WSL Future of Health Event

Retail Rx wins fight with CMS

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WASHINGTON — The Centers for Medicare & Medicaid Services has issued a final rule that withdraws provisions of the Medicaid pharmacy reimbursement formula using the average manufacturer price (AMP) model.

The Centers for Medicare & Medicaid Services has issued a final rule that withdraws provisions of the Medicaid pharmacy reimbursement formula using the average manufacturer price (AMP) model.

The move is a triumph for retail pharmacy after three years of effort by the National Association of Chain Drug Stores (NACDS) and National Community Pharmacists Association (NCPA).

The new final rule removes provisions of a rule issued in 2007 that threatened major cuts to pharmacy reimbursement. It was blocked by an injunction secured by a lawsuit filed by NACDS and NCPA.

"The end result is not an increase in reimbursement for pharmacy, but rather the lessening of cuts that previously would have involved pharmacies selling most generic drugs at a loss, thereby threatening their long-term ability to provide patient care and access," said NACDS president and chief executive officer Steven Anderson and Kathleen Jaeger, executive vice president and chief executive officer of NCPA.


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