Call to Action!
See Sample Comments here!
Submit your comments electronically by clicking here.
Community pharmacies will be paid on average 36% below their acquisition cost for every Medicaid generic drug prescription they fill under a reimbursement formula proposed by the Centers for Medicare & Medicaid Services (CMS), a report by the Government Accountability Office has determined (report can be found here).
On July 1, CMS plans to begin reimbursing for generics with a Federal Upper Limit (FUL) based on a new definition of Average Manufacturers Price (AMP), which it proposed in a regulation released Dec. 15. As required by the Deficit Reduction Act, the FUL will be a ceiling of 250% of the AMP.
Community pharmacies will lose money on virtually every one of those transactions, the report by GAO, the investigative arm of Congress, confirmed. The GAO examined the AMPs of 27 high expenditure generics, 27 frequently used ones, and 23 that overlapped both categories.
For the high expenditure drugs, GAO calculated the new FULs were 65% lower on average than community pharmacies’ actual acquisition costs. For the frequently used drugs, acquisition costs were 15% lower. In the overlap category, acquisition costs were 28% lower. For all 77 drugs, the average acquisitions costs were 36% lower.
The Centers for Medicaid and Medicare Services (CMS) is now accepting comments on the proposed regulation to implement the part of the Deficit Reduction Act of 2005 (DRA) that changes the Medicaid program's reimbursement for generic medications to one based on 250% of the Average Manufacturer's Price (AMP). This proposed regulation could have a dramatic impact on your practice. Now is the time to make your voice heard!
Submit Comments to CMS
CMS has challenged a recent Government Accountability Office (GAO) report that found that the new reimbursement formula may result in an average 36% reduction in pharmacy reimbursement for generic medications. Now is the time to share with CMS how the proposed change in the reimbursement formula will impact your practice. Comments to CMS are due by Tuesday, February 20.
See Sample Comments here!
Submit your comments electronically by clicking here.
