Here we go again with the battle of the contracts and restricting patients to where they can and can’t go.  When all of this started it was not so bad years ago but now that business intelligence hasimage entered the picture so strongly, the choices are getting fewer and the association here states the contract did not have federal approval.  CVS was put on notice that they would no longer be reimbursed for Medicaid prescriptions.  WellPoint just bought Amerigroup for just under $5 billion.  Contract says to patients shift gears again.  They did say other independent pharmacies and other chains would be added…wait till the contract business intelligence numbers are calculated to see which ones I guess.  BD

WellPoint to Buy Amerigroup for $4.9 Billion As the Battle for Medicare and Medicaid Management Contracts/Exchanges Continues Between Two Major Health Insurers–Subsidiary Watch

The Florida Pharmacy Association is suing the Agency for Health Care Administration for what it says amounts to no longer allowing Medicaid patients to use pharmacies of their choice.

The lawsuit, filed on behalf of a host of local pharmacies and Medicaid patients, says that a contract ACHA entered with Amerigroup – a Medicaid HMO – was done without needed federal approval.

After inking its contract with the state, Amerigroup, whose affiliated pharmacy is CVS, notified several pharmacies that serve Medicaid patients they would no longer be reimbursed under the company’s Medicaid pharmacy network.

“Amerigroup has made a business decision to add a number of new independent and chain pharmacies to their network and terminate other,” read ACHA’s letter.

Opponents of the move see it as a dangerous shift of Florida’s at risk patients to for-profit HMOs.

“  Medicaid was designed to be the health insurer of last resort…Such patients cannot be relegated to for-profit HMOs lightly and certainly not outside of the standards and safe-guards established by law,” said Michael Jackson, CEO and executive vice president of the Florida Pharmacy Association.


Post a Comment

Google Analytics Alternative