H-E-B Executive Slams CMS Rule

DAN ALAIMO

WASHINGTON — Describing cuts to Medicaid reimbursement as “devastating” to retail pharmacies, Dennis Wiesner, senior director of privacy, regulatory, government and industry affairs, and pharmacy managed care, H.E. Butt Grocery Co., San Antonio, this month called on Congress to pass the Fair Medicaid Drug Payment Act that would permanently overturn the average manufacturer price regulations put in place by the Centers for Medicare and Medicaid Services, Baltimore, and are now blocked by a federal judge.

If allowed to stand, Medicaid reimbursements would be based on AMP where they used to be based on AWP — average wholesale price. AMP has historically been used as a benchmark for manufacturer rebates, but CMS seeks to implement AMP as a reimbursement benchmark, potentially putting 10,000 to 12,000 pharmacies out of business, according to industry estimates.

“The AMP rule was fundamentally flawed in many ways, but in particular, it fails to provide a thorough analysis of the economic impact that the rule would have on small pharmacy businesses, as required under the Regulatory Flexibility Act,” Wiesner said. He testified at a hearing on the impact of CMS regulations before the U.S. House of Representatives Committee on Small Business' Subcommittee on Regulations, Health Care and Trade on behalf of the National Association of Chain Drug Stores, Alexandria, Va.