New Rule Continues Medicaid Burden on Independent Pharmacists

A recent decision on drug co-pays by a statewide Medicaid operator has independent pharmacists upset -- again.

In January, complaints from a group of pharmacists drew attention to problems in Kentucky’s Medicaid managed care system.

Back then, they were angry over a lack of co-pays on drugs. Now, managed care operator Coventry Cares has reversed course, claiming it will now charge co-pays.

But in doing so, Kentucky pharmacist Jason Wallace said the managed care operators are just moving money around, not actually compensating pharmacists any better than before.

“This is hardly a win because what they simply will do is deduct it from what they pay us,” Wallace said.

Wallace said the operator will now eliminate a $1 additional dispensing fee in order to make up for letting pharmacists collect co-pays.

“I know we’re talking about a dollar here, but when you’re talking about the cost of dispensing a drug in the 10 to 11 dollar territory and we’re being reimbursed somewhere around a dollar in terms of a dispensing fee, that extra dollar that we were talking about in House Bill 262, makes a big difference,” Wallace said.

With the defeat of that House bill, Wallace said he and his fellow pharmacists are unsure of what their next direction is.