Florida pharmacies might need to cut their staff and operating hours if state lawmakers change the way Florida calculates Medicaid reimbursement rates for prescription medication.
The Florida Retail Federation, which represents some of the states largest pharmacies, said a House appropriations bill would cut Medicaid reimbursements by 2 percent for brand-name drugs.
To take another cut would make it hard for us to sustain our Medicaid programs, said Sally West, the Federation lobbyist concentrating on the issue.
The bills chief sponsor says numbers from the Federation dont gel with the committees, and the disparity will be worked out when the House hammering out changes on its $67.2 billion budget.
HB 5301, a broad Medicaid budget proposal from the House Health Care Appropriations Committee, attempts to compensate for the federal reduction of a formula used to calculate reimbursements for prescription ingredients for primarily brand-name products.
The formula, which reimburses businesses for the average wholesale price of a product, minus 16.4 percent and a $3.73 dispensing fee, was ruled last year by the Federal District Court of Massachusetts to be inflated. The rate was rolled back by 4 percent federally on Sept. 26.
The bill eliminates the AWP formula and instead sets reimbursement rates at the lesser of three other components of the formula.
The current proposal would result in closed 24-hour pharmacies and laid off staff, West said. The Retail Federation wants the formula to remain at its current level.
Pharmacies are already ailing from the 4 percent reduction that barely covers the medication costs, she said
Were being expected currently to dispense medication for which we are not being reimbursed at a proper rate, she said.
Health Care Appropriations Committee Chairwoman Rep. Denise Grimsley, R-Lake Placid, said the committee has not been trying to disadvantage pharmacies with its formula.
Its not our intent to reduce their funding, she said.
Grimsley said the numbers the committee is working from, provided by the Agency for Health Care Administration, dont show the loss the Federation is fearing. She said the committee plans to reconcile the pharmacies numbers with its own once the House goes into its budget conference.
Were trying to determine where the inaccuracy is, she said.
DeAnn Mullins, an owner of Mullins Pharmacy in Lynn Haven, said that the reduction would be disastrous to her business, which employs 14 people. She said the company is already barely making a profit due to the September rollback. After a recent $26,000 prescription, the business made only a little more than $1 after reimbursements, she said.
We are bleeding and hemorrhaging from the AWP rollback, she said. If they take another 2 percent, I will be out of the Medicaid business.
