Texas Can Not Afford Managed Care for Pharmacy
Visit the following link to find your elected official
http://www.fyi.legis.state.tx.us/Pharmacy Carve Out Serves Patients, Saves Money, Saves Jobs
SB 23 by Senator Jane Nelson (R)-Flower Mound has now gone to the Texas House for consideration. As it stands now, the Texas Medicaid Vendor Drug Program will be pushed to managed care and administered by a Pharmacy Benefit Manager (PBM). According to a recent study by the Perryman Group, moving the VDP program into managed care would have an extreme negative impact on the state’s economy, eliminating approximately 43,000 jobs and resulting in a $3.1 billion hit on the economy. Now is the time for pharmacists across the state to contact their representatives in the Texas House to advocate for keeping the Vendor Drug Program CARVED OUT of managed care
Strong-arming of Pharmacies by PBMs under a managed care system, coupled with proposed reductions in Medicaid reimbursements for pharmacies could result in the closure of the pharmacy you work for.
Visit the following link to find your elected official
http://www.fyi.legis.state.tx.us/
Saves the Texas Medicaid vendor drug program and Texas Taxpayers millions of dollars in administrative costs by preventing a carve-in of pharmacy services to a restricted Medicaid managed care network
How Pharmacy Carve Out Serves Patients, Saves Money and Jobs . . .
Serves Patients
The Texas Health and Human Services Commission’s Vendor Drug Program permits all Texas Pharmacies to participate as providers in the Medicaid prescription drug program. This policy ensures that Medicaid recipients have access to their medications and adhere to their prescription regimen. Many studies have shown that failing to follow proper medication therapy increases hospital visits and drives up healthcare costs. Texas can ill afford to incur avoidable health care expenditures at a time when so many services are being cut or reduced. In addition, pharmacy has been carved out of Medicaid managed care since its inception.Saves Money
HHSC has shown that the Vendor Drug Program can save nearly $73 million dollars by implementing cost savings measures within the agency. This can be done without statutory change and without disruption to a system that supports some of our most fragile and vulnerable Texans. It can also be done without handing one of the nation’s finest pharmacy programs over to a Pharmacy Benefit Manager (PBM).
Conversely, collection of additional Premium Tax is the driving economic force behind the push to managed care. Semantics will not change the fact that this revenue is a tax, not “cost savings”. Collection of this tax revenue is dependent on the federal government through federal matching and the soundness and sustainability of this tax, even in the short term, is questionable. Policy experts from across the political spectrum are strongly advocating for a complete overhaul of federal Medicaid funding. There is current discussion about funding state Medicaid programs through block grants by U.S. Rep. Paul Ryan, many state governors as well as well as the Texas Public Policy Foundation. If this happens, Texas would be left to fill a $56 million hole left behind by reliance on the premium tax. In addition, the state would be contractually obligated to pay a managed care organization $47.6 million dollars a year for services that the state had operated superlatively for less than $1.2 million a year.
Saves Jobs
According to a report recently issued by the Perryman Group, between 770 and 1,150 independent or small chain pharmacies would close their doors if the Vendor Drug Program is pushed to managed care. These pharmacies would primarily be in small towns scattered across Texas. The Group reports that that the associated ripple effect would mean the loss of between 43,000 and 65,500 jobs in Texas - again mostly in small towns and rural communities where population contraction and economic stagnation are continuing problems.
