The Associated Press
Pharmacists from across the state load boxes with slices of pie, representing small reimbursements from the state Medicaid program, to bring to lawmakers at the Capitol in Olympia on Wednesday.

Pharmacists oppose reimbursement cuts

Senate plan to slice into Medicaid compensations

BRAD SHANNON, THE OLYMPIAN

OLYMPIA -- Pharmacists worried that their Medicaid reimbursements for filling prescriptions could be cut by state budget writers handed legislators "very skinny" slices of pie Wednesday morning.

"We can't afford another bite out of our slice of the pie," Bellevue pharmacy owner C.J. Kahler complained in a short rally at the sundial near the Capitol.

He said 2 cents for every $1 spent on a prescription goes to pharmacy profits, a margin that would get even slimmer, putting smaller pharmacies at risk of closure.

House Republican Co-Speaker Clyde Ballard joined the pharmacists and encouraged them to raise a fuss, getting their customers and pharmacy employees to write legislators and ask for better reimbursements.

"If you're going to be politically correct ... you'll fail," Ballard said. "You're an endangered species."

Pharmacists in white coats then went door-to-door to House members' offices, handing out thin wedges of pumpkin pie. House budget writers are drawing up their spending proposal for 2001-03 this week.

A Senate budget proposal reduces the state's reimbursement to pharmacists for poor patients by about 1 percent, according to Kahler. But Sen. Lisa Brown, the Spokane Democrat who wrote the budget, has said it brings state payments in line with what private insurers such as health maintenance organizations are paying.

"As a legislator, that may appear OK on the outside," Kahler said, but it causes problems for pharmacies. The clientele served by Medicaid have greater needs and pharmacists go an extra mile to help them out, he said.

"A number of them can't drive. We drive to them," he said, adding that pharmacists also put medications in special packaging for adult family homes and make emergency prescriptions available in the night to nursing homes.

Kahler estimated the state is saving $8.7 million with the proposed reimbursement cuts.

Pharmacists already were smarting from Gov. Gary Locke's AWARDS program for retirees who lack prescription drug insurance coverage. That program asks pharmacists to accept a lower reimbursement rate, which Ballard blasted.

"It's not government helping; it's government hurting," Ballard said.

To Paul Martin, owner of Southgate Pharmacy in Tumwater, a reimbursement cutback means he'll probably lay off an employee who already is "on borderline" of being cut due to cost pressures.

"We're right across from the Capitol 5000 building, and we get a lot of first-timers," he said, referring to a local welfare office where many of the needy apply for state aid.

"There's other alternatives," said Martin, who carried slices of pie to lawmakers with Rochester Drug pharmacy technician Cindy Ferbrache.

The state should consider putting limits on which drugs are prescribed, Martin said. Several medications -- including Prilosec and Prevacid, used to treat stomach acid, which can cost $100 a month -- could be replaced with less costly alternatives, he said. It's an idea the Department of Social and Health Services is already exploring.

State budget writers are in a bind, however.

Despite a possible transfusion of $250 million from a law enforcement pension fund, they are coping with an increase of more than $1 billion in medical costs for state employees and the poor during 2001-03, as well as $800 million in new education costs driven by citizen initiatives. At the same time, state revenues are expected to level off.

On the Web

Washington State Senate Ways & Means Committee (www.leg.wa.gov/senate/scs/wm/default.html)

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