Battle Over Medi-Cal Payments to Pharmacists Set To Continue
Pharmacists expressed disappointment at the Ninth U.S. Circuit Court of Appeals decision to revoke a temporary injunction that would have halted a 10% Medi-Cal pay cut for pharmacists, but the court will hear arguments in the matter again this week, the Oakland Tribune reports. Medi-Cal is California's Medicaid program.
On July 11, the appeals court issued a temporary injunction, barring the state from cutting payments to pharmacists, but the court revoked the injunction on Wednesday after attorneys for the Department of Health Care Services argued that the injunction would cost the state more than pharmacists would lose under the payment cuts.
DHCS administers Medi-Cal (Bohan, Oakland Tribune, 7/19).
The Legislature and Gov. Arnold Schwarzenegger (R) approved a 10% cut in Medi-Cal provider payments in February to help address the state budget deficit (California Healthline, 7/18).
In the hearing scheduled for this week, the Tribune reports that the court could reinstate the injunction, providing time for pharmacists to petition lawmakers for legislation to reinstate the pay cuts. Alternatively, the court could allow the state to continue using the reduced reimbursement rates.
Lynn Rolston, CEO of the California Pharmacy Association, said the payment cuts will make it difficult for small pharmacies to serve Medi-Cal beneficiaries, especially to provide brand-name drugs.
Rolston said beneficiaries who need medications to manage HIV/AIDS, diabetes, cancer and serious mental illnesses could face serious problems finding pharmacists to fill their prescriptions, possibly leading to conditions that will be more expensive to treat.
Michael Polzin -- a spokesperson for pharmacy chain Walgreen, which operates 486 stores in California -- said Walgreen would continue to fill Medi-Cal prescriptions even though the reduced reimbursements do not cover the store's costs. Polzin said some smaller pharmacies have begun directing Medi-Cal beneficiaries to Walgreen to get their brand-name prescriptions filled.
Toby Douglas, deputy director of health care policy for DHCS, said that a joint legislative budget committee is considering a proposal that would revisit the Medi-Cal rate reductions. Instead of the 10% cuts for all health care providers, effective Sept. 1, the proposal would impose:
- 5% cuts for pharmacists; and
- 1% cuts for other health care providers, including physicians and dentists.
Douglas did not speculate about the proposal's chances for winning approval (Oakland Tribune, 7/19).
On Saturday, the Fresno Bee published recommendations for addressing health care in California from local health care leaders. Responses ranged from universal health care to better use of health information technology (Anderson , Fresno Bee, 7/19).
Experts worry that cuts to Medi-Cal will have particularly strong effects on the San Joaquin Valley, which already faces a shortage of health care providers (Anderson , Fresno Bee, 7/19).