Local News Features Our Pharmacist Client and His Fight to Keep Healthcare Choices Available for the Community
Last night, a local news channel featured one of my clients and his on-going battle against a California company that wants to restrict pharmacy benefits in Alabama. Below is the video clip featured on the news:
So, what is the story here? Long ago, the Alabama Legislature created an employee benefit plan providing medical benefits to public school teachers. The plan is commonly referred to as PEEHIP (Public Education Employees' Health Insurance Plan). Its benefits include pharmacy benefits. The plan is similar to the plans most of us enjoy through our private employers. However, because there are school teachers throughout our state, the impact of changes to their health plan affects every area of Alabama both urban and rural.
So, what is the problem? Alabama law provides certain protections that allow us to go to the pharmacy of our choice for prescription medications. Our laws also require that pharmacists be paid usual and customary rates. These are important protections for both the pharmacist and the person having their prescription filled. For individuals, it means we can choose a pharmacist we know is competent instead of having someone else choose for us. It also means that we can go to a nearby pharmacy rather than being forced to drive for miles and miles just to get necessary prescriptions. In rural areas, this is very important since there may not be many nearby options. Even in highly populated areas, the recent tornado disaster provides a valuable lesson concerning the impact of limited access to necessary commodities such as prescription medications. During that disaster, the only pharmacies open in some areas of our State were those independently and locally owned. The protections in our laws also insure that pharmacies can compete with each other fairly. This is the way it is supposed to work. It is in the best interest of the public.
In 2010, a company known as MedImpact Healthcare Systems hired a new executive whose previous employer was Walmart. In fact, at Walmart, he had responsibilities over the provision of pharmacy benefits. Unfortunately, for the school teachers in our State, in 2010 MedImpact also became the administrator of their pharmacy benefits. As the following news articles relate in stories from Jackson County and Cullman County, this is when MedImpact began providing pharmacy contracts that kept local, independent pharmacies from providing medications under PEEHIP. Instead, huge chain stores benefited. MedImpact justifies its current actions in the name of cost savings. Really? Does it save costs for teachers in rural areas who cannot easily get their medications? Does it save costs in the long run when there is no competition left among pharmacies and the few large chain stores have control over the supply, the market, and the price? What will happen to prices then? Does it save costs to push local pharmacies with much lower error rates from the market? Prescription errors result in huge costs.
With these administrative changes to one of the largest health plans in our State, how are individual pharmacies being treated? How do payment terms differ between pharmacies? Since starting its plan to limit pharmacy access in Alabama, MedImpact has never provided any data concerning the claims it has paid various pharmacies. These are all important, but unanswered, questions.
