Highway Robbery

[RX CARE]

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Texas Medicaid and Chip have shifted all claims processing to managed care organizations! The entire process came with a slashing of the dispensing fee from $6.50 per rx to $1.30 per rx. If there wasn't any other signs of pharmacy going down the crapper...what is? Do tell!

 

[PharmDstudent]

We moving from Medicaid over to LaCare in Louisiana. We'll see how it goes, but I'm expecting the same **** thing!

 

[StevePerry]

Texas Medicaid and Chip have shifted all claims processing to managed care organizations! The entire process came with a slashing of the dispensing fee from $6.50 per rx to $1.30 per rx. If there wasn't any other signs of pharmacy going down the crapper...what is? Do tell!

Come on man, why you gotta **** on the private sector? Don't you know you cut costs and serve society better by pocketing $2 per script and pissing on everyone downstream to the tune of $5 per script? Simple concept that has made America great. Keep on rotting in the free world homie.

 

[phampau]

Unfortunately, this has already happened in most states and will be a way for states to cut costs on their healthcare programs.

 

[kvl1027]

Texas Medicaid and Chip have shifted all claims processing to managed care organizations! The entire process came with a slashing of the dispensing fee from $6.50 per rx to $1.30 per rx. If there wasn't any other signs of pharmacy going down the crapper...what is? Do tell!

Done and Done in Florida. We are dying more and more everyday. How a state can agree to move everything to private sector, essentially diverting millions of dollars to companies outside the state is just beyond me.

 

[Ackj]

diverting millions of dollars to companies outside the state is just beyond me.

That was a big factor about NY passing it's anti-mandatory mail order bill. Billions in revenue left the state since we have no mail order facilities here, so all that money was sent right across state lines. I'd like to say it had something to do with improved outcomes, having a pharmacist to talk to, etc, but unfortunately money talks.

 

[awval999]

Done and Done in Florida. We are dying more and more everyday. How a state can agree to move everything to private sector, essentially diverting millions of dollars to companies outside the state is just beyond me.

I don't mean to be devil's advocate, but they are simply saving the taxpayers of Florida money. Eventually the pharmacies will stop taking Florida Medicaid.

 

[Dr Wario]

I don't mean to be devil's advocate, but they are simply saving the taxpayers of Florida money. Eventually the pharmacies will stop taking Florida Medicaid.

And they will simply make a law that forces them to.

 

[awval999]

And they will simply make a law that forces them to.

Do you even know what you say?

What do they teach in high school civics?

A state (or federal) government cannot force the pharmacies to take the insurance. The government can't force a private enterprise to sell things. Why doesn't Obama just force the gas stations to sell gasoline at $1/gallon. Sounds like a good idea.

I honestly don't know what to say if you think the State of Florida can force pharmacies to accept certain insurance plans.

 

[Dr Wario]

Do you even know what you say?

What do they teach in high school civics?

A state (or federal) government cannot force the pharmacies to take the insurance. The government can't force a private enterprise to sell things. Why doesn't Obama just force the gas stations to sell gasoline at $1/gallon. Sounds like a good idea.

I honestly don't know what to say if you think the State of Florida can force pharmacies to accept certain insurance plans.

Is a hospital legally allowed to refuse care for inability to pay? What reality are you from and how can I get there?

 

[Ackj]

Do you even know what you say?

What do they teach in high school civics?

A state (or federal) government cannot force the pharmacies to take the insurance. The government can't force a private enterprise to sell things. Why doesn't Obama just force the gas stations to sell gasoline at $1/gallon. Sounds like a good idea.

I honestly don't know what to say if you think the State of Florida can force pharmacies to accept certain insurance plans.

Just like they can't force you to buy a healthcare plan.... oh yeah, Obama decided he can do that. By the way, he'd much rather have gas prices higher, not lower.

 

[awval999]

Is a hospital legally allowed to refuse care for inability to pay? What reality are you from and how can I get there?

Yes. If you are talking about EMTALA it only refers to hospitals that take Medicare dollars from the federal government.

