“Chairman Baucus’ legislation gives Congress the opportunity to legislate a reimbursement plan that enables pharmacies to continue serving the neediest families in our nation,” said Cathy Polley, FMI vice president of pharmacy services.
The measure, titled the Medicare Improvements for Patients and Providers Act of 2008 (S. 3101), would also accelerate reimbursement for Medicare Part D claims to 14 days for those submitted electronically and 30 days for those submitted by other means. The current reimbursement time often exceeds a month.
Numerous pharmacies would lose money filling generic Medicaid prescriptions under the Average Manufacturer Price (AMP) reimbursement formula, according to the General Accountability Office, Health and Human Services Inspector General and research released last month conducted by Pricewaterhouse Coopers LLP for FMI and the National Association of Chain Drug Stores.
“The AMP formula presents pharmacies with the deplorable choice of no longer serving Medicaid patients or operating at a loss. We must preserve patient access to vital medicines, particularly in the urban and rural areas where low-income Americans depend on pharmacies for their health and lack alternatives.”