Alliance News

AIP-Texas and Texas Pharmacy Association Enter into an Affiliation Agreement

As part of its commitment to advancing the interests of independent pharmacy in Texas, the Alliance (described below) and with the complete approval of the AIP-Texas Board of Directors, has entered into an Affiliation Agreement with the Texas Pharmacy Association. This Agreement, while reaffirming the independent nature and structure of both organizations, also pledges continued cooperation by both entities toward the mutual goal of the betterment of the pharmacy profession.  

Importantly, the Agreement also provides a mechanism whereby the AIP member/investor funds that are currently held by TPA will be transferred to the Alliance of Independent Pharmacists of Texas (“Alliance”) for their use as the Academy Board determines is appropriate. As part of this effort, a new non-profit entity has been created---the Alliance of Independent Pharmacists of Texas (“Alliance”). The Alliance has also applied with the IRS for tax-exempt status as a 501(c)(6) organization and, once approved, the Alliance will be a tax-exempt entity (like TPA) capable of receiving dues and investor funds in an appropriate manner protected from tax liability. While both TPA and the Alliance acknowledge that each party is an independent legal entity, with governing bodies separate from each other, each party also recognizes they each play an important and critical role in cooperating with each other on issues impacting the entire profession and practice of pharmacy.   

Toward that end, the Alliance has also established a new financial account for the deposit of dues/investor funds dedicated solely to the advancement and advocacy efforts on behalf of independent pharmacy/pharmacists interests in Texas. Given the current legislative/regulatory climate, it is more important than ever that the collective voice of independent pharmacy be heard consistently and widely.  We are therefore asking that you authorize the redirection of your investor funds (0.1% of wholesale purchases) to the Alliance banking account dedicated to the use and retention of these funds.  In short, nothing is changing, but the establishment of a new, self-directed, non-profit organization to promote independent pharmacy.    

In appreciation for your continued support, the Alliance will pay your 2012 National Community Pharmacists Association (NCPA) and Texas Pharmacy Association (TPA) membership dues for investors with a minimum contribution of $100 per month.

To authorize your redirection of investor funds to the Alliance, please direction of funds form and return to (512) 836-0308 or e-mail to khorvath@texaspharmacy.org.

Sincerely,
 
William “Bill” O. Moore
President


AIP-Texas Pharmacists from Across the State Outlined Devastating Effects of Transition to Medicaid Managed Care

AIP-Texas members, other pharmacy stakeholders, and doctors from across the state met with House Human Services Committee on the Medicaid managed-care program at the Capitol yesterday for more than five hours to voice their concerns on the new program rolling out in March 1.  Committee Chairman Richard Raymond of Laredo and the Interim Committee heard testimony after testimony outlining the devastating effects the transition of the Medicaid/CHIP Vendor Drug Program to managed care will have on patient care and pharmacies throughout the state, especially South Texas.

Among pharmacists top concerns include: low reimbursement rates, slow reimbursement turn times, transparency, and questionable contract negotiations from managed care companies. An additional component included patient awareness. John Hawkins, senior vice president of advocacy and public policy with the Texas Hospital Association stated, “85 percent of the patients have no clue about these changes.”

AIP-Texas Chair Bill Moore of Sinton, Texas, told committee members he will have to cut $200,000 in operating expenses from his two pharmacies to stay in business under the Medicaid reimbursement rates being offered to his pharmacy.

“In order to stay in business, I will have to let some staff go and reduce the amount of time I can counsel patients daily…patients will be noncompliant,” Moore said. “Quality of patient care will go away and patients will end up in the emergency room.”

Honorary Committee member Sid Miller of Stephenville reminded Health and Human Service (HHSC) representatives that the legislators indicated in the law and several state representatives wrote letters to direct HHSC not to contract with bad actors.

“Why did we contract with CVS Caremark and Amerigroup?” Miller asked HHSC representatives. “They have been issued numerous fines.”
 
HHSC stated a conviction was needed for providers to be eliminated. Miller responded by stating, “This is not what we intended.”

Testimony continued with AIP-Texas member Louis Rumsey, owner of Elam Road Pharmacy in Dallas, Texas explaining that 75 percent of his client base is Medicaid and another 10 percent is in the Children's Health Insurance Program. He told the Committee that he provided loaner nebulizers when necessary to patients and trained parents on how to care for their asthmatic children.  He continued by saying, "The prescription reimbursement cuts that come with the move to Medicaid managed care will force me to close my business and my customers will be left without good options for their pharmacy services."

Pharmacist testimony concluded with Texas Pharmacy Member Michael Luna of Eagle Pass telling the Committee he had no intention of signing these ridiculous contracts with such low rates.  In his closing statement to the Committee he said, “I love being an independent pharmacist, please keep me independent.”

HHSC representatives told Committee members and witnesses in the hearing they have heard the concerns and thought better communication with patients and professionals was key to making the program work.

Chairman Raymond said he expected to be hearing from HHSC in the near future about how they plan to address some of the issues. He plans to set a follow-up meeting before March 1.

Several other AIP-Texas pharmacists gave oral and written testimony on the issue. The hearing was covered by KVUE News in Austin and ran on the 6:00 p.m. news.

AIP-Texas Contributes $50,000 to American Pharmacies Medicaid Law Suit

As you know, the Texas Health & Human Services Commission (HHSC) is rushing to obtain federal approval to move the Texas Medicaid program’s prescription drug benefit from a fee-for-service model to managed care without allowing for meaningful public comment or an economic impact study by the state. The managed care model would replace an efficient, well-run Vendor Drug Program with for-profit middlemen—managed care organizations and pharmacy benefit managers who have a vested financial interest to maximize profits by offering low, take-it-or-leave it reimbursements. HHSC is seeking approval from Centers for Medicare and Medicaid Services (CMS) for the program change in time to implement managed care by March 1, 2012.

American Pharmacies (AP) has filed suit in Travis County State Court asserting, in part, that HHSC failed to comply with state law requiring a meaningful public notice and comment period in connection with their request to CMS to implement this change. On behalf of their investors, the Academy of Independent Pharmacists of Texas Board of Directors has voted to support this necessary legal action with a current contribution of $50,000.00 to AP, with consideration of further possible funding.

On November 3, the court will hear AP’s Motion for Summary Judgment over HHSC’s plans to transition to managed care for Texas Medicaid Drug Benefit. This means AP is asking the Judge to rule immediately on the merits of the lawsuit.

If you have any information to share regarding this topic as developments occur in your day-to-day practice such as contractual negotiations with various Medicaid managed care organizations and benefit managers, please contact khorvath@texaspharmacy.org, so AIP-Texas can pass it along to the AP’s general counsel.

AIP-Texas will keep you informed of this critical action as it develops.          

AP Thanks AIP-Texas for $50,000 to Aid Medicaid Lawsuit

Update on Medicaid Lawsuit from American Pharmacies