Last year I blogged about a group of Texas pharmacists (independent operators) lobbying the White House for reimbursement for Medicare Part D prescription drugs. (See Texas Pharmacists Lobby White House)
The pharmacists were not receiving sufficient reimbursement to make up for the millions of dollars worth of drugs they gave to Part D patients for free, in part because Part D was new and confusing, and patients who needed medications couldn’t afford to wait for approval.
To make matters worse, the group said pharmacists had to wait up to 30 days to receive any reimbursement at all, as opposed to the usual week or 10 days for Medicaid or private insurers.
A year later, pharmacists are still feeling the fall-out. Some smaller pharmacists claim that Part D is forcing them to shut down because reimbursement rates are too low. From the Washington Times:
Community and independent pharmacists say the new Medicare prescription-drug benefit, known as Part D, has given pharmacy benefit managers leverage with insurance companies to set low reimbursement rates to pharmacies. As a result, beleaguered pharmacies are struggling to survive.
“You’re going to see considerably more pharmacies close in 2007. They cannot continue in this vein,” said Mike James, pharmacy owner and director of government affairs for the Association of Community Pharmacists.
The Association of Community Pharmacists estimates that the drug benefit’s payment structure was responsible for more than 1,000 closures of independent pharmacies nationwide last year.
One independent pharmacist still in business says he loses money with every Part D prescription. Things may get worse before they get better. A new Medicaid rule proposed late last year would save the government $8.4 million, but it also would further reduce reimbursements for pharmacists. (See Pharmacists Face Reduced Medicaid Reimbursements)