The drug supply chain can be a complicated process. There are many different layers that go with the process that ultimately ends with your prescriptions making their way into your medicine cabinet, especially when it comes to deciding the amount each entity within the process pays. While the structure of this supply chain remains seemingly intricate, there is one thing relatively easy to understand: Middlemen at the center of this process often do not share the savings they negotiate with consumers at the pharmacy counter.
With opioid-related fatalities on the rise in Florida, it is not difficult to find someone whose life has been affected by overdose. Like many of our fellow Floridians, community pharmacies throughout Florida are concerned about the epidemic facing both our state and our country.
Florida’s current Agency for Healthcare Administrations (AHCA) rules state managed care plans can limit the number of pharmacies allowed to participate in their Medicaid Managed Care networks based on meeting the federal Medicare network adequacy standards. ACHA adopted these standards, which only require plans to have one pharmacy within a 30-minute travel time for patients in urban areas and a 60-minute travel time for patients in rural areas.
Most recently, many health insurance providers have drastically restricted Medicaid Managed Care networks throughout Florida. Those restrictions are forcing patients to leave their trusted pharmacist and go to a pharmacy their health plan chooses for them. Such unnecessary restrictions limit consumer choice, restrict healthy business competition and prevent access to community pharmacies.