KFDA - NewsChannel 10 / Amarillo News, Weather, SportsMedicaid changes mean trouble for independent pharmacies

Medicaid changes mean trouble for independent pharmacies

NewsChannel 10

Amarillo, Texas - Major Medicaid cutbacks in Texas could force some pharmacies in our area to shut their doors.

The managed care plan will significantly reduce the amount a pharmacy receives from the state for filling medicaid prescriptions.

The new plan is leaving pharmacies faced with a decision and it's not an easy one, to lose a lot of money or to stop accepting Medicaid patients.

Pharmacist Roger Wann says, "They need to talk to small town pharmacists and find out exactly what's going on. It's not the same as it is in Houston and Dallas and other places because some of these people have to drive a long way just to get to a pharmacy."

The managed care plan could lower dispensing fees by as much as 80 percent.

Pharmacist Robin Johnson explains, "Our reimbursement at this time is approximately $7.37 for each prescription. If they reduce my fees as they are talking about doing, we will get paid $1.47 for each prescription we fill."

It costs a pharmacy about $9 to fill a prescription. That's a huge loss for any pharmacy, but especially for those independently owned or that compound medications which are complicated and expensive to make.

Johnson says, "We will not stop compounding prescriptions for Medicaid. That need needs to be filled. We will fill at a loss, compounded prescriptions."

It's an even bigger loss for pharmacies like Roger's in Dumas, where a quarter of its customer base is on Medicaid.

Wann explains, "You cannot stay in business with a reimbursement of $1 or $1.25 for a prescription. We want to be here to help people, but if they cut it so much that we would literally lose money to fill the prescriptions, then independent pharmacies could not do that and that would limit access to the patients."   

Many fear it could cause some pharmacies to cut hours and employees or worse, close their doors.

This plan is expected to go into effect March 1st.