PA Proposed DPW Reimbursment Cuts

Today my inbox has been flooded with emails about the proposed Department of Public Welfare reimbursement cuts.

After reading through the emails, I realized just how detrimental this will be to our independent pharmacies in Pennsylvania.

According to the Pennsylvania Pharmacists Association, the proposed regulations would cut at least $64 million from community pharmacies within our state. You may be asking how this can be so? Well in the proposed regulations, Medicaid prescriptions reimbursements would be cut by 50%. So every Medicaid prescription that you process, saying that it is a normal drug, you will only be getting back $2, and then if you process a compounded drug, well that will get you $3.

The average cost to a pharmacy to dispense a medication is $12, and that does not include the cost of the drug.

Okay now that I have depressed all of my pharmacy friends in Pennsylvania, let me give you a battle plan to help stop this.

You need to make some very important phone calls. Call your representative and senator as well as the governor’s office.  You must alert them that this is going to make a huge economic impact to our pharmacies. Tell them that there are other options, like generic dispensing.

Here are some talking points from PPA to help you out.

  • "Reimbursement levels in Pennsylvania are already extremely low and significant cuts will put Pennsylvania among the lowest 50 states."
  • "It is already common knowledge that the cost to the pharmacy for purchasing, filling, and distributing some prescriptions in MA programs costs more than the reimbursement. Further cuts would be devastating to pharmacies in Pennsylvania and would eventually threaten the existence of com-munity pharmacy, thus limiting access."
  • "Pharmacies rely on what little reimbursement they receive from Medicaid and this helps them keep their doors open. Cutting reimbursement rates will force them to close their doors and in turn, family sustaining jobs will be lost at a time where we can't afford to lose any more."
  • "Community pharmacies going out of business will decrease access to prescription medications which will result in greater overall health care costs."
  • "Cuts at the Medicaid level will set a scary precedent that many managed care organizations will soon follow. Thus, the same negative effects will be felt throughout the entire state; threatening Pennsylvania's entire health care system."

Jenny Schell

Jenny is a Board Certified DME Specialist and for the last 9 years has assisted independent pharmacies, home health care facilities, medical supply companies, physicians and small healthcare practices in choosing the best comprehensive customized healthcare compliance and consulting services they require.

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