"Gone To The Hill"

Special thanks to Tobey Schule, RPh, Peter Wolfgram, RPh, and Gina McCarthy Pharm.D. for taking time from their busy schedules and family to go to the Hill to support Senator Baucus’s AMP (average manufacturer price) fix bill S.1951. NCPA (National Community Pharmacists Association) will be flying these 3 Montanans to DC this morning on Tuesday December 4th to talk to Senator Baucus, David Schwartz, and hopefully, a meeting with some of the Senate Finance Committee.

Centers for Medicare and Medicaid Services (CMS) had announced on July 6th, 2007 that Medicaid must use the new Federal Upper Limit (FUL), the maximum amount states can pay pharmacies for generic Medicaid drugs, which will be based on 250% of the lowest generic medications AMP. This rule is part of the Deficit Reduction Act of 2005, mandating CMS to reduce Federal and State Medicaid costs by 8.4 billion dollars over the next 5 years.

Ever since CMS had announced their drastic cuts for Medicaid reimbursement, pharmacy associations including: NCPA, NACDS, APhA, NRHA, and MPA are pushing for Senator Baucus’s S.1951 AMP fix. NCPA and NACDS have even joined forces and filed suit against CMS for their AMP ruling. This is all for a good reason. The Government Accountability Office (GAO) identified the reimbursement on average is 36% less than the acquisition costs for generic medications. What this means is pharmacies may have to turn Medicaid patients away or close their doors trying to serve them. Tobey, Peter, and Gina are in DC to meet with NCPA then head to the Hill to speak with Senator Baucus, his staff, and maybe some members of the Senate Finance Committee in attempts to safeguard patient access to community pharmacies by giving their support for S.1951 and H.R.3700.

Senator Baucus had introduced S.1951 "The Fair Medicaid Drug Payment Act of 2007" on August 2nd, 2007. For the most part, this bill removes the outlying mail order acquisition costs from the mix on figuring AMP, uses Average AMP instead of Lowest AMP, and raises reimbursement from 250% to 300%. Please visit GrizRPh.com “In the Spotlight” for more information.

In addition, Representative Pallone had introduced H.R.3700 on October 28th, which is the companion bill to Senator Baucus's S.1951, also known as the "The Fair Medicaid Drug Payment Act of 2007" in the Senate. The two bills can be meshed easily and can save our pharmacies before the dreaded new AMP attacks pharmacies pocket books.

Jim Smith, Executive Director of the Montana Pharmacy Association explains, ‘this is where I figured we'd be around now with AMP legislation...S.1951 is the last realistic vehicle for getting anything done on AMP this session of Congress. That's why I felt strongly that I needed to go to DC in September...to beat the drum with my counterparts in other states, and with APhA (American Pharmacists Association) regarding AMP and S.1951. Both S.1951 and H.R.3700 are identical versions of AMP legislation in the Senate and the House and we have two committee chairs, both Senator Baucus, Chairman of the U.S. Finance Committee, and Representative Pallone, Chair of the Subcommittee on Health in the Energy and Commerce Committee, which has sole jurisdiction over Medicaid, sponsoring these bills which is key to our success in the next week or so.’

In addition, Jim Seifert, RPh, President of the Montana Pharmacy Association, asked Tobey Schule to hand deliver letters of support from MPA, in which you can read on GrizRPh News just above..Lets give a special thanks to Tobey, Peter, and Gina for their efforts in safeguarding patient access to community pharmacies. Hats off to all three of you…Thank you!

Eric Shields, Pharm.D.