Pharmacists Concerned About Florida’s Planned Medicaid Overhaul

June 12, 2011

“I need my nighttime pill. And I need my little red one.”

Sometimes there’s just no substitute for a local pharmacist that knows customers by name. And knows exactly what they need when the ask for their “nighttime pill”. That’s just one of the points being made by independent pharmacists across the state worried that Florida is opening the door to increased use of mail-order pharmacies — and, ultimately, threatening the mom-and-pop store’s existence.

Pharmacist Kim Cadenhead of Kim’s Family Pharmacy in Cantonment is concerned about a massive Medicaid overhaul that lawmakers passed last month. If approved by the federal government, the overhaul will shift hundreds of thousands of Medicaid beneficiaries into managed-care plans, which could rely more on mail-order pharmacies.

“It will be hard for some Medicaid patients to navigate a system that relies on mail order and phone calls,” she said. “Many people with Medicaid appreciate that one on one or face to face with their pharmacist.”

Independent pharmacy operators from across the state are raising similar concerns.

“It’s not about saving money,’’ said Tracey Jackson, whose family runs Jackson’s Drug Store in the north Florida town of Monticello. “It’s about the big corporations having every ounce of the business.’’

Cadenhead makes no secret that she has a personal vested financial interest in Medicaid patients having the right to choose their pharmacy. At Kim’s Family Pharmacy, which is located in a shopping strip next to Grocery Advantage a short distance north of the paper mill, about 30 percent of the business is from Medicaid customers.

If about 30 percent of her business is lost, Cadenhead said her business will obviously suffer and employees with lose their jobs.

Preston McDonald agrees. He is vice-president of the Escambia County Pharmacy Association and board member for the Florida Pharmacy Association. While he works for a corporate-owned pharmacy at the Winn Dixie in Cantonment, he said some community pharmacies depend heavily on Medicaid customers for business.

“If they lose that, they might as well hang a sign on the door,’’ McDonald said. “They will close.’’

But the real concern is still about the Medicaid patients, Cadenhead insists. Her list of concerns about exclusive mail order requirements, or even the requirement that only certain, and most likely large corporate, pharmacies could be used.

“What if they were allowed to just use CVS for instance,” she said. “That can’t work.” An elderly patient in Century or Walnut Hill might have a difficult time getting transportation to the nearest CVS in Cantonment, rather than using one of the pharmacies in Century or Molino.

Any pharmacy mail order program implemented for Florida’s Medicaid patients would be for so-called “maintenance drugs” — drugs taken month after month for conditions like high blood pressure, diabetes or acid reflux. The plan would direct Medicaid recipients to certain pharmacies for urgent prescriptions like antibiotics.

The law leaves it up to managed-care plans to determine how beneficiaries will receive prescriptions. But Roberta Bradford, deputy secretary for Medicaid at the Agency for Health Care Administration (AHCA), said the agency would make sure plans have adequate provider networks so beneficiaries will have access to medications.

Jessy Fry, co-chairman of the Florida HIV/AIDS Advocacy Network, asked. Fry said mailing expensive HIV medications could help fuel theft and sales on the black market. He also questioned whether drugs could go bad in the Florida heat.

“Mail order in Florida? In July? Really?’’ Fry asked.

Other provisions in the law passed during the spring legislative session are also raising complaints, such as its requirement that seniors go into Medicaid managed-care plans.

Laura Cantwell, an official with AARP Florida, said it is unrealistic to expect seniors to move into managed-care plans by an October 1, 2013, deadline included in the overhaul. She said it should first be tried as a pilot program.

Tallahassee elder-law attorney Twyla Sketchley went further, saying the system could lead to “granny dumping for profit,’’ as HMOs would have financial incentives to move people out of costly nursing homes.

But Michael Garner, president of the Florida Association of Health Plans, vehemently disputed that characterization. Garner and legislative supporters say managed care will allow seniors to receive services in their homes and communities and stay out of nursing homes as long as possible.

“I really have to question how anyone could call that granny dumping,’’ Garner said.


Comments

16 Responses to “Pharmacists Concerned About Florida’s Planned Medicaid Overhaul”

  1. kelly underwood on June 13th, 2011 8:26 pm

    I think this is great people should be happy as much as they talk about people on foodstamps and medicaid. I will like it now i wont have to feel like people are talking about me when i get my chiilds meds now maybe I wont have to hear all the crap that is said you all should know what is said since so many people talk about poor single mothers.

  2. Mama on June 13th, 2011 6:20 pm

    I agree with Angel. I have tried mail-order drugs that should have been delivered to my address but went to another. They did not return the drugs and when I called the post office they said there was nothing they could do. I called the mail order drug store and they did fill the prescription again & it was delivered later. I had already run out of the medication. Thank goodness it was not one of my essential medications. MAIL ORDER DOES NOT WORK UNLESS EVERYONE IS HONEST & RETURNS THE PRESCRIPTIONS THAT ARE INCORRECTLY DELIVERED.

  3. Elizabeth on June 13th, 2011 5:06 pm

    I personally decided to say farewell to the pharmacy and started treating chronic illnesses with alternative medicine … but that’s just me.

