ALEXANDRIA, Va. — The National Association of Chain Drug Stores, American Pharmacists Association (APhA), National Community Pharmacists Association (NCPA) and National Alliance of State Pharmacy Associations (NASPA) applauded a 5-4 decision by the U.S. Supreme Court that upholds the ability of pharmacists and other health care providers to challenge reimbursement cuts in Medi-Cal, California’s Medicaid program.
The pharmacy groups previously filed a legal brief in this case, supporting the right of pharmacies to challenge Medicaid cuts that violate federal patient access law.
NACDS said Friday that the decision is the result of a 2008 case filed in California’s Federal District Court, Douglas v. Independent Living Center of Southern California, which argued that a 10% Medicaid reimbursement cut in California violates the federal patient access law because it would impact access to care for Medicaid patients.
"We applaud the court’s decision ruling, which favors preserving patient access to pharmacy care," NACDS president and chief executive officer Steve Anderson said in a statement Friday. "Ensuring patient access to pharmacy care should not be compromised in an attempt to remedy budget challenges. Community pharmacy provides unsurpassed value in improving health and reducing costs across the board. We appreciate the Supreme Court putting patients first with their decision."
The Supreme Court’s decision ultimately returns the decision to the Ninth Circuit Court of Appeals, on whether health care providers may challenge Medicaid reimbursement cuts under the U.S. Constitution’s supremacy clause. The Ninth Circuit Court had previously ruled that providers had standing to sue over reimbursement rate cuts.
"We are gratified that today the Supreme Court kept the door open for pharmacists to challenge unfair reimbursement cuts that would deny patients access to care," stated Thomas Menighan, APhA executive vice president and CEO. "As the case goes back to the Ninth Circuit, the efforts will continue to eliminate cuts that harm patients. We want to recognize the constrained budgets that states are under, but these reimbursement cuts will further disrupt the relationships between patient and pharmacist that are essential to effective medication use."
Rebecca Snead, executive vice president and CEO of NASPA, commented, "State pharmacy associations across the U.S. are very happy with the Supreme Court’s ruling to allow health care providers to challenge Medicaid reimbursement cuts. Appropriate medication use and patient care is pharmacists’ primary concern, and a critical avenue to protect to the patient is to prevent cuts that would result in patient harm."
B. Douglas Hoey, CEO of NCPA, noted that the Medi-Cal reimbursement cutbacks would impact independent pharmacies especially hard.
"Community pharmacists provide vital services and expert medication counseling to help reduce costs to patients, taxpayers and the state of California," Hoey explained. “Independent community pharmacies in particular often care for Medicaid recipients in underserved rural and inner-city areas where there may be few, if any, other pharmacy options. The cuts would endanger patients’ continued access to pharmacy services, so we commend the court’s decision."
Earlier this month, NACDS joined with other pharmacy groups in blasting the proposed reimbursement cuts in Medi-Cal. The association also hailed a tentative decision by a federal court to block the 10% reimbursement reduction in Medi-Cal. The move stemmed from a lawsuit that NACDS joined other health care organizations in filing in late November.
