Pain in the Meds

Drug-store chains aren't getting very far in their effort to squeeze more money from Medicaid in this state.

The ongoing effort by area pharmacies to get Washington to pay more for Medicaid prescriptions hasn't been terribly successful so far—in court or in the capital.Bartell Drugs' line in the sand, drawn at 15 of its 57 stores, took effect on Feb. 1, when it stopped filling Medicaid prescriptions, as previously threatened. But the state has heard almost no reaction from patients, according to Jim Stevenson, a spokesperson for the Department of Social and Health Services, who says the state quickly identified alternative pharmacies nearby that patients could go to.Walgreens, which was due to pull the plug on Medicaid prescriptions at 64 stores on Feb. 15, announced three days before that deadline that it was extending the deadline until March 15, pending talks with the state.Meanwhile, a federal judge has issued a stinging preliminary ruling against pharmacy trade groups that have sued Washington over the issue.The groups' claim rests in part on the notion that more pharmacies will stop offering services to Medicaid clients. In a ruling last month denying the groups' request for an injunction, Judge Richard Jones said that he wasn't convinced pharmacies would carry through on their threats. And he was right: The same day, Walgreens announced it was backing down from its Medicaid cutoff, at least temporarily.Jones bluntly told the pharmacy groups that he didn't think they would ultimately prevail with their suit. "Perhaps the most striking aspect of plaintiff's evidence is that they offer not so much as a word from any Medicaid patient about the effect of the pharmacy cutbacks. This omission is critical, because [Medicaid] is not a guarantee of revenue for pharmacies, it is a guarantee of pharmacy service for patients."Rather than offering to compromise on the reimbursement rate, Walgreens has offered suggestions for what the state should do to fund higher payments to pharmacies—like encouraging the use of cheaper generics by requiring patients to make a co-payment for brand-name drugs. That's a broad policy change which would probably require a federal waiver, according to Stevenson, who nonetheless says administrators are reviewing Walgreens' suggestions.

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