Walgreens: no new Medicaid Patients as of April 16

[bonnie]

Walgreens will stop taking new Medicaid patients in Washington state as of April 16, saying it loses money filling their prescriptions.

By Janet I. Tu

Seattle Times staff reporter

Effective April 16, Walgreens drugstores across the state won't take any new Medicaid patients, saying that filling their prescriptions is a money-losing proposition — the latest development in an ongoing dispute over Medicaid reimbursement.

The company, which operates 121 stores in the state, will continue filling Medicaid prescriptions for current patients.

In a news release, Walgreens said its decision to not take new Medicaid patients stemmed from a "continued reduction in reimbursement" under the state's Medicaid program, which reimburses it at less than the break-even point for 95 percent of brand-name medications dispensed to Medicaid patents.

Walgreens follows Bartell Drugs, which stopped taking new Medicaid patients last month at all 57 of its stores in Washington, though it still fills Medicaid prescriptions for existing customers at all but 15 of those stores.

Doug Porter, the state's director of Medicaid, said Medicaid recipients should be able to readily find another pharmacy because "we have many more pharmacy providers in our network than we need" for the state's 1 million Medicaid clients.

He said those who can't can contact the state's Medical Assistance Customer Service Center at 1-800-562-3022 for help in locating one.

Along with Walgreens and Bartell, the Ritzville Drug Company in Adams County announced in November that it would stop participating in Medicaid.

Fred Meyer and Safeway said their pharmacies would continue to serve existing Medicaid patients and to take new ones, though both expressed concern that the reimbursement rate is too low for pharmacies to make a profit.

The amount private insurers and Medicaid pay pharmacies for prescriptions isn't the actual cost of those drugs but rather is based on what's called the drug's estimated average wholesale price. But that figure is more like the sticker price on a car than its actual wholesale cost.

Washington was reimbursing pharmacies 86 percent of a drug's average wholesale price until July, when it began paying them just 84 percent. While pharmacies weren't happy about the reimbursement reduction, the Department of Social and Health Services said that move was expected to save the state about $10 million.

Then in September came another blow. The average wholesale price is calculated by a private company, which was accused in a Massachusetts lawsuit of fraudulently inflating its figures. The company did not admit wrongdoing but agreed in a court settlement to ratchet its figures down by about 4 percent.

That agreement took effect in September — and prompted a lawsuit by a group of pharmacies and trade associations that said Washington state didn't follow federal law in setting its reimbursement rate, and that that rate is too low. The lawsuit is pending.

"Washington state Medicaid is now reimbursing pharmacies less than their cost of participation," said Jeff Rochon, CEO of the Washington State Pharmacy Association.

Pharmacies that continue to fill Medicaid prescriptions at the current state reimbursement rate are "at risk of putting themselves out of business altogether," he said.

Information from Seattle Times archives was used in this report.

[karl]

Walgreens will stop taking new Medicaid patients in Washington state as of April 16, saying it loses money filling their prescriptions.

OK, all you who are pushing for more government intervention in healthcare.

Give us your wisdom on this. What could possibly have gone wrong with the benevolent healthcare dictatorship for the poor in the state of Washington? Your government is soooo good at fixing everything. Why is it that Walgreens still accepts private insurance as well as the horror of cash, credit cards and checks, but not Medicaid?

[rudywoofs (Pam)]

KARL

now just because the pharmacies are not accpeting

new medicare patients does not mean that all the

new people getting the new health coverage will

not be denied a few year down the road

wait let me do some more study on this

hhhmmmmmmm well hhhmmmmmmm well hhhmmmmmm well

after doing some study here it could happen

dgrimm60

Medicaid is NOT Medicare

[rudywoofs (Pam)]

They are talking about Medicaid patients, not Medicare patients. There are lots of pharmacies that will still take Medicaid patients. Walgreen's is a drop in the bucket.

[rudywoofs (Pam)]

Originally Posted By: bonnie

Walgreens will stop taking new Medicaid patients in Washington state as of April 16, saying it loses money filling their prescriptions.

OK, all you who are pushing for more government intervention in healthcare.

