January brought big changes in the reimbursements Arkansas pharmacies receive from some insurance companies, and pharmacists across the state have protested that the changes affect their continued existence. Changes affect anyone insured with Blue Cross and Blue Shield and includes those enrolled in Arkansas Works under the Affordable Care Act.
Blue Cross contracted with CVS Caremark to handle the claims from pharmacies and set the amounts they will pay for prescriptions. In some cases, those rates do not even cover the pharmacies’ costs.
Spencer Mabry, co-owner and pharmacist at Economy Drug in Berryville, explained the problem last week. “Last year, they used a ‘fee for service’ payment method,” he said, covering the cost of drugs plus a fee to the pharmacy. The fixed repayment rates set this year sometimes do not even cover the cost.
“I filled more than a hundred and twenty prescriptions below cost in January,” Mabry said. “Imagine having seven percent of your business suddenly turn negative!” He explained that Arkansas law allows him to refuse service, but that would contradict the very nature of his business.
The situation affects large chains just as it does independent pharmacies. On Jan. 31, at a Senate subcommittee meeting in Little Rock, representatives of smaller pharmacies sat shoulder-to-shoulder with Walmart and Walgreens to respond to the changes.
Mabry, who serves on the board of the Arkansas Pharmacists Association, attended the meeting. “There were so many people at the meeting, they had to make some of them leave the room to meet the fire codes,” he said. No immediate relief came out of the meeting, because the legislature does not have any direct control of a contractor. Lawmakers control the purse strings, however, and Mabry said people could help by contacting their representatives. “Everybody would like to see this solved without the legislature,” he said, “but public awareness will help keep pressure on CVS Caremark.”
Mabry explained the potential threat to the public. “It’s not just about our profits. Some pharmacies have filled as many as fifty percent of their prescriptions below cost.”
Pharmacist Tara Willmott owns Poynor Drug in Berryville and Sam Alexander Pharmacy in Harrison, and she elaborated on that theme.
“People need to know this is not just about our profits,” she said regarding Caremark’s policies increasing the cost to taxpayers while crippling the pharmacies who serve them. “We’ll see higher prices, lower quality, and less access.”
Willmott’s concerns go past the financial effects. “As an independent pharmacist, I do my best to take care of everyone who walks through my door. This undermines my ability to serve them.” She also explained that Internet providers have additional competitive advantages under this plan.
State Sen. Bryan King brought this to the Independent’s attention, and Willmott said, “He’s been very helpful in getting the message out.”
She encouraged the public to share their concerns with legislators, and said public attention has already brought some results, as Arkansas Attorney General Leslie Rutledge has announced an investigation, calling the situation a public health concern.
King said issues like this have often put him at odds with his own Republican Party. He spoke of “cronyism and corruption” in Little Rock, and compared this to another recent struggle. “This is just like the fluoride issue,” he said. “Big money wins the day, not the people.”