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Jan 11, 2008 1:57 pm US/Central
Pharmacists Decry Medicare Drug Payments
WASHINGTON (AP) ―
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The report from the Health and Human Services inspector general showed that pharmacies are able to charge insurers about 18 percent more than what they pay for medicine.
AP
Pharmacists say a government report released Thursday validates
their concerns that payments under the Medicare drug benefit are
driving some of them out of business.
The report from the Health and Human Services inspector general
showed that pharmacies are able to charge insurers about 18 percent
more than what they pay for medicine. Also, the pharmacists get a
dispensing fee of about $2.27 cents per prescription.
But the Association of Community Pharmacists said that spread was
not enough to cover all their expenses, such as employee wages, taxes
and utilities. The association said an independent pharmacy typically
needs to be reimbursed at about 20 percent to 21 percent above its
acquisition costs just to keep its doors open, said Mike James, the
association's government affairs director.
James said that more than 1,100 pharmacies closed last year, and
many blame the reimbursement rates under Medicare Part D, which
provides drug coverage for the elderly and disabled.
The inspector general's report made no recommendation on whether the
reimbursement rates were adequate or not. Under the program,
beneficiaries get coverage through private insurers. The insurers
negotiate with pharmacists the rates that they'll pay for a Medicare
customer's prescription. The inspector general's report noted that the
dispensing fee for each prescription filled under Medicare Part D is
about $2 less than what pharmacists get when serving the poor in
Medicaid.
The report was requested by 33 members of the Senate. The lawmakers
have received complaints from many pharmacists that payments are too
low under Medicare Part D. The lawmakers are expected to seek
additional information from the inspector general.
Medicare officials said they were pleased to see in the report that
payments from Part D plans to rural pharmacies were nearly identical to
those in urban areas.
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