Give us your wisdom on this. What could possibly have gone wrong with the benevolent healthcare dictatorship for the poor in the state of Washington? Your government is soooo good at fixing everything. Why is it that Walgreens still accepts private insurance as well as the horror of cash, credit cards and checks, but not Medicaid?

Because Walgreens pharmacy cannot operate in the red. (But I'm not pushing for more govt intervention in healthcare.)

[bonnie]

They are talking about Medicaid patients, not Medicare patients. There are lots of pharmacies that will still take Medicaid patients. Walgreen's is a drop in the bucket.

Medicaid I believe is what welfare recipients are on.Most things do begin with a drop in the bucket.

Those truly in need of medicaid should not have to be penalized. There are many that do need help but it seems they get lost in the shuffle.

[Dottie]

My son is on medicaid. It was part of the adoption agreement. We are thankful for it, because he is on expensive drugs, one of which is a controlled substance. They don't make him a "regular kid" but do help him somewhat. But the medicaid is secondary payer to my husband's health insurance plan.

[Renewed_faith]

That is truly a terrible mistake for those who have a walgreens close to them, who sells their medications and now can not receive their medications there. I know some who do not have cars and if they did not have that walgreens close by, they have to either take a bus, AFTER walking half a mile or more in some instances with a baby or a toddler with them. I believe they are making a mistake not letting people get their medications. There are many who have now lost their jobs and can not find anything out there suitable for supporting a family. Even with both parents (should there be both parents) working it is hard to live on today's wages.

I wonder if this is somehow connected to the proposed medical reform Obama is introducing????

[karl]

I wonder if this is somehow connected to the proposed medical reform Obama is introducing????

No, it has to do with only one government healthcare program - Medicaid. The scary thing is that the only way we can prevent the government from doing this with all prescription coverage, or, for that matter, any aspect of our lives, is by having a citizenry that will vote the "bigger government" advocates out of office.

I'm hoping that will happen soon, but we keep hearing from libs that the government should be doing more, not less. Makes me wonder about the future of liberty.

As Adventists, we are traditionally in favor of religious liberty. But if we cede our other liberties to the control of the state, what is going to make the state stop at religious liberty?

Liberty is liberty. To say that you are not concerned about, say, private property rights, but are in favor of private religious rights can be very dicey. Unless, of course, your church and your church members don't own any property.

[Neil D]

Quote:

No, it has to do with only one government healthcare program - Medicaid. The scary thing is that the only way we can prevent the government from doing this with all prescription coverage, or, for that matter, any aspect of our lives, is by having a citizenry that will vote the "bigger government" advocates out of office.

So let me get this straight...

Walgreens, currently votes to reduce medicare payments to itself, by opting out of those same very low medicare payments.

Thus, those who can not get health care, or who have health care that choose not to cover people, are having a harder time getting thier medications.

And you want goverment out of all insurance [medicare, medicaid, reduce legislation toward insurance companys] so that NO ONE gets any insurance or what they get is bogus [ie money giveaway??]

Just how is this 'building up america' when you don't have an insurance program? How can America be the 'land of the free, home of the brave' when it has more of the 'land of the moneygrabbers, home of the poor'?

[karl]

Quote:

No, it has to do with only one government healthcare program - Medicaid. The scary thing is that the only way we can prevent the government from doing this with all prescription coverage, or, for that matter, any aspect of our lives, is by having a citizenry that will vote the "bigger government" advocates out of office.

Walgreens, currently votes to reduce medicare payments to itself, by opting out of those same very low medicare payments....

Just how is this 'building up america' when you don't have an insurance program? How can America be the 'land of the free, home of the brave' when it has more of the 'land of the moneygrabbers, home of the poor'?

Medicaid IS a government insurance program, Neil. Walgreens is not a fly-by-night outfit. Walgreens is not reducing payments to itself. It is cutting losses. It has determined that it loses so much money on filling Medicaid prescriptions that it cannot afford to accept this government insurance program. I'm sure Walgreens did not take this decision lightly. It is willing to take a little loss just to get people in the door. Obviously, the research shows that, even with other expenditures Medicaid recipients and those accompanying them might make, it is still a net loss.

The take-home message here is that this is the kind of thing you can expect with government in charge of healthcare. You may or may not pay less, but you will definitely GET less.

