed care framework; permitting users of Medicaid pharmacy services to continue to retain the option of being served by their community pharmacy rather than a mail-order service; and prompt pay for critical pharmacy services.

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