Locally-owned pharmacies feeling the crunch

Locally-owned pharmacies feeling the crunch

Reduction in reimbursements putting financial strain on independent stores

news@theeveningtimes.com

Auto, homeowners, renters or health insurance, you take out a policy and expect the plan to cover costs when you have a claim.

That’s how it’s supposed to work, right? Pharmacists are saying health insurance prescription payment plans have broken down in Arkansas. Insurance companies have cut reimbursements to pharmacists for medicine. The squeeze has been so tight pharmacists told the Arkansas Health Insurance Marketplace Oversight Subcommittee drugs often cost more than insurance companies would pay and the news also prompted an emergency Board of Pharmacy meeting. By all accounts, payment schedules were reduced at the beginning of the year.

Earle Pharmacist Cissy Clark called it a crisis. She wasn’t the only one to use that descriptor at the special hearing. Arkansas Pharmacists Association Chief Executive Scott Pace said, “This is a crisis and not just a crisis that effects independent pharmacies, it also a crisis that effects chains.”

According to testimony, chains reported 2017 reimbursements $4 below what they paid drug wholesalers. An Arkansas pharmacists’ Facebook page is tracking the low ball reimbursements being offered.

Posts read: The cost of the medicine was $183.95, the price submitted to insurance was $230.72, but the insurance paid only $83.13. The loss was $100 on Am Better, and Arkansas Works plan. Another example was for generic Tamiflu, the wholesale purchase cost to the pharmacy was over $90 but they got paid just $40.

The pharmacist from Earle weighed in at market place oversight hearing about drug reimbursements through Arkansas Works plans, the State’s answer for Obamacare.

“I am losing on a large portion of those,” said Clark. “Anyone that owns a business knows this is a catastrophic event.”

The undercut payments were also reported from Care Mark and Blue Cross and Blue Shield to the review boards.

The plans force pharmacists to accept the scheduled payment or operate at a loss when filling certain prescriptions. This puts the druggist in a pickle.

“Most pharmacists aren’t going to let people go without needed medicine and do everything they can through proper channels and get it done the right way,” said a local chain pharmacist who could not go on record for the company. “We are here to help people. But pharmacists won’t long function on reimbursements of negative $50.”

Certainly small town pharmacies, are concerned with ramifications of not accepting an insurance plan that may force a patient into a decision forgo footing the cost of medication or make travel plans out of the community to get the persecution filled elsewhere.

City Drug Pharmacist Bill Slaughter provided more information saying that if a patient’s insurance plan is accepted then whatever reimbursement the insurance company offers must be accepted by the pharmacist.

But the West Memphis pharmacist pulled up short of labeling the reduced reimbursements a crises.

“Reimbursements have gone down noticeably since the first of the year, to the point where we are having to reject claims,” said Slaughter. “They’ve cut the rate to the bare minimum where it is not even covering your cost. We are watching it very carefully.”

What is the impact on pharmacy customers?

“In some cases they are having to pay for it themselves,” said Slaughter.

“Most people are able to figure out a way to get their medicine. Some go back to their insurance agent and get something worked out.

We haven’t had cases of people doing without their medicine.”

By John Rech