Op-ed by Prominent Community Leaders Highlights Severe Damage of New York’s Proposed Medicaid Carve-out

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Op-ed by Prominent Community Leaders Highlights Severe Damage of New York’s Proposed Medicaid Carve-out

On March 23, an op-ed written by three prominent community leaders, Ms. Hazel Dukes, Rev Kirsten John Foy, and Rev Dr. Johnnie Green, was published in several outlets, including savenysafetynet.com and empirereportnetwork.com.  Their op-ed highlights the severe damage that will be inflicted on vulnerable communities resulting from the impending policy of the New York Department of Health to “carve-out” the Medicaid pharmacy benefit from managed care.  New York’s carve-out policy will require all reimbursement for prescription drugs to be paid under the state’s Medicaid fee-for-service plan.  As the op-ed notes, 340B safety-net providers are strongly opposed to New York’s policy change because it will require reimbursement for Medicaid fee-for-service pharmacy claims at the pharmacy’s actual acquisition cost (AAC).  This means that 340B safety-net providers would be reimbursed at the 340B price they paid for the drugs, thereby completely obliterating the important, and often lifesaving, 340B revenue that the providers receive through the 340B program.  By contrast, under New York’s current Medicaid pharmacy benefit, pharmacies that dispense drugs to Medicaid managed care organization (MCO) enrollees are reimbursed by the MCO, which directly negotiate reimbursement for prescription drugs with the pharmacies and are not restricted by the AAC reimbursement requirement imposed under the Medicaid fee-for-service plan.  Higher negotiated reimbursement allows the covered entity to retain the benefit of 340B savings and continue to fund vital services for underprivileged communities.

The op-ed explains how the 340B program funds services for underserved communities, explains the history and purpose of the 340B program, and concludes by asking the state to prevent the dire consequences of the impending policy.

Ms. Hazel Dukes is the President of the NAACP New York State Conference. Rev Kirsten John Foy is a Minister and the President and Founder of the Arc of Justice. Rev Dr. Johnnie Green is the President of MPAC and Sr Pastor of Mt. Nebo Baptist Church of Harlem.

The full op-ed is available here.

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