Pharmacies File Suit Against Texas Human and Health Services Commission

Posted by Cary Byrd

Lopez Pharmacy has been open for business in Brownsville for the past eight years. A team of three pharmacists and eight technicians help service about 5,000 patients - most who depend on Medicaid - according to owner and lead pharmacist Jose Luis Lopez. "Per day, we roughly expedite about 300 to 450 prescriptions," Lopez said. However Lopez said all that could change when legislature goes into effect on March 1. He said currently, when Medicaid patients fill their prescriptions, pharmacies bill the state directly. They also bill the state for costs of any other services they offer the community, such as home delivery. In an attempt to save money in healthcare costs, the state will now have HMO's and managed care managers bill the pharmacies. Pharmacist said this will reduce their reimbursement by as much as 50 to 90 percent, "(That) in turn will make us make decisions of either reducing our services, laying off employees, maybe even some people are considering closing," Lopez said. Lopez Pharmacy is one of the hundreds of pharmacies represented by American Pharmacies organization, which has filed suit against this new state measure. Lopez said the new laws are not transparent and Medicaid patients have not had enough time to adjust. "That's our main issue behind this lawsuit," Lopez said. "Sometimes the reimbursement models through the pharmacy benefit managers, is not transparent enough to let us know what we're getting reimbursed. Consequently, forcing to sign into a contract that we don't know exactly how we're going to get reimbursed." Lopez said for the sake of small pharmacies and patients who need their medications, he hopes the state will push back the date these new laws go into effect by six months to a year.