Florida’s Medicaid system fails children and local pharmacy owners

A federal judge recently ruled that Florida’s health system violated Medicaid laws when it comes to providing care for disabled and impoverished children. Judge Adalberto Jordan found the care provided through the insurance program for the poor failed to “promote quality of care or equal access” for kids.
This ruling came as no surprise to local community pharmacy owners who have been dealing with low Medicaid reimbursements for years and have been losing money by providing services to Medicaid patients.
Carmen Cintron, owner of the South Orange Pharmacy in Orlando said, “Medicaid has been underpaying for prescription drugs for as long as I have been in business. I try to make sure that my Medicaid patients pay the same amount out of pocket for their drugs as privately insured patients, and often that means I take a loss.”
Medication costs are always on the rise, and local pharmacy owners have seen the greatest increases in the cost of generic drugs. Generics used to be a way that low income folks could afford prescription drugs, but now local pharmacies are even losing money on generic medications.
“Medicaid takes 3-6 months to update their reimbursement rates, while prescription costs rise on a weekly basis. A drug that is profitable for me to dispense one week may lose me money the next week,” said Al Sheikh, owner of Good Homes Pharmacy in Ocoee. “I have a patient whose medication costs me $305 a month, but their Medicaid coverage only reimburses $281. Every time they fill that prescription I lose about $25. I’ve tried passing that cost on to the patient, but they just can’t afford it.”
While business owners and community members across Florida are ready for the state to accept federal dollars to expand Medicaid it is clear that in addition to adding more folks to the coverage plan the state must address low reimbursements that are causing children, families, and small businesses to suffer.