  4. hello on June 13th, 2011 2:39 pm

    I work for the state – not only have we not gotten a raise or cost of living increase for about 6 years we took a 3% paycut this year and through BCBS we have to use the mail order option for “maintenence drugs” (any medication that you take for more than 3 months) Like some others on here some of my meds are adjusted often – I would prefer face to face contact with my pharmicist – The first month my meds were delivered the post person threw them over the fence into the yard – I dont know what will happen when those get refilled if they will go in the mailbox – on the porch or thrown over the fence again…………………btw the mail order is through CVS/Caremark so I guess it supports “big” business

  5. David on June 13th, 2011 10:09 am

    I am an independent pharmacy owner and our pharmacy has been in business since 1985. What baffles me is how Rick Scott can sit there and take huge political contributions from CVS/Caremark in one hand and force all medicaid recipients and state employees to use CVS/Caremark mail order with the other. Wow, can you say in the pocket of large corporations. They just tried to force all controlled drugs to be filled at publicly traded companies but it was voted down. If medicaid goes mail order both of my pharmacies will go out of business. We work very hard to compete with the box stores by providing exceptional customer service, but how can you compete when our state officials are skewing the rules for big corporate. We go out of business 9 people will lose there jobs. Thanks Rick Scott you are out of touch.

  6. David Huie Green on June 13th, 2011 10:08 am

    REGARDING:
    “You’re making our area look bad, please just read the entire article before make ridiculous claims. THIS IS A STATE GOVERNMENT ISSUE!”

    There you go trying to confuse folks with the facts.

    Nonetheless, you may not have gotten the memo that all bad things are the fault of ………………….

    (You have to fill in the blank, for some it’s President Obama, for some it’s former President Bush. Some blame President Roosevelt. Grandpa Green always blamed President Hoover. I know a fellow in Bluff Springs who still blames President Lincoln for whatever bad happens.)

    Please note that some blame Governor Scott even though he has NO power to pass legislation. The people we elected pass or refuse to pass legislation, same as at the federal level. That would suggest WE are to blame if legislators we elected do things with which we disagree, but we NEVER blame ourselves, so we HAVE to blame somebody else.

    David for blaming the aliens
    (ET, not Mexican)

  7. mcooky on June 13th, 2011 9:48 am

    The Gov saves a few bucks on social program cutbacks, then robocalls everyone in the state. how much does that cost?

  8. Not A Rick Scott Fan! on June 13th, 2011 7:53 am

    Geeze, did you even read the article this IS NOT a federal government mandate this is our STATE GOVERNMENT under RICK SCOTT!

    You’re making our area look bad, please just read the entire article before make ridiculous claims. THIS IS A STATE GOVERNMENT ISSUE!

  9. Angel on June 12th, 2011 11:45 pm

    I also use Winn-Dixie! Preston, Susan, and the whole staff treat you like family! I have to take 12 different med’s! Some are life threatening med’s if I dont have them I could die. If we have to use mail order what happens if we run out of med’s on Saturday the mail doesnt run on Sunday! The way the heat has been going lately my med’s have to stay at room temperature at 77 degrees and away from light. Is the government going to put A/C on the mail trucks??? I dont think so!!!! WHAT IF ALL GOVERNMENT OFFICALS TAKE A PAY CUT! How would they feel!!!!! Dont cut the poor people who need help and that has work for it all their lives!!! Start cutting other things first!!!!!

  10. Me Myself and I on June 12th, 2011 8:39 pm

    I wish the government would get out of our lives. They are about worthless. The way things are going, we will soon be under a FULL dictatorship. Right Corporal Obama?

  11. Tina P on June 12th, 2011 6:58 pm

    I like to go to Preston and Susan because they always always watch the meds coming across to let me know if I should be concerned or if I should watch for any particular side effects. They have even caught a time or two that the doctor prescribed something that adversley reacted with another med my child was taking. You just can not replace face to face or one on one attention.

  12. for a face-to-face pharmacy on June 12th, 2011 2:45 pm

    I am young, and fairly knowledgeable on the computer…BUT… I would rather go to the pharmacy (preferably CVS in Century) to get mine and my family’s meds. They always have someone to help when you have questions on the meds, possible interactions, etc. There is a REAL person who cares, and can catch it if you get a script for something that could cause major health problems by interacting with something you are already on, or is too closely related to something you are allergic to. They also go the extra effort to help when a ‘computerized’ prescription system messes up on getting your meds when you need them. I recently had to go a week without much needed meds because of a ‘computerized’ system ‘lost’ my new prescription, and it was the great pharmacy help at CVS that was able to get it straight for me.
    My meds have to be changed fairly regular due to major side effects. I would like to know when a change is made that I can get my new meds that day, or the next day…not have to wait weeks for a computer to process it and then have to wait and depend on it to send them in the mail!

    Computerized is NOT better than REAL people!!!

  13. barrineau on June 12th, 2011 8:26 am

    I personaly like the face to face, look you in the eye ball way things are done for me.I’m sure some people will like this idea. People will start steeling your meds from your mail box. If it aint broke dont fix it.

  14. jobs? on June 12th, 2011 8:24 am

    hey scott, wheres the jobs?????

  15. Jane on June 12th, 2011 8:13 am

    I think this needs to be looked at very carefully. Many people (not always the seniors) need help figuring out a system like this and need to ask questions of their pharmacists and doctors. Where do they go for answers when medicine is mail-ordered. This could lead to all sorts of problems.

  16. dad on June 12th, 2011 5:47 am

    I would love to be able to give my local pharmacy, Scott’s, my business for my maintanance drug. But my insurance won’t allow it. It has to be done via mail order.
    Also, thinking back on my grandmothers. I can’t imagine them being able to navigate the mail order system. It’s too confusing for a lot of elderly people and not everyone has someone else who can and will keep up with it them.