PROVIDENCE, R.I. (AP) – Local pharmacists say they’re not getting paid for much of the medicine they’re providing under the new federal prescription drug program, potentially causing big problems for their businesses.
Health insurers typically reimburse pharmacists twice a month, and pharmacists rely on the money to cover their purchases. But under the new Medicare Part D program, pharmacists now have more insurers to deal with because the program required beneficiaries to choose from various private drug plans.
“I’ve been getting phone calls from a lot of pharmacists,” said David Feeney, president of an association of independent pharmacies in Rhode Island. “Some of the payments are coming through incorrectly. You submit 100 claims; only 70 get paid for.”
Although the problems may get resolved, Feeney said, “that might be four to six to eight weeks down the road. The vendors you owe money to are not understanding or sympathetic.”
About 30 of Rhode Island’s pharmacies are independent, according to The Providence Journal. Spokespeople for drug plans Blue Cross & Blue Shield of Rhode Island, Humana, and UnitedHealthcare say their companies are making payments on schedule.
The problem is not unique to Rhode Island, said Carol Cooke, spokeswoman for the National Community Pharmacists Association, which represents about 24,400 independent pharmacies nationwide.
“It’s a real cash-flow crisis for our folks,” Cooke said.
The Part D drug benefit began on Jan. 1 and is paid for by the government and beneficiaries while administered by private insurers. Under the program, some 42 million disabled and older people are eligible to enroll in private plans that will subsidize their prescription drug costs. The signup period closes May 15.
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On the Net:
Medicare Part D: www.medicare.gov
AP-ES-01-28-06 1414EST
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