California Pharmacies Win Court Order to Halt 10 Percent Cut for Medi-Cal Prescription Drugs
Medi-Cal beneficiaries to experience no further interruptions in
access to needed pharmacy services and medications
SACRAMENTO, Calif.--(Business Wire)--
Late Friday, pharmacy providers were notified that a three judge
panel of the Ninth Circuit Court of Appeals had acted to halt the ten
percent payment cuts for prescription drugs dispensed under the
Medi-Cal Program. The action was made in response to an emergency
appeal in the case, Independent Living Center of Southern California,
et.al. v. Shewry, to challenge a lower court ruling that the
plaintiffs did not have standing to sue under the Supremacy Clause of
the U.S. Constitution. The Ninth Circuit panel reversed the ruling,
issued an order to stop the ten percent Medi-Cal cuts for prescription
drugs until at least August 11, 2008 and sent the case back to the
Federal District Court in Los Angeles for further consideration of the
plaintiffs' motion for a preliminary injunction.
This outstanding victory shows the strength of a united profession
working together to ensure patient safety and care. The lawsuit is one
of three supported by a coalition of pharmacy interests, including the
California Pharmacists Association, the National Community Pharmacists
Associations and the National Association of Chain Drug Stores.
Several independent community pharmacies have also contributed to the
lawsuit.
"The California Pharmacists Association, which represents
pharmacists in the state of California, applauds the Court of Appeals
for making this crucial decision," said Lynn Rolston, chief executive
officer of the California Pharmacists Association. "This is a victory
for pharmacy and patients alike. Patients have experienced significant
problems in getting lifesaving prescription medicines since the cuts
went into effect on July 1 and the Court's action will prevent
additional patient harm."
"The judgment is only temporary and unfortunately doesn't apply to
any other provider," continued Rolston. "We want to acknowledge and
congratulate lead attorney Lynn Carman and his associate Stanley
Friedman for a job extremely well done and thank the many plaintiffs
in this case for their efforts, including CPhA member Jerry Shapiro."
"We are pleased that the concerns of pharmacy were heard," said
Steve Anderson, president and CEO of the National Association of Chain
Drug Stores, whose organization is a member of the Coalition for
Community Pharmacy Action (CCPA). "Maintaining pharmacy access is
important not only to Medi-Cal beneficiaries' health and safety, but
also to the Medicaid program's overall ability to constrain healthcare
costs, including those related to preventable emergency room visits
and catastrophic care."
At this time, it is not known if the State will appeal the action
by the Court of Appeals.
As this case makes its way back to District Court, other legal
actions are still proceeding. A preliminary injunction hearing in a
lawsuit filed by the California Medical Association, CPhA and other
provider groups is scheduled for July 25 and will be key in putting a
more permanent hold on the cuts for all providers, including pharmacy.
It is expected that Electronic Data Systems, which processes
prescription claims for the Medi-Cal program, will not have a "fix" in
place immediately for the on-line electronic billing system used for
prescription claims. Pharmacies may continue to see payment
information that shows below cost reimbursement and may have to
re-bill claims once the fix is in place.
For the California Pharmacists Association
Bill Bradley, 916-658-0144
bill@perrycom.com
Copyright Business Wire 2008
