Medicaid Reimbursement Found to Be Below Cost

Feb 5, 2007 12:00 AM

ALEXANDRIA, Va. -- Bolstering retail pharmacy advocates, a national study released Friday by the Coalition for Community Pharmacy Action found that the average cost to dispense a prescription in the United States is $10.50, not including the cost of the medication itself. The average dispensing fee paid by government programs, such as Medicaid, reimburses pharmacies on average approximately $4.50, the report said. In addition, a report released earlier in the week by the Government Accountability Office, Washington, assessed the impact of the new Medicaid reimbursement rates on pharmacy, after proposed cuts in the Medicaid program that are scheduled to go into effect on July 1. The report found that the new reimbursement formula, called Average Manufacturer's Price, will result in pharmacists being paid, on average, 36% less than their acquisition cost on every Medicaid prescription they fill. The National Community Pharmacists Association, based here, has recommended that federal policymakers to take immediate steps to ensure changes in the reimbursement formula for Medicaid so that, at a minimum, it covers the pharmacist‘s acquisition cost for the prescription.