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Legislative ALERT - OH Senate to Vote on Budget

Please call your state senator THIS WEEK to make an impact!

The Ohio Senate will be voting on the budget in the next couple of weeks and we need your help! Below is a summary of HB66 as it was passed by the Ohio House. Call your state senator and explain to them the importance of the changes we have made, and stress your concern over the issues that are still unresolved. Please call them THIS WEEK to make an impact! Thanks.

Currently, HB 66 proposes to:

  1. Reduce your reimbursement for product cost from WAC + 9% (AWP – 12%) to WAC + 7% (AWP – 14%). When you talk to your legislators, let them know how this cut will directly impact YOUR pharmacy. Remind them that reducing your product reimbursement cost:
    a)Doesn’t change how much it costs you to purchase the product from the manufacturer; it only reduces the amount you are reimbursed by Medicaid.
    b)Doesn’t do anything about the root cause of the problem…the skyrocketing cost of the pharmaceutical manufacturer’s prices.

  2. Daily price updates on generic drugs in the Medicaid program. OPA worked to get language in the Budget to update your prices in the Medicaid program in a timelier manner. A modification was made in the language to update only GENERIC prices, leaving brand names to be only updated MONTHLY! When you talk to your state senator explain why it is critical for brand names and generics to be updated daily or AT LEAST weekly.

  3. Eliminate the ODJFS Medicaid Dispensing Fee survey. This does not bode well for fair and reasonable dispensing fee increases in the future. This survey should be put back into the budget, and the results of the survey should be taken more seriously when the department sets the Medicaid dispensing fee. The $3.70 dispensing fee has not been increased in over 10 years, even though the department’s own survey shows that it costs pharmacists between $7 and $10 to fill each prescription.

  4. Right of Refusal language. Medicaid wants to implement a copay on ALL drugs. Keep in mind that federal rules require that you dispense the drug, even if the patient doesn’t pay the copay! We were able to have language added that will allow pharmacists the right to refuse service to patients who refuse to pay the co-pay after the first time, if this is the normal course of business with cash paying customers and third party payers. This will not only save pharmacists millions of dollars in unpaid debt, but it will make patients more aware and involved in their own healthcare decisions.

  5. Institute Co-pays on some Medicaid prescriptions.
    - $3 on all non-formulary drugs
    - $2 on brand name drugs
    We were successful in having the $1 co-pay taken off generic drugs. We feel this is one way to encourage patients to use the lesser expensive generic drugs.

The Senate Finance Committee will be hearing our testimony on May 17, but we need them to hear from you too. This budget will affect pharmacy for years to come. For many pharmacies the cut in reimbursement could be the difference between being able to serve the Medicaid population or being forced to turn them away. Don’t let them pass the budget thinking that pharmacists don’t care enough to get involved!

Contact information for your state senator may be found at the following link:

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