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ALEXANDRIA, Va. — Pharmacy advocates have condemned the federal government’s approval of reimbursement cuts to the profession in Medi-Cal, California’s Medicaid program.
“We are extremely disappointed with the unconscionable Medi-Cal reimbursement cuts proposed by the state and approved by [the Department of Health and Human Services],” the heads of the National Association of Chain Drug Stores and National Community Pharmacists Association (NCPA) said in a statement. “If left in place, we believe that these reductions would greatly harm millions of Californians by effectively reducing their access to community pharmacies and the health care system as a whole. The impact in terms of compromised health outcomes for patients or delayed access to needed services could be significant.”
The state plans to reduce reimbursements by 10% to many health care providers, including pharmacies. Cindy Mann, deputy administrator of the Centers for Medicare and Medicaid Services, said the move gives California the flexibility it had requested to deal with its budget deficit.
“We know that the reductions that are being approved … will have significant impact on affected providers, and we regret the very difficult budget circumstances that have led to their implementation,” Mann was quoted as saying in the Los Angeles Times.
The cutbacks are expected to save $623 million. The state spends $14 billion on Medi-Cal, which serves 7.6 million poor and disabled Californians.
The statement from NACDS president and chief executive officer Steve Anderson and NCPA CEO B. Douglas Hoey listed three reasons for opposing the cuts.
“First, community pharmacists provide expert medication advice and promote cost-saving generic drugs. Now patient access will likely suffer, as many pharmacies may be forced to cease filling prescriptions and providing counseling to these patients for fear of jeopardizing their pharmacy’s financial viability.
“Second, we believe that the Medi-Cal cuts will mean fewer jobs and local tax revenue at the worst possible time for the state’s economy. Pharmacy reimbursement by public and private health plans has already been declining for many years. These cuts could be the tipping point that forces community pharmacies to scale back operating hours, employee hours, or to close altogether.
“Third, these shortsighted cuts could very well backfire and ultimately increase costs for California and the federal government. Pharmacy services are arguably the best value in health care. As a result of the diminished pharmacy access these cuts will trigger, patients will likely either endure greater and costlier health problems or have to turn to more expensive providers such as emergency rooms for the medication and counseling they need.”
Moreover, Anderson and Hoey accused federal and state officials of acting with disregard to the judicial system, noting that a related case is pending before the U.S. Supreme Court. “No one should presume the outcome of the case of Douglas v. Independent Living Center of California, and the federal review of California’s proposed cuts should never have been concluded while the case is active,” they said.
“Community pharmacists can work with states to reduce health care costs by eliminating needless medical expenses and increasing appropriate generic drug use,” they added. “As state and federal health care officials begin to realize the consequences of these actions, it is our hope that they will go back to the drawing board to develop a more practical budget approach.”
Officials in virtually every state are enacting a variety of cost-cutting measures as states’ spending for Medicaid is projected to increase 28.7% this fiscal year to make up for the loss of federal funds, according to a survey by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured.
