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Pharmacy group sues over state's Medicaid fee cut

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A non-profit group for local pharmacies statewide is suing the state’s Medicaid office in federal court, attempting to block cuts to the fees given to local pharmacies participating in the Medicaid program.

Community Pharmacies of Indiana and Williams Brothers Healthcare Pharmacy in Southern Indiana filed a lawsuit July 1 in U.S. District Court for the Southern District of Indiana seeking a temporary restraining order and permanent injunction against Indiana Family and Social Services Administration’s Office of Medicaid Policy and Planning. The suit aims to stop the state from imposing a 38 percent cut in the Medicaid pharmacy-dispending fee, which would mean pharmacies would receive $3 instead of $4.90 for preparing and dispensing a particular drug.

If imposed, that cut would be in effect from July 1, 2011 until June 30, 2013, and the CPI says it could result in pharmacies closing. Such closings could put patients at risk who may not have access to their needed medications as a result.

“We don’t feel as though we have any choice,” said Nathan Gabhart, president of CPI that represents about 170 pharmacies statewide. “Litigation is always the last resort, and in this instance, it’s the only option left. We have a very real concern, based on our research, that this cut will force a number of pharmacies in Indiana to drop out of the Medicaid program and jeopardize many Medicaid patients’ access to the vital prescription drugs that they need to stay healthy and in some cases to stay alive.”

On top of this cut, the lawsuit says pharmacies already took a 34 cut on brand name medication reimbursement in September 2009.

The lawsuit alleges the cut violates federal Medicaid law because the state FSSA secretary didn’t approve the fee reduction as required and that also runs contrary to the Supremacy Clause of the U.S. Constitution. The suit also alleges the fee reduction violates Indiana Code 12-15-13-2, which states that Indiana Medicaid providers must offer services to program recipients similar to what the general population might receive.

Since the suit was filed July 1 challenging a cut designed to take effect that day, Judge Tanya Walton Pratt held an emergency hearing to hear initial arguments from both sides. The Attorney General’s Office had just received notice that day, and so the judge gave the state office until 4 p.m. July 6 to file a brief in the case before she decides on the temporary injunction that would halt the new cut.
 

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  1. A traditional parade of attorneys? Really Evansville? Y'all need to get out more. When is the traditional parade of notaries? Nurses? Sanitation workers? Pole dancers? I gotta wonder, do throngs of admiring citizens gather to laud these marching servants of the constitution? "Show us your billing records!!!" Hoping some video gets posted. Ours is not a narcissistic profession by any chance, is it? Nah .....

  2. My previous comment not an aside at court. I agree with smith. Good call. Just thought posting here a bit on the if it bleeds it leads side. Most attorneys need to think of last lines of story above.

  3. Hello everyone I'm Gina and I'm here for the exact same thing you are. I have the wonderful joy of waking up every morning to my heart being pulled out and sheer terror of what DCS is going to Throw at me and my family today.Let me start from the !bebeginning.My daughter lost all rights to her 3beautiful children due to Severe mental issues she no longer lives in our state and has cut all ties.DCS led her to belive that once she done signed over her right the babies would be with their family. We have faught screamed begged and anything else we could possibly due I hired a lawyer five grand down the drain.You know all I want is my babies home.I've done everything they have even asked me to do.Now their saying I can't see my grandchildren cause I'M on a prescription for paipain.I have a very rare blood disease it causes cellulitis a form of blood poisoning to stay dormant in my tissues and nervous system it also causes a ,blood clotting disorder.even with the two blood thinners I'm on I still Continue to develop them them also.DCS knows about my illness and still they refuse to let me see my grandchildren. I Love and miss them so much Please can anyone help Us my grandchildren and I they should be worrying about what toy there going to play with but instead there worrying about if there ever coming home again.THANK YOU DCS FOR ALL YOU'VE DONE. ( And if anyone at all has any ideals or knows who can help. Please contact (765)960~5096.only serious callers

  4. He must be a Rethuglican, for if from the other side of the aisle such acts would be merely personal and thus not something that attaches to his professional life. AND ... gotta love this ... oh, and on top of talking dirty on the phone, he also, as an aside, guess we should mention, might be important, not sure, but .... "In addition to these allegations, Keaton was accused of failing to file an appeal after he collected advance payment from a client seeking to challenge a ruling that the client repay benefits because of unreported income." rimshot

  5. I am not a fan of some of the 8.4 discipline we have seen for private conduct-- but this was so egregious and abusive and had so many points of bad conduct relates to the law and the lawyer's status as a lawyer that it is clearly a proper and just disbarment. A truly despicable account of bad acts showing unfit character to practice law. I applaud the outcome.

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