Thursday, June 28, 2007

States vs. CMS: No One Loses

The Average Manufacturer Price (AMP) issue made it all the way to page A6 in today's Wall Street Journal with States Are Taking Steps To Offset Medicaid Cuts.

The articles provides a concise summary of the legislative issues, highlighting the attempts by States to raise dispensing fees to offset the reimbursement cuts from the Deficit Reduction Act. I highlighted Iowa and Kansas last month in Topping Off AMP.

The article notes that CMS must approve any increases in state dispensing fees. I did not consider this point in my earlier posts, but it makes sense given the Federal government's role in financing and overseeing Medicaid.

So, let's see if I understand the situation. Elected officials in the states can pass laws to increase dispensing fees, earning the votes of pharmacists. But these same officials can then claim that the big bad Federal government will not approve the increases, leaving state budgets intact and reducing the Federal deficit as planned.

No one loses -- except retail pharmacists, of course.

Hmmm...that's quite a cynical thought. Perhaps I'd better stop watching The Daily Show every night.

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Resources

1) CMS publishes a useful summary of reimbursement methodologies and co-pays for each state on its web site. Here is the most recent one: Medicaid Pharmacy Reimbursement by State (Quarter Ending March 2007).

2) I added "Average Manufacturer Price (AMP)" to the topic list on the right hand side of the page so you can easily find previous posts.

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