Yesterday, it was reported that Kroger, Target, Walmart and two independent pharmacy networks acting on behalf of more than 500 pharmacies have decided to drop the Employee Retirement System’s HealthSelect Network. This action will leave thousands of the state’s public employees and retirees looking for access to their prescription drug plan. The decision was triggered by ERS’ announcement that it would lower reimbursements
based on a reduced AWP methodology.
However, not all pharmacies or pharmacy groups have taken this drastic step. “I believe that serving my patients takes priority,” said Buda pharmacist and TrueCare Legislative team member Tammy Gray. “While I am not happy with the ERS’ decision, I believe that this issue will ultimately get worked out.”Historically, Texas pharmacy has been successful in presenting its case for reasonable reimbursement. “In the past, our arguments have resonated with state decision makers for pharmacy to be compensated fairly for the valuable services we provide,” said McAllen pharmacist and Texas TrueCare Legislative Council member Carlos Solis. “Our state leaders understand the importance of that reasoning, and we believe they will work to find the right solution to this issue,” added Solis, whose patients include many state and local government employees.
Texas TrueCare has been in contact with state leaders to help find an equitable remedy and on Thursday learned that several members of the legislature, including Sen. Leticia Van de Putte, Rep. Todd Hunter and Rep. Chuck Hopson, are sending a letter to ERS seeking a delay in the reduced reimbursement. To view the letter, visit www.TrueCareTexas.com.
“We will continue to work with the ERS to ensure community pharmacists are fairly compensated as an integral part of the health care delivery system,” said Jacksonville pharmacist and State Representative Chuck Hopson. Added Corpus Christi Rep. Todd Hunter, “I understand that there are competing interests between costs and providing
benefits, but I am confident that an equitable solution can be found.”
Texas TrueCare Government Affairs Director John Heal agreed. “We believe that once this issue gets fully aired, an agreement will emerge that protects the interests of independent pharmacy while continuing to provide pharmacy access to these important members of our communities.”
TriNet, a pharmacy third party network that represents hundreds of Texas pharmacies, was one of the few groups that chose not to opt out and leave state employees stranded without prescription coverage.
“Pharmacies affiliated with TriNet are open for business,” said Director of Third Party Programs Dale Smith. “While we do not support ERS in their initial decision, we believe that it is premature to leave patients out in the cold particularly during a horrific flu season. Our patients have been loyal to TrueCare pharmacies across Texas and we will continue to serve them.”
Smith said that the interests of TriNet members are always a top priority, but that too many variables exist to make a hasty decision at this point.
“Although we have reviewed preliminary analytical data from the ERS on the potential reduction in reimbursements,” Smith said, “we believe it is premature to take the drastic step of dropping enrollees without knowing the ultimate effect on our stores. We feel that further analysis is required to determine the overall business impact of the ERS decision for TriNet member pharmacies.”
The narrow margin of Texas Pharmacist Chuck Hopson’s victory is another example of how one election can make a difference in independent pharmacy’s ability to get its message to the decision makers of the future. We must be ready and able to work with both political parties and with a variety of different lawmakers to ensure that our voice will be heard. Today we must decide if we want to be participants, or spectators in the legislativeand regulatory arenas. Participants have a say in their destiny. Spectators watch from the sidelines and read tomorrow’s newspaper to find out what happened. We must be proactive, and not reactive.
In the past, many of you have shown a commitment to the future of pharmacy by supporting the Texas Pharmacy Survival Fund, which has been instrumental in protecting the interests of independent pharmacy. Today pharmacies continue to reap the rewards from the work of the Survival Fund as it expands its grassroots efforts to educate legislators, opinion makers and the general public on issues important to independent pharmacy. We need your help again. In January we will face another legislative session and we cannot afford to wait two months to begin getting out pharmacy’s message to new legislators and legislative leaders. There is much work to be done and pharmacy needs your help to ensure that we maintain our momentum. Our voices must be heard in Austin. Please make a contribution to the future of independent pharmacy through the Pharmacy Survival Fund. The stakes have never been so high.
Respectfully,
The TrueCare Legislative Council
