ALEXANDRIA, Va. (April 2, 2021) — The National Community Pharmacists Association is urging New York Gov. Andrew Cuomo and leaders of the New York Senate and Assembly not to delay implementation of the Medicaid pharmacy benefit “carve-out,” in which pharmacy benefits would be administered under the state’s transparent fee-for-service program.
In a letter to Cuomo, Senate Majority Leader Andrea Stewart-Cousins, and Assembly Speaker Carl Heastie, Anne Cassity, NCPA Vice President, Federal and State Government Affairs, pointed out that New York paid $605 million in unnecessary costs over four years to PBMs, and that other states that enacted a carve-out have realized substantial savings.
“We urge you to move forward with the carve-out in order to protect New York’s Medicaid beneficiaries, taxpayers, and community pharmacies,” Cassity wrote.
NCPA represents the interest of America’s community pharmacists, including the owners of more than 21,000 independent community pharmacies across the United States and 2,482 independent community pharmacies in New York. These New York pharmacies filled over 142 million prescriptions last year, including 25 million Medicaid prescriptions, impacting the lives of thousands of patients in New York.
“Not only have MCOs/PBMs wasted taxpayer dollars, but they also threaten patient access to community pharmacy services. And the problems are not unique to New York. An audit of Florida’s Medicaid managed care program found Medicaid beneficiaries were steered to MCO/PBM-owned pharmacies, which were reimbursed at higher rates than non-affiliated pharmacies for dispensing the same specialty drugs,” Cassity wrote. “Keeping Medicaid prescription drug benefits in the managed care program allows MCO/PBM conflicts of interest to supersede beneficiaries’ ability to make health care decisions for themselves.”
The problems caused by MCO/PBM management continue to exist in New York. Delaying implementation of the carve-out will only allow those problems to continue wasting tax dollars while providing no added benefits for Medicaid beneficiaries.
NCPA urges New York to finish what was started last year and fully implement the carve-out without delay.
Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing more than 21,000 pharmacies that employ 250,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America's most accessible health care providers. To learn more, visit www.ncpa.org.