Salisbury pharmacies decry new Medicaid controls

Independent pharmacists have begun a local campaign to raise awareness of their importance in the face of a Medicaid change they fear will hurt some customers.

Pharmacies were informed by fax – and blindsided, one said – that Medicaid patients who have the managed-care organization United Health Care will no longer get prescriptions filled at independent pharmacies.

Beginning April 1, only Walmart, CVS and Giant pharmacies will be permitted to fill them.

“We are not happy about the change,” said Melissa Batie Johnson, operations manager at Riverside and Milford Street Pharmacies.

“This means customers won’t be able to get delivery anymore. If they can’t get their prescriptions delivered we’re not sure how they’re going to do it,” she said.

“We are concerned about the population that is under-resourced, with no reliable transportation. There is a health concern of making sure these folks get their medicine and get it as they are supposed to. It’s the independent pharmacies that offer free delivery,” Johnson said.

“A lot of people who aren’t in that position think of that as a luxury and it’s not. It’s not. It’s necessary,” Johnson said.

Only Medicaid patients who have United Health Care as a managed care organization will be affected. There will be no change for Medicare patients.

Johnson didn’t know the number of customers who will be impacted at her two pharmacies, but said it will be significant.

“What is more frightening than the number is the Department of Health and Mental Hygiene’s response when local pharmacies asked about it and said, ‘Hey, wait.’ They said, ‘No, that’s fine. In rural areas it’s OK for Medicaid patients to drive up to 30 miles to get their prescriptions.’ This decision was made by United Health Care, but it was the Department of Health that said, ‘Yes, that’s fine,’” she said.

“It isn’t always the elderly who need delivery. It can be younger people who have no transportation or no reliable transportation who are dealing with chronic illness. “

Jeff Sherr, pharmacist and owner of Apple Discount Drugs, wrote a letter of concern to local media.

“If you think you have to wait for your prescription at chain pharmacies now, can you imagine what it will be like when nearly half of the pharmacies in the state of Maryland won’t be able to fill those UHC Medicaid prescriptions?” Sherr wrote.

“There’s not much we can do. We have been contacting  the governor’s office and the Department of Health and Mental Hygiene, asking patients to let legislators know they are unhappy, to let health care know,” Johnson said.

Last week, she said, two bills were introduced in the Maryland House. One seeks to reduce geographic requirements for access to care. The other asks the legislature to enforce provider laws.

“It is important for the health of our collective patients and it’s absolutely critical for small  businesses,” Johnson said.

She said there about 350 independent pharmacies in the state and about a dozen in Wicomico County, each with hundreds of customers.

“This has caused a lot of upset for them.  A lot of them don’t want to change because it took a long time to get their health insurance in place,” she said.

“We found out this month. We were shocked. We were absolutely blindsided. We started right then with phone calls and letters,” she said.

It could also lead to layoffs, since drivers are hired to deliver prescriptions.

Sherr said United Health Care managed to convince state officials that the measure will save money.

“It is very shortsighted for the patients of the Eastern Shore, with negative consequences to occur. In their haste, they neglected to assure practical access for these patients,” he wrote.

“Those who are disabled and depend on delivery as well as those without transportation will suffer. Drugs don’t work if you don’t take them and if you can’t get them, the results will be increased healthcare costs with hospitalizations as a reality. It obviously makes no sense to save on drug costs but in turn increase total healthcare expenditures with hospitalization,” he said.

“If you’re an existing UHC MCO patient, you can change to another state MCO by calling 800-977-7388, and choose Option #3,” he advised.

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