EMTALA applies to "participating hospitals." The statute defines "participating hospitals" as those that accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program

If I had a for-profit, private pay hospital, I could legally allow patients without the ability to pay to die in my parking lot. While nearly all hospitals do take CMS payments, EMTALA applies, but yes, the government gives an out and does not force a hospital to provide care for patients without the ability to pay, unless they take Medicare dollars.

Please stop talking about things you do not understand.

 

[awval999]

Just like they can't force you to buy a healthcare plan.... oh yeah, Obama decided he can do that. By the way, he'd much rather have gas prices higher, not lower.

Florida v. United States Department of Health and Human Services

The Court narrowed the questions to be addressed to:[20]
Whether Congress had the power under Article I of the Constitution to enact the minimum coverage provision.[21]
Does PPACA's mandate that virtually every individual obtain health insurance exceed Congress's enumerated powers and, if so, to what extent (if any) can the mandate be severed from the remainder of the Act?[22][23]
Does Congress exceed its enumerated powers and violate basic principles of federalism when it coerces States into accepting onerous conditions that it could not impose directly by threatening to withhold all federal funding under the single largest grant-in-aid program, or does the limitation on Congress's spending power that this Court recognized in South Dakota v. Dole no longer apply?[24]
Whether the Tax Anti-Injunction Act bars the pre-enforcement challenge by the respondent's to the minimum coverage provision of the PPACA?[25]

Obamacare is unconstitutional, and will be decided that way in June.

Please stop talking about things you do not understand.

 

[awval999]

All the answers to everything is on Wikipedia. So before arguing on the internet please look up relevent Wikipedia articles so I don't have to correct each and every one of you.

 

[All4MyDaughter]

Yes. If you are talking about EMTALA it only refers to hospitals that take Medicare dollars from the federal government.

EMTALA applies to "participating hospitals." The statute defines "participating hospitals" as those that accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program

If I had a for-profit, private pay hospital, I could legally allow patients without the ability to pay to die in my parking lot. While nearly all hospitals do take CMS payments, EMTALA applies, but yes, the government gives an out and does not force a hospital to provide care for patients without the ability to pay, unless they take Medicare dollars.

Please stop talking about things you do not understand.

I'm not so sure about the "die in the parking lot" thing. I thought they had to stabilize the patient but were then free to ship them out to other facilities. I might be wrong, though. Don't yell at me, bro.

 

[awval999]

I'm not so sure about the "die in the parking lot" thing. I thought they had to stabilize the patient but were then free to ship them out to other facilities. I might be wrong, though. Don't yell at me, bro.

🙂

You don't talk condensendingly so I would never yell at you.

EMTALA only applies if the hospital takes Medicare dollars, but most do. They could let them die. Most physicians wouldn't though, because of their oath. And most hospitals wouldn't want the negative press. But there would be no civil or criminal penatly for a for-profit hospital to do such a thing.

 

[awval999]

Anyway, this whole argument got started with the idea that the State of Florida is going to "require" its pharmacies to accept lowering Medicaid reimbursements. They won't "require" it. They can't "require" it.

Using that logic why not just "require" all Florida pharmacies to give the medications for free to all Medicaid patients and the State will reimburse zero for it.

Doesn't work that way.

Just like Walgreens told ESI 'no' pharmacies can tell the state sponsored Medicaid insurance 'no'.

 

[All4MyDaughter]

Anyway, this whole argument got started with the idea that the State of Florida is going to "require" its pharmacies to accept lowering Medicaid reimbursements. They won't "require" it. They can't "require" it.

Using that logic why not just "require" all Florida pharmacies to give the medications for free to all Medicaid patients and the State will reimburse zero for it.

Doesn't work that way.

Just like Walgreens told ESI 'no' pharmacies can tell the state sponsored Medicaid insurance 'no'.

In Kentucky we are currently getting screwed by our new Medicaid MCO/PBMs. Well, at least 2/3 of them. But we (independent pharmacists) have organized and are getting some help from the legislature. I will post more about it later when I am not pecking away via iPad.