Pennsylvania Pharmacy 'Carve-out' Poses Risks for Commonwealth's Neediest Citizens and Taxpayers, National Organization Testifie

HARRISBURG, Pa., May 2 /PRNewswire-USNewswire/ -- The Association for Community Affiliated Plans (ACAP) is urging State lawmakers to reject a risky proposal by the State Department of Public Welfare to assume management of pharmacy benefits for as many as one million Medicaid enrollees in the Commonwealth.

"We strongly oppose Pennsylvania's efforts to carve prescription drugs away from the health plans and urge the Commonwealth to maintain the integrity of coordinated care by ensuring that prescription drugs remain part of a holistic strategy of care management," Margaret A. Murray, ACAP Chief Executive Officer told lawmakers in testimony before House and Senate Health Committees of the Pennsylvania legislature this week.

Murray encouraged State lawmakers to endorse federal legislation, the Drug Rebate Equalization Act, that would allow plans to access federal drug rebates. Currently, as a result of an outdated federal law, states get much higher rebates from the drug manufacturers than plans do. By carving drugs out of the capitation, states will get higher rebates but will lose the benefits that the plans provide of care management, data collection, and consideration of more cost effective generic alternatives. If Congress passed the Drug Rebate Equalization Act, plans would get the higher rebates as well, passing savings on to states and the federal government. The bill has been endorsed by four Pennsylvania lawmakers -- Representatives Brady, Doyle, Fattah, and Platts.

The Department of Public Welfare has tried for the last two years to assume responsibility for managing prescription benefits for Medicaid recipients. In each of the past two years, the General Assembly has overwhelmingly rejected the proposal.

A complete copy of Ms. Murray's testimony, along with a Lewin Group study examining the costs and benefits of pharmacy "carve-outs" can be found at http://www.communityplans.net.

ACAP is a national trade association representing "safety net health plans" that non-profit or owned by not-for-profit providers and are Medicaid-focused. ACAP represents 37 plans serving over 4.5 million Medicaid beneficiaries in 21 states.

SOURCE Association for Community Affiliated Plans

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.