“This vote is a victory for low-income families across America,” said Cathy Polley, FMI vice president of pharmacy services. “A delay would give Congress an opportunity to legislate a reimbursement formula that preserves pharmacies that serve the neediest Americans.”
This legislation is critical because pharmacies that serve numerous Medicaid patients cannot survive a 10 percent to 20 percent loss filling prescriptions. When these pharmacies shut down, especially in rural and inner-city areas, many consumers would have to travel long distances to obtain critical medicines.
The measure, titled the Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331), delays until September 30, 2009, the implementation of the Average Manufacturer Price (AMP) reimbursement formula. Government, academic and industry studies agree that this formula would cause pharmacies to lose money when dispensing generic Medicaid prescriptions.
The legislation also helps pharmacies by accelerating 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.
The measure is pending in the Senate.