Chairmen Dingell, Pallone Express Concern Over Impact of Proposed Cuts on Pharmacies, Patients
ALEXANDRIA, Va., April 26 /PRNewswire-USNewswire/ — Two powerful allies in the U.S. House of Representatives joined the growing number of lawmakers who are voicing concern over the Centers for Medicare & Medicaid Services’ (CMS) proposed changes to the pharmacy reimbursement formula for generic medications in Medicaid. Rep. John Dingell (D-Mich.), chairman of the Energy and Commerce Committee, and Rep. Frank Pallone Jr. (D-N.J.), chairman of the Subcommittee on Health, raised concerns over the impact of the rules on pharmacies and Medicaid patients in a recent letter to Health and Human Services (HHS) Secretary Michael Leavitt. The National Community Pharmacists Association (NCPA) has repeatedly warned CMS that, if the rules aren’t modified, independent pharmacies could be forced to stop providing Medicaid coverage, or even be forced out of business.
In their letter, Reps. Dingell and Pallone asked Secretary Leavitt to address three aspects of the CMS regulations that appear to create clear hardships for pharmacies. The deadline for those answers is May 1.
The first question challenges CMS’ Average Manufacturer Price benchmark for pharmacy reimbursement, and that the AMP definition includes prices unavailable to retail pharmacies, such as rebates given to mail order and pharmacy benefit managers. “What evidence does CMS have that the inclusion of these purchasers will not reduce AMP to a level below that of actual acquisition costs of pharmacies?” the two chairmen asked Leavitt.
The second question is about the need for AMP to closely adhere to its original intent of allowing drug manufacturers to ascertain the rebates they owe to state Medicaid programs for medicines provided to Medicaid recipients. Leavitt is pressed, “How can we be certain that any reductions in the Medicaid rebate will not make it more difficult for states to fund their drug programs or limit access?”
The third question centers on the Government Accountability Office’s assessment of the proposed CMS regulations, which concluded that on average, retail pharmacies would be reimbursed 36 percent below their cost for generic drugs dispensed for Medicaid patients. “What evidence does CMS have that this approach will not negatively affect access to lower-cost generic drugs for Medicaid beneficiaries?” Dingell and Pallone asked Leavitt.
“We are heartened that chairmen Dingell and Pallone are asking the tough questions of Secretary Leavitt regarding Medicaid pharmacy cuts that we believe will be so disastrous for independent pharmacies and the Medicaid patients they serve,” said NCPA Executive Vice President and CEO Bruce Roberts, RPh. “Those answers will go a long way in confirming the GAO analysis of the proposed Medicaid generic drug reimbursement under CMS’ definition of AMP, and we hope to see a reconsideration of the definition that will make financial sense for the 24,000 communities pharmacies currently serving Medicaid patients.”
Last month, a similarly themed letter about the forthcoming implementation and dire consequences of the AMP alterations were sent by Sens. Ken Salazar (D-Colo.) and Pat Roberts (R-Kan.) to the Acting Administrator of CMS, Leslie Norwalk. A bipartisan group of 44 additional senators across the political spectrum were signatories of the letter in expressing the need to redo the AMP rules. The list ranged from Minority Whip Sen. Trent Lott (R-Miss.) to presidential candidate Sen. Hillary Clinton (D-N.Y.).
“The Senate has joined the House, through two important sets of letters, in holding HHS and CMS accountable for AMP guidelines whose financial prudence crumbles under the weight of close examination,” said NCPA President John Tilley, RPh, a pharmacy owner from Downey, Calif. “We believe a justifiable backlash is building into a crescendo comprised of Congress, NCPA, other health care organizations, and thousands of pharmacists and consumers across the country. It is our hope that Secretary Leavitt and Administrator Norwalk will hear the criticism and react accordingly by avoiding the implementation of misguided policies that could cause millions of vulnerable Americans to lose access to the medicines they so badly need.”
To view the Dingell/Pallone letter go to: (http://www.ncpanet.org/pdf/leg/amp20070417dingell_letter_toleavitt.pdf)
To view the Salazar/Roberts letter go to: (http://www.ncpanet.org/pdf/leg/letter-amp20070313senate.pdf)
The National Community Pharmacists Association, founded in 1898, represents the nation’s community pharmacists, including the owners of more than 24,000 pharmacies. The nation’s independent pharmacies, independent pharmacy franchises, and independent chains dispense nearly half of the nation’s retail prescription medicines.
National Community Pharmacists Association
CONTACT: Robert Appel, Senior Vice President, Communications, NationalCommunity Pharmacists Association, +1-703-838-2682, bob.appel@ncpanet.org
Web site: http://www.ncpanet.org/