Magazine article Drug Topics

Backlash

Magazine article Drug Topics

Backlash

Article excerpt

Independents' success in pushing for any-willing-provider legislation may be coming back to haunt them. While they may get new access to previously closed third-party networks, they may also get hit by lower reimbursement rates from the networks in which they already have been participating.

That was the consensus of several managed care pharmacy executives participating at a roundtable discussion at the Managed Health Care Congress, held late last month in New York City.

Although they did not wish to be quoted by name, both an executive from a drugstore chain-based pharmacy benefit manager (PBM) and one from a health maintenance organization that uses a network of pharmacies to provide pharmacy services described how any-willing-provider legislation in several states has hurt more than helped independent pharmacies.

Both executives said they have had a two-tiered reimbursement arrangement in their networks. Chain drugstores, which have various administrative and volume-purchasing advantages, have been receiving lower reimbursement rates than independents.

But when any-willing provider legislation appeared, the executives explained, independents in those states had to begin accepting the same contract offered to chain drugstores--resulting in a lower reimbursement rate. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.