Pharmacists Sue CMS over Medicaid Drug Cuts
WASHINGTON–Trade organizations representing chain drug stores
and community pharmacists have brought suit against CMS to block
more than $8 billion in Medicaid drug reimbursement cuts scheduled
over the next five years.
In their lawsuit, filed Nov. 7 in the U.S. District Court for
the District of Columbia, the National Association of Chain Drug
Stores and the National Community Pharmacists Association argue
that CMS’ final AMP (average manufacturer price) rule, published in
the Federal Register in July, violates the Social Security
Act and will result in the closure of thousands of pharmacies
nationwide. (See
HomeCare Monday, July 16.)
The groups said that the AMP rule, set to take effect in
January, contradicts the language of the Social Security Act by
inappropriately including dozens of prescription transactions that
do not fit within the rule’s definition, such as sales to patients
and physicians. The rule will result in reimbursement for Medicaid
generic drugs at a rate 36 percent below those drugs’ acquisition
costs, the groups said.
“We’re being asked to lose money on almost every generic we
dispense,” Charles Sewell, NCPA’s senior vice president of
government affairs, told reporters in July. Sewell estimated that
2,300 NCPA members could be forced to close their doors if the rule
is implemented.
In a joint letter to Congress about the lawsuit, the trade
groups–which represent 62,000 community pharmacies–called
implementation of the rule “an impending crisis …We cannot risk
the potential that patients will not receive the medications they
need, as this creates unacceptable human costs and higher health
care costs in the form of emergency room visits and other
catastrophic care.”
The lawsuit asks for a court order declaring the AMP rule
illegal, as well as for permanent relief against its implementation
and against the posting of AMP data based on the rule.
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