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APhA INITIATES DIALOGUE WITH STATE ASSNS. ON MEDICAID Rx REFORM

Executive Summary

APhA INITIATES DIALOGUE WITH STATE ASSNS. ON MEDICAID Rx REFORM in anticipation of Health Care Financing Administration (HCFA) action on MAC/EAC overhaul. The American Pharmaceutical Association (APhA) will hold seven regional meetings, covering HCFA Medicaid regions, with state pharmacy association executives during the months of June and July. According to APhA, the objectives of the meetings are threefold: to provide state executives with background on Medicaid Rx reform, to obtain feedback to help APhA develop a national position on Medicaid reform, and to gather information on third party activities within various HCFA regions. HHS has set October 1 as a target for a Medicaid drug reform final rule ("The Pink Sheet," April 21, p. 4), and pharmacy group officials expect a notice of proposed rulemaking sometime soon ("The Pink Sheet," June 2, p. 5). Due to the tight deadline, a short comment period would be necessary. APhA policymakers are preparing the association to take a position based on the information give-and-take at the regional meetings. The APhA regional meeting program is designed to prepare state association executives for commenting on the proposed rule and for dealing with local Medicaid administrators, who will play an important role in implementing a new system. The agenda includes a background on Medicaid Rx reimbursement, analysis of third party induced cost shifting, chronology of recent Medicaid reform activities and summaries and comparison of the current MAC (Maximum Allowable Cost) program and the proposed Pharmacists Incentive Program (PhIP) and Competitive Incentive Program (CIP). APhA's Medicaid reform program is being accompanied by a newly issued book for states, "Medicaid Prescription Reimbursement Reform, 1985-1986." The book pulls together APhA reports on Medicaid presciption reimbursement reform; analysis of the PhIP and CIP models; a summary of the MAC Task Force report; a "National Pharmaceutical Association Coalition Statement" endorsing drug vouchers and marketplace pricing ("The Pink Sheet," June 2, p. 5) and April 9 testimony by APhA, the National Associaton of Chain Drug Stores and the National Association of Retail Druggists requesting HHS to investigate a "smart card" voucher system ("The Pink Sheet," April 21, T&G-1). Faculty of Colleges of Pharmacy Administration also have been invited, along with state association executives, to attend the free sessions. APhA started the program June 11 with a meeting in Sturbridge, Mass., covering states in HCFA Medicaid Region I. The last meeting will be July 17 in Atlanta.
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