Attorney general will investigate pharmacists' complaints about reimbursements | Arkansas Blog

Thursday, February 8, 2018

Attorney general will investigate pharmacists' complaints about reimbursements

Posted By on Thu, Feb 8, 2018 at 4:43 PM

click to enlarge COMPLAINTS: Pharmacists turned out at force at the Capitol last week for hearing on drug reimbursement practices under Medicaid. - KARK
  • KARK
  • COMPLAINTS: Pharmacists turned out at force at the Capitol last week for hearing on drug reimbursement practices under Medicaid.

Attorney General Leslie Rutledge
says she will review Arkansas pharmacists' complaints about insufficient reimbursements for drugs set by CVS Caremark, a pharmacy benefit manager.

Rutledge echoed pharmacists' complaint at a Capitol hearing last week that the reimbursements didn't cover the cost of the drugs covered by Medicaid under the Arkansas Works plan. The situation had already developed (and a similar complaint has been made in other states) but it worsened when Blue Cross, which covers more people in the state, adjusted its reimbursement system. It had been paying for cost of the drug and an administrative fee, but had cut reimbursements to hold down costs under pressure from the state to reduce Medicaid expenditures. A major complaint concerned cuts in the reimbursements for cheaper generic drugs.

Blue Cross uses Caremark as a pharmacy benefits provider. Caremark told the Arkansas Democrat-Gazette that it makes money on 18 percent of prescriptions, loses on 9 percent and breaks even on the rest.

Rutledge has taken the side of the Arkansas pharmacists.

Earlier this year, the Attorney General began reviewing reports that CVS Caremark reduced its reimbursement rate for pharmacies in the Arkansas Health Insurance Marketplace. In roughly 20 percent of prescription fills, prescription reimbursement rates reportedly dropped lower than purchase costs. Local pharmacists are forced to cover the additional costs of these rate changes, which impacts their bottom line and could lead to these businesses closing their doors. Investigators and attorneys have requested information pertinent to establishing if the reimbursement rate change triggers provisions of Arkansas’s Deceptive Trade Practices Act

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