NCPA Offers Recommendations for Medicaid Managed Care to Trump Administration

ALEXANDRIA, Va., June 14 -- The National Community Pharmacists Association issued the following news release:

Upon learning that the Administration is reviewing the policies included in the Medicaid managed care final rule, the National Community Pharmacists Association (NCPA) sent a letter to Seema Verma, Administrator for the Centers for Medicare and Medicaid Services (CMS), urging her to retain several critical provisions that will preserve Medicaid beneficiaries' access to prescriptions and pharmacy services. Access to prescription drug services are critical to helping stave off the expensive downstream medical interventions (e.g., emergency room visits, hospitalizations) that add costs to the Medicaid program.

As the letter states, "Independent community pharmacists are proud to play a vital role in the Medicaid program as the backbone of its drug benefit. Local pharmacists provide expert medication counseling and other cost-saving services that help mitigate the estimated $290 billion that is spent annually as a result of patients who do not adhere properly to their medication regimen. More than any other segment of the pharmacy industry, independent pharmacies are often located in the underserved rural and urban areas that are home to many Medicaid recipients."

NCPA's recommendations for the Administration and CMS regarding final rule--scheduled to go into effect July 1--are as follows:

* Keep the provision requiring states to develop and enforce network adequacy standards for critical provider types, including pharmacies;

* Retain the provision mandating managed care organizations (MCOs) meet Medicaid fee-for-service standards regarding the availability and prior authorization of covered outpatient prescription drugs; and

* Recommend that CMS advise states that MCOs must use fee-for-service Medicaid pharmacy provider reimbursement rates as the minimum floor for reimbursement.

The National Community Pharmacists Association (NCPA(R)) represents the interests of America's community pharmacists, including the owners of more than 22,000 independent community pharmacies. Together they represent an $81.5 billion health care marketplace and employ more than 250,000 individuals on a full or part-time basis. To learn more, go to www.ncpanet.org