NACDS, NCPA urge guidance for states on Medicaid reimbursements

NACDS expresses concerns about using AMP as basis for reimbursements

ALEXANDRIA, Va. — Two groups representing the retail pharmacy industry are urging the federal government to provide guidance to the states on how to adjust Medicaid dispensing fees to determine pharmacy reimbursement.

Following a meeting with the Centers for Medicare and Medicaid Services, the National Association of Chain Drug Stores and the National Community Pharmacists Association sent a letter to the agency stressing what they called the importance of providing the guidance promptly, before the government finalizes current draft federal upper limits based on average manufacturer price.

"Addressing pharmacy reimbursement comprehensively, both the cost of the drug product and the cost of dispensing, is critical to maintaining access to pharmacy services for our Medicaid patients," read the letter, signed by representatives of both groups and addressed to Cindy Mann, CMS administrator and director for the Center for Medicaid, CHIP and Survey and Certification.

In addition, NACDS said it was reviewing a rule proposed by CMS on Medicaid pharmacy reimbursement using the AMP model, which the Patient Protection and Affordable Care Act redefined. "NACDS is currently reviewing the proposed rule with its members and will provide comments to CMS based on this analysis," NACDS president and CEO Steven Anderson said. "However, NACDS has long expressed concerns with using AMP as a basis for pharmacy reimbursements, as it is not a price paid in the marketplace but instead is a benchmark to determine manufacturer rebates in the Medicaid program."

 Click here to read the letter.

Check out the full proposed rule from CMS here.


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