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Legislative Update - May 2002

Pharmacy Medicaid Reimbursement Cut, OPA Exec. Dir. on Medicaid Panel, HB 4, Pharmacists Needed

Legislative Update - May 2002
Alyson Welsh, Director of Government Affairs

Pharmacy Medicaid Reimbursement Cut Effective May 1, 2002!
Approximately two weeks ago, the State of Ohio implemented a two percent reduction in reimbursement to Ohio’s pharmacies for Medicaid services. As part of the comprehensive budget bill, the Ohio Medicaid program was required to slice $150 million off their operating budget. The Ohio Department of Job and Family Services has estimated that this two percent pharmacy reimbursement reduction will save the Medicaid program approximately $14.5 to $16 million in one year.

OPA strongly fought these cuts, both in Medicaid hearings and before the Joint Committee on Agency Rule Review (JCARR). Although the cut will go into effect May 1, 2002, we will continue to work to increase your reimbursement.

OPA has been meeting with top legislative leaders, as well as several department officials to offer some cost savings alternatives for the upcoming budget. State officials have already documented that the next budget cycle will be difficult due to lower than expected business revenues for Ohio.

OPA will continue to work with those necessary to ensure that the state implements long term cost savings approaches for the Medicaid program, other than cutting pharmacists’ reimbursement.

OPA Executive Director Designated “Pharmacy Representative” on Medicaid Panel
Ernest Boyd, OPA Executive Director, has been appointed to serve on the Ohio Department of Job and Family Services (ODJFS) Medicaid Study Group on behalf of retail pharmacy in Ohio. This working group is comprised of State officials, as well as representatives of the pharmaceutical industry, long term care pharmacy, and hospital pharmacy. ODJFS Director Tom Hayes is leading the discussions of the group. OPA is looking forward to working on this panel to ensure pharmacy is well represented as the state pursues additional cost savings measures.

Another Version of House Bill 4 Introduced in Ohio Senate
Senator Lynn Wachtmann (R-Napoleon) introduced the 11th version of House Bill 4 to the Senate Health and Family Services Committee in mid-April which will be discussed in the upcoming months.
In conjunction with OPA and other pharmacy representatives, Sen. Wachtmann drafted a bill that contains the following components:
 Prohibits the administrator from reimbursing participating pharmacies less than a $3.75 dispensing fee for filling each prescription under this plan;
 Prohibits the administrator from requiring a participating pharmacy to charge less than AWP minus 11 percent for a prescription under the plan;
 Requires the Ohio Department of Aging to compile an annual report of the program that details how cost savings were achieved under the plan, how much participants are paying for admission into the program, and what costs have been accrued by the state, consumer and participating pharmacies;
 Creates a Joint Legislative Study Committee to look at pharmacy issues and to study the continuing increasing costs of prescription drugs, discount drug cards and how they work, actual costs of filling prescriptions for retail pharmacy and the regulation of pharmacy benefits managers.

OPA will continue to work with members of the Ohio Senate and Sen. Wachtmann on provisions for House Bill 4. Your phone calls and letters explaining your opposition to House Bill 4 and discount drug cards have been extremely helpful. OPA lobbyists hear directly from your state legislators when they receive those calls and/or letters! Thank you for all your efforts and keep the calls and letters coming!

Pharmacists Needed to Attend Events Honoring your Local Legislators!
OPA is a member of the Ohio Healthcare Provider Coalition. This Coalition is a group of health care providers in Ohio that represents over 70,000 members. The Coalition is comprised of pharmacists, physicians, podiatrists, dentists, psychiatrists, and optometrists. As we continue to lobby our “legislative agenda,” we also need to raise funds for the legislators who have supported health care providers in Ohio.

We are scheduling fundraising receptions around the state for 10 legislators who have repeatedly supported our issues. The idea is to have an informal cocktail reception at the homes of health care providers in Ohio where we can thank them for their support, and encourage their future support! OPA will assist in all the details, planning and invitations for these events, but we are looking for pharmacists to volunteer to serve as hosts! Please contact Alyson Welsh at the OPA office if you would like more information about participating in these events!

Pharmacist Health Screening Day at the Statehouse has been postponed until the fall. Watch the journal and web for more information.

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