ALEXANDRIA, Va. — The Department of Health and Human Services’ Office of Inspector General, Washington, released an analysis last week confirming that proposed Medicaid prescription reimbursement payment rules would result in significant underpayments to community pharmacies in the Medicaid program, the National Association of Chain Drug Stores said. The study projected the impact of the Deficit Reduction Act of 2005 on the Medicaid Federal Upper Limit (FUL) program, finding that the average pharmacy acquisition costs for 19 of 25 selected high-expenditure drugs “would have been higher” than what the federal program would have reimbursed them. The report further states that for 12 of those 19 drugs, the average pharmacy acquisition costs “would have been more than double the new reimbursement limit.” NACDS President and Chief Executive Officer Steven C. Anderson said, “Rather than reflecting actual pharmacy drug costs, the reimbursement limits currently proposed by CMS would dramatically limit the availability of community pharmacy services to millions of Medicaid beneficiaries.” The OIG report increases the pressure on Congress to act promptly and decisively on this matter, and that NACDS will launch an effort to ensure Congress is aware of the findings of the report, Anderson said.
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