AUSTIN -- State lawmakers are taking a closer look at Medicaid funding in Texas. Some of those dollars could be going away.
The State Legislature passed a new law over the summer that does away with the current procedures pharmacies follow to fill Medicaid and CHIP prescriptions. Now pharmacies are fighting back, saying the new rules will make it impossible for them to continue serving those in need.
“The Texas Department of Health and Human Services needs to understand such severe cuts in reimbursement rates will reduce access to vital medications and other pharmacy services for Medicaid patients,” said Dorinda Martin, R.Ph., owner of the Lamar Plaza Drug Store in Austin and the Dripping Springs Pharmacy.
Monday morning at the State Capitol, the House Human Services Committee opened a hearing into the matter.
The committee is taking in testimony of the new Medicaid model. It did away with a state-run Medicaid prescription program and moved to a managed care program. Therefore, when pharmacies send in reimbursements for Medicaid prescriptions, the rates aren't controlled the same way. Pharmacy owners from across the state say the rates could be so low that they'll lose 80 percent of those reimbursement dollars. Many say they can't survive with such deep cuts.
“I will literally go broke trying to keep my pharmacy open,” said Louis Rumsey, R.Ph., owner of the Elam Road Pharmacy in Dallas. “The reimbursement is so low that even if I let go of several employees, cut back on expenses and do not even pay myself a salary, I will still lose money.”
According to pharmacy groups in Texas, there are 1,700 community pharmacies in the State. The group cites a study by The Perryman Group, an economic analysis firm, which estimates that if this plan goes through, 1,300 of those pharmacies are at severe risk of closing down.
A similar program recently went into effect in the state of Kentucky. Pharmacy groups say those businesses are already seeing job loss and economic distress.
It doesn't go into effect in Texas until March 2012. Officials are hopeful the hearing with lawmakers Monday will urge the state to outline restrictions for the managed care program.
