Screw Medicaid

I am now 100% anti-Medicaid. Not because of the stereotypical Medicaid recipient's attitude and such. This is due to the downright crappy reimbursement.

Let me set the stage. Pharmacy God Pharmacy doesn't fill very many Medicaid prescriptions. If we fill 10 scripts in a week, that's a lot of Medicaid for us. Medicaid is less than 1.5% of our prescription volume. I know, you're thinking how great, less than 10 Medicaid scripts a week. It's nice not having to mess around with all of the Medicaid BS, especially with the new rules that are in effect next week. But back to the point.

Today I spent 15 minutes on the phone trying to get a claim for Forteo to go through. Even with the assistance of a customer service representative, it took about 10 claim submissions for the claim to finally be approved.

The results of my efforts....

A reimbursement of $1.96 above my cost. Holy crap does Medicaid suck. AWP-20%, plus 3.70. Screw this crap. Gross profit on a script of 0.3%. You can take your Medicaid business and shove it.............someplace not very nice.





But you know what? Pharmacy just sits back and takes all the BS from the insurers. The people who sign the insurance contracts don't have the balls to tell the insurers that the reimbursement rates are inadequate. When did pharmacy become so weak?

Guess what people...we can say "No" to these insurers. Too bad we can't band together and outright reject all third party contracts that screw us. That would be collusion.





I'd like to see the people that run Pharmacy God's state's Medicaid program try to keep their offices running if the state would slash their budget to the previous year's budget less 20% plus 3.50.







This concludes Pharmacy God's thoughts on Medicaid for today. Please join us in the future for more thoughts on Medicaid, Medicare, third-party insurers, and other issues that Pharmacy God deems worthy of mentioning.