LITTLE ROCK, Ark. – A committee meeting at the state capitol Wednesday was filled over capacity with pharmacists demanding fair pay for what they spend on drugs.
The hundreds in attendance claim they are losing money because of major cuts to their prescription reimbursement rates in the state’s Medicaid expansion program, Arkansas Works.
“This year, we’ve been slammed and taken aback by how little we’re getting reimbursed to the point we’re actually losing money on some prescriptions that we end up filling,” said Ian Seng, a pharmacist at family-owned Medicine Man Pharmacy in Little Rock.
According to the Arkansas Pharmacists Association, pharmacies across the state receive about four dollars less than what they spend on prescriptions.
They blame pharmacy benefit managers (PBMs), the middle men between a pharmacist and health insurer who dictate what amount will be reimbursed.
“They’re kind of just mooching off the insurance companies and feeding us the scraps, while at the same time, they don’t have to be transparent about anything they’re doing,” Seng said.
Scott Pace, the CEO of the Arkansas Pharmacists Association, told the legislative council’s Health Insurance Marketplace Oversight Subcommittee that pharmacies are asking for more PBM oversight, fair pay and the enforcement of existing laws, referencing a 2009 act.
“In a state-funded plan, it is illegal for the pharmacy benefit manager to charge one price to the health insurer and pay the pharmacy a different price,” Pace said.
In response to a representative’s question, Pace admitted PBMs have been helpful with claim adjudication and patient eligibility. However, he said they are also forcing pharmacists to turn away loyal customers.
“When I need something if they don’t have it, I’ll get it the next day, and they’ll even bring it to your house. You can’t beat that,” said Patty Bruton, a customer at Medicine Man Pharmacy for the past 25 years. “If they were forced to close or something, I would probably have to get a sign and protest. Not really, but it would be bad. I would be very disappointed.”
Wednesday’s meeting just started the discussion with lawmakers. The committee was not allowed to take any action.
Some legislators don’t think they should get involved, while others believe if they don’t, who will.
The vice president of finance and analytics at CVS Health told the committee that his company would conduct a review over the next month.