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Senate Co-Sponsorship Memoranda
Senate of Pennsylvania
Session of 2015 - 2016
Regular Session
MEMORANDUM
| Posted: | May 11, 2015 12:07 PM |
|---|---|
| From: | Senator David G. Argall |
| To: | All Senate members |
| Subject: | Amending payment methodology for prescriptions paid by PACE and PACENET |
| In the near future, I will introduce legislation amending the State Lottery Law to modify the payment methodology for drugs paid for by the PACE and PACENET programs in the Commonwealth. The change in the State Lottery Law is needed because the current federal upper limit (FUL) amounts that can be used to calculate the reimbursement to pharmacies for a drug are often below the actual price paid by an independent community pharmacy for the drug. In addition, under the federal Affordable Care Act (ACA), the new federal upper limit (FUL) amounts, once implemented, have the potential to further reduce reimbursement received by independent community pharmacies in Pennsylvania for those drugs subject to the FUL. As a result, the availability of drugs will be impacted, as will the economic viability of our community pharmacies. Under my legislation, pharmacies will be paid no less than their invoice cost for a generic or brand name medication. Pharmacies will also receive a dispensing fee of not less than $12. Use of the federal upper limit (FUL) payment amount is eliminated under the legislation. The legislation also directs that a Pharmacy Medication Therapy Management Program be developed by the Department of Aging for use in the PACE and PACENET programs to assist and counsel those with medical conditions who receive prescription drugs in selected therapeutic classes. Finally, my legislation will require that a study be conducted every two (2) years to determine the cost to pharmacies for dispensing pharmaceuticals and for providing professional services. |