[Neil D]

Medicaid IS a government insurance program, Neil. Walgreens is not a fly-by-night outfit. Walgreens is not reducing payments to itself. It is cutting losses. It has determined that it loses so much money on filling Medicaid prescriptions that it cannot afford to accept this government insurance program. I'm sure Walgreens did not take this decision lightly. It is willing to take a little loss just to get people in the door. Obviously, the research shows that, even with other expenditures Medicaid recipients and those accompanying them might make, it is still a net loss.

The take-home message here is that this is the kind of thing you can expect with government in charge of healthcare. You may or may not pay less, but you will definitely GET less.

Hmmmm.....Like the insurance companys, it decides that it's not making the profit that it needs and closes the door to medicaid.

But the real question is what about the medicaid person? He needs those medicines to

1] get well so that he can get back to work

2] to maintain himself for whatever medical condition that he has so that he can get back to work

3] to maintain himself without dying

If he ain't well, he can't work. If he can't work, he will not be able to look for a job. If he can't get a job, he will not be paying his share of taxes. If he can't pay his share of taxes, then he might as well be dead. If you get enough people who cant work, you got a bigger drain on those that are working...which make for a slow tearing down of a nation.

So, again, where is this building up of America thru the removal of necessary items?

And you ain't gonna tell me that Walgreen's ain't making money on the medicaid people. They may not be making green stuff, but they will demand a lower cost to thier medicines thru the volume purchase...IOWs, the medicines that they get will cost less per pill than without the extra demand...

[karl]

And you ain't gonna tell me that Walgreen's ain't making money on the medicaid people. They may not be making green stuff, but they will demand a lower cost to thier medicines thru the volume purchase...IOWs, the medicines that they get will cost less per pill than without the extra demand...

Come on, Neil. Think for a minute. Walgreens pharmacy would gladly fill those prescriptions even if it were just a break-even proposition because to do so will get people in the store in hopes they will buy something else.

Do you seriously think Walgreens would turn down the immense volume of business that Medicaid represents unless they were actually losing money? What possible motive could they have for doing such a dumb thing???

[GreatLakesGramma]

That is truly a terrible mistake for those who have a walgreens close to them, who sells their medications and now can not receive their medications there. I know some who do not have cars and if they did not have that walgreens close by, they have to either take a bus, AFTER walking half a mile or more in some instances with a baby or a toddler with them. I believe they are making a mistake not letting people get their medications. There are many who have now lost their jobs and can not find anything out there suitable for supporting a family. Even with both parents (should there be both parents) working it is hard to live on today's wages.

I wonder if this is somehow connected to the proposed medical reform Obama is introducing????

It isn't reasonable to expect a private business to operate at a loss because the government refuses to pay them enough to cover their expenses. There are a lot of doctors around here who won't take Medicaid patients anymore for the same reason, and the number keeps growing all the time.

[Neil D]

Come on, Neil. Think for a minute. Walgreens pharmacy would gladly fill those prescriptions even if it were just a break-even proposition because to do so will get people in the store in hopes they will buy something else.

[karl]

Originally Posted By: karl

Do you seriously think Walgreens would turn down the immense volume of business that Medicaid represents unless they were actually losing money? What possible motive could they have for doing such a dumb thing???

Greed....

You're not making any business sense, Neil.

This is not confined to Walgreens. The Bartell chain was first out. Along with Walgreens and Bartell, the Ritzville Drug Company in Adams County announced in November that it would stop participating in Medicaid.

Fred Meyer and Safeway said their pharmacies would continue to serve existing Medicaid patients, though both expressed concern that the reimbursement rate is too low for pharmacies to make a profit.

Washington Medicaid was reimbursing pharmacies 86 percent of a drug's average wholesale price until July, when it began paying them just 84 percent. While pharmacies weren't happy about the reimbursement reduction, the Department of Social and Health Services said that move was expected to save the state about $10 million.

"Washington state Medicaid is now reimbursing pharmacies less than their cost of participation," said Jeff Rochon, CEO of the Washington State Pharmacy Association.

-----------

Your benevolent government using its clout to squeeze healthcare. Expect more of the same.