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

facebook - twitter on Facebook & Twitter

Indiana State Bar Association

Indianapolis Bar Association

Evansville Bar Association

Allen County Bar Association

Indiana Lawyer on Facebook

facebook
ADVERTISEMENT
Subscribe to Indiana Lawyer
  1. KUDOS to the Indiana Supreme Court for realizing that some bureacracies need to go to the stake. Recall what RWR said: "No government ever voluntarily reduces itself in size. Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we'll ever see on this earth!" NOW ... what next to this rare and inspiring chopping block? Well, the Commission on Gender and Race (but not religion!?!) is way overdue. And some other Board's could be cut with a positive for State and the reputation of the Indiana judiciary.

  2. During a visit where an informant with police wears audio and video, does the video necessary have to show hand to hand transaction of money and narcotics?

  3. I will agree with that as soon as law schools stop lying to prospective students about salaries and employment opportunities in the legal profession. There is no defense to the fraudulent numbers first year salaries they post to mislead people into going to law school.

  4. The sad thing is that no fish were thrown overboard The "greenhorn" who had never fished before those 5 days was interrogated for over 4 hours by 5 officers until his statement was illicited, "I don't want to go to prison....." The truth is that these fish were measured frozen off shore and thawed on shore. The FWC (state) officer did not know fish shrink, so the only reason that these fish could be bigger was a swap. There is no difference between a 19 1/2 fish or 19 3/4 fish, short fish is short fish, the ticket was written. In addition the FWC officer testified at trial, he does not measure fish in accordance with federal law. There was a document prepared by the FWC expert that said yes, fish shrink and if these had been measured correctly they averaged over 20 inches (offshore frozen). This was a smoke and mirror prosecution.

  5. I love this, Dave! Many congrats to you! We've come a long way from studying for the bar together! :)

ADVERTISEMENT