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TO: IPA NJ Members FROM: Heidi A. Stokes DATE: April 12, 2006Please Check Your Remittance Advices For Medicaid, PAAD & Senior Gold Starting Today For The $2.00 Supplemental Dispensing Fee Increase!
As you may recall, Governor Codey signed a $2.00 supplemental dispensing fee for low volume Medicaid, PAAD and Senior Gold pharmacies to help offset costs due to the Medicare Part D program. Not all pharmacies qualify for the additional fee. Payments totaling $1.4 million for Medicaid, PAAD and Senior Gold will be made to approximately 267 pharmacies.
The law provides a cap on the amount of prescriptions dispensed in each of these programs. Pharmacies that have not filled more than 8,562 Medicaid prescriptions during calendar year 2005 and no more than 10,443 PAAD or Senior Gold prescriptions qualify for the supplemental dispensing fee. The $2.00 additional compensation will apply to all prescriptions filled for Medicaid, PAAD and Senior Gold from January 1, 2005 through June 30, 2005.
IPA has met with the new administration to let them know that this law does not go far enough explaining that the supplemental fee should include ALL New Jersey pharmacies thereby eliminating the cap limitations for these prescription programs.
IPA continues to work with the NJ State Legislature through this years’ budget process. IPA is asking the Legislature to not only reconsider the proposed $30.1 million in pharmacy reimbursement budget cuts, but also to supplement our dispensing fee over and above the $2.00 supplemental fee now in effect. As you know, pharmacies will lose $58 million in reimbursement this year due to the Medicare Part D prescription program.
As part of our cost-savings budget plan, IPA recommended to both the Assembly and Senate Budget Committees that the State carve out prescription drugs from the FamilyCare / KidCare HMO Managed Care plan and return the benefit back to Medicaid fee‑for‑service. The doctor / hospital benefit would remain with the HMO. We believe the State would save approximately $40 million due to the HMO’s increases in administrative fees plus the growth in manufacturer rebates that is no longer available to the State under the HMO Managed Care contract.
If you have any questions concerning the budget or the $2.00 supplemental dispensing fee, please contact Heidi Stokes at 800 575-2667. A special thank you to everyone who has donated to the 2006 IPA RxPAC Lobby Fund. If you have not contributed, I urge you to make your contribution today!
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