Mar 30, 201704:24 PMBlog

Pharmacies sue on reimbursements

Mar 30, 2017 - 04:24 PM

Washington State Pharmacy Association, National Association of Chain Drug Stores and National Community Pharmacists Association today sued the State of Washington over the reimbursement process by which they are paid for dispensing to Medicaid patients. 

The action seeks to stop a “substantively and procedurally flawed” rule that plaintiffs allege would pay pharmacies below their actual costs to dispense Medicaid prescriptions.

“This Motion seeks to halt further reimbursement cuts, until such time as the State properly implements Medicaid reimbursement rates that cover the actual costs that pharmacies incur when they serve Medicaid patients, as required by law,” wrote NACDS, WSPA and NCPA in a Motion filed today in the Superior Court of Thurston County. It argues that the state rule does not adjust to account for a pharmacy’s “professional dispensing fee.”

The court filing claims that fee must cover actual costs to safely fill the prescription, such as the pharmacist’s professional services. The current dispensing fee in Washington state is significantly lower than the cost of dispensing identified in studies conducted by other states and experts.

“The State’s new rule is both substantively and procedurally flawed,” the groups summarized in their motion. “First, it should be stayed because it constitutes arbitrary and capricious agency action that violates federal law. Second, it should be stayed because the State failed to follow the clear procedural directives that apply when amending a rule.”

            

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