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Tallahassee Democrat: For smart health care, protect our pharmacies

Friday, July 15, 2011

State laws are bringing sweeping changes to Florida’s health care system that will affect access to quality pharmacy and health care services for each and every person even sooner than the much debated federal laws.

With the need to balance the state budget, Florida officials are calling for a shift of the state’s Medicaid program to managed care while simultaneously pushing for expanded mandatory mail-order laws. A similar program was put into place for state employees.

Without proper precaution, these new laws could have a negative effect on Florida based businesses and even the most fundamental pharmacy care and services to which you and your family are accustomed. What Floridian’s should be aware of is that some of these new laws do not guarantee monetary savings for the state, but their potential to cost Florida jobs and eliminate individual health care choices is very real.

Floridians must have a voice through all of these changes, and that is why the Florida Pharmacy Association has joined the Pharmacy Choice and Access Now (PCAN), a coalition of consumers, local businesses and pharmacists from across the nation committed to preserving quality and affordable health care and pharmacy services for patients. Members will be speaking at the coalition’s inaugural Florida news conference today in Tallahassee.

To understand the true impact of Florida’s new health care laws, take into consideration the structure of the new managed care system for Florida Medicaid patients. Under the new laws, the administrators of this new system, known as managed care organizations (MCOs) and pharmacy benefit managers (PBMs), have the ability to arbitrarily pick and choose which pharmacy providers will have the opportunity to serve Medicaid patients, even excluding pharmacies that agree to the terms and requirements set forth in the provider contract.

This could render community-based pharmacies unable to serve Medicaid patients, reducing critical access to care for patients from pharmacies that provide critical  value added services and threatening Florida jobs.

When the potential for this type of anticompetitive behavior under managed care is coupled with Florida’s mandate that all Medicaid patients and state employees use out-of-state, mail-order companies to fill their prescriptions, the potential for serious harm to Florida’s local, trusted,
community-based pharmacies becomes apparent.

With this unnecessary loss of business to out-of-state companies, the mom-and-pop pharmacy in your community may be forced to shut its doors.  Further, because mail-order companies are subject to the same rules as your local pharmacy, taxpayers may see little to no savings.

Simple, common-sense solutions are necessary to meet the intent of enacted legislation. Such sensible solutions that can be incorporated into Florida’s new health care law include making mail-ordered prescriptions optional for Medicaid patients and state employees and allowing patients
to obtain 90-day refills from their local pharmacies. In addition, any pharmacy that can demonstrate value-added services and has a history of playing by the rules should be able to serve Medicaid patients without being rejected simply because it is a small business.

The protection of Florida patients and small businesses, and ensuring access to quality care, should be essential pillars of Florida health care law, and I urge our lawmakers to adopt these much-needed protections as quickly as possible.

ABOUT THE AUTHOR: Michael Jackson is the executive vice president of the Florida Pharmacy Association.

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