Massachusetts Medicaid has set new pharmacy reimbursement rates that pharmacies can live with - State News in Brief

Drug Cost Management Report, Nov, 2002

* Massachusetts Medicaid has set new pharmacy reimbursement rates that pharmacies can live with. The new pharmacy reimbursement rate for Massachusetts Medicaid is wholesale price plus 6%, retroactive to Aug. 3. The pharmacy dispensing fee increased from $3 per drug to $3.50 per brand-name drug and and $5 per generic drug, effective Nov.

1, 2002. Previously approved cuts in the pharmacy reimbursement rate had the major drug stores in the state threatening to discontinue participating in Medicaid, which would have seriously inhibited beneficiaries' access to prescription drugs (DCMR August 2002). The CVS and Brooks pharmacy chains told the Boston Globe that they will continue serving Medicaid customers under these rates. The state now has to find an additional $25 million in its budget to cover the new rates. Another issue pharmacists want addressed in Massachusetts is Rx copay levels. Pharmacies estimate that 30% to 40% of Medicaid patients don't pay their copays, yet the pharmacy cannot legally withhold the medication in these cases.