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Sunshine State News: Allow Vulnerable Medicaid Recipients to Choose Their Pharmacies

Friday, February 05, 2016


Most recently, many health insurance providers have drastically restricted Medicaid Managed Care networks throughout Florida. Those restrictions are forcing patients to leave their trusted pharmacist and go to a pharmacy their health plan chooses for them. Such unnecessary restrictions limit consumer choice, restrict healthy business competition and prevent access to community pharmacies.

According to the Agency for Healthcare Administration’s (AHCA) Managed Medical Assistant Program’s most recent report, there could be nearly 3 million Floridians displaced and forced to change pharmacies. Staywell Health Plan of Florida has already contacted patients to change pharmacies and they service 694,384 people in the state.

According to National Community Pharmacists Association, restrictive networks could cost Florida nearly 13,000 jobs and almost $5 billion in small business revenue.
Something needs to be done this legislative session to prevent restricting Medicaid Managed Care pharmacy networks. SB 780 and HB 583 address the mail order requirement for chronically ill patients and this legislation is a good start; however it does not go far enough to alleviate the larger problem.

Instead of patients and their families being able to focus on their health and getting better, they will be switching pharmacies and may have to drive up to 45 miles to a pharmacy chosen by their insurance provider. That would cause difficulties for Florida’s most vulnerable population, Medicaid recipients, many of whom have transportation challenges, are home-bound, in assisted living facilities or need special pharmaceutical services only available from their local pharmacy — such as delivery of medications and special packaging.

It is imperative that leaders in the Florida Legislature act quickly to ensure that patients can continue to access their community pharmacies. We also need to protect Florida’s small business community and prevent local pharmacies from leaving the state or being forced to close their doors.

We need legislation that will allow Medicaid patients to choose their pharmacy and fix this flawed approach. We encourage people who are experiencing this challenge to file complaints with AHCA (here) and reach out to your lawmakers (as these pharmacies and patients have already done) and tell them you want to choose your own pharmacy.

Bill Mincy, national board chairman and Florida advocate for Pharmacy Choice and Access now, and vice president of PPSC. 

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