Rule Continues Medicaid Burden on Independent Pharmacists

A recent decision by a statewide Medicaid operator has independent pharmacists upset again. Back in January, it was a group of pharmacists who blew the door off the hinges when it comes to problems with Kentucky’s Medicaid managed care system. Then, they were angry over a lack of co-pays on drugs. Now, operator Coventry Cares has reversed course, claiming it will now charge co-pays.

But in doing so, Kentucky pharmacist Jason Wallace says the MCOs are just moving money around, not actually compensating pharmacists any better than before.

“This is hardly a win because what they simply will do is deduct it from what they pay us,” he says.

Wallace says the operator will now eliminate a $1 additional dispensing fee in order to make up for letting pharmacists collect co-pays.

“I know we’re talking about a dollar here, but when you’re talking about the cost of dispensing a drug in the 10 to 11 dollar territory and we’re being reimbursed somewhere around a dollar in terms of a dispensing fee, that extra dollar that we were talking about in House Bill 262, makes a big difference,” Wallace says.

Wallace says with the defeat of that House bill, he and his fellow pharmacists are unsure of what their next direction is.