HHSC Agrees to Rate Setting Hearing for Fee for Service 


In response to a joint letter from Senate Finance Committee members Sen. Charles Schwertner (R-Georgetown) and Sen. Kevin Eltife (R-Tyler), the Texas Health and Human Services Commission has agreed to hold a rate setting hearing on proposed changes to the Medicaid pharmacy dispensing fee.

At the request of the Alliance of Independent Pharmacists and Texas TrueCare Pharmacies, Senators Schwertner and Eltife sent a letter to HHSC Executive Commissioner Kyle Janek in support of the research conducted earlier this year through the Myers and Stauffer Cost of Dispensing study to arrive at a professional fee for pharmacists that reflects the true costs in dispensing a prescription. Their letter also highlighted the importance of transparency in establishing the reimbursement methodology and asked for a rate setting hearing to obtain testimony and other relevant information from pharmacy providers prior to any change being made to the current pharmacy dispensing fee. They also noted the importance of the Commission working closely with pharmacy representatives to identify, with specificity, MCO/PBM payments to pharmacies and benchmark those reimbursements to ensure the rates paid support an adequate pharmacy network.

We are pleased to report Senator Schwertner's staff has heard back from HHSC and a rate setting hearing will be forthcoming. HHSC will also be responding to the other inquiries relating to MCO/PBMs payments as well.

Once the hearing date has been determined, we will be reaching out to membership for volunteers to testify at the public hearing to share personal experiences and how lack of transparency and reimbursement rates effect you and the patients you serve.

We appreciate the Senators' efforts on behalf of independent pharmacy and encouraging fair reimbursements for our providers as well as transparency.