ILNews

Pharmacy group sues over state's Medicaid fee cut

Back to TopCommentsE-mailPrintBookmark and Share

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.
 

ADVERTISEMENT

Post a comment to this story

COMMENTS POLICY
We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
 
You are legally responsible for what you post and your anonymity is not guaranteed.
 
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in Indiana Lawyer editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
 
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
 
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.
 

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by
ADVERTISEMENT
Subscribe to Indiana Lawyer
  1. IF the Right to Vote is indeed a Right, then it is a RIGHT. That is the same for ALL eligible and properly registered voters. And this is, being able to cast one's vote - until the minute before the polls close in one's assigned precinct. NOT days before by absentee ballot, and NOT 9 miles from one's house (where it might be a burden to get to in time). I personally wait until the last minute to get in line. Because you never know what happens. THAT is my right, and that is Mr. Valenti's. If it is truly so horrible to let him on school grounds (exactly how many children are harmed by those required to register, on school grounds, on election day - seriously!), then move the polling place to a different location. For ALL voters in that precinct. Problem solved.

  2. "associates are becoming more mercenary. The path to partnership has become longer and more difficult so they are chasing short-term gains like high compensation." GOOD FOR THEM! HELL THERE OUGHT TO BE A UNION!

  3. Let's be honest. A glut of lawyers out there, because law schools have overproduced them. Law schools dont care, and big law loves it. So the firms can afford to underpay them. Typical capitalist situation. Wages have grown slowly for entry level lawyers the past 25 years it seems. Just like the rest of our economy. Might as well become a welder. Oh and the big money is mostly reserved for those who can log huge hours and will cut corners to get things handled. More capitalist joy. So the answer coming from the experts is to "capitalize" more competition from nonlawyers, and robots. ie "expert systems." One even hears talk of "offshoring" some legal work. thus undercutting the workers even more. And they wonder why people have been pulling for Bernie and Trump. Hello fools, it's not just the "working class" it's the overly educated suffering too.

  4. And with a whimpering hissy fit the charade came to an end ... http://baltimore.cbslocal.com/2016/07/27/all-charges-dropped-against-all-remaining-officers-in-freddie-gray-case/ WHISTLEBLOWERS are needed more than ever in a time such as this ... when politics trump justice and emotions trump reason. Blue Lives Matter.

  5. "pedigree"? I never knew that in order to become a successful or, for that matter, a talented attorney, one needs to have come from good stock. What should raise eyebrows even more than the starting associates' pay at this firm (and ones like it) is the belief systems they subscribe to re who is and isn't "fit" to practice law with them. Incredible the arrogance that exists throughout the practice of law in this country, especially at firms like this one.

ADVERTISEMENT