Pharmacists revolt against provision in governor’s TennCare bill
NASHVILLE (AP) — Tennessee pharmacists oppose a provision in Gov. Phil Bredesen’s TennCare legislation they say could drive them out of business and leave their customers without the help they alone provide.
The governor says he’s simply trying to clarify the law and make sure he has as much authority as possible to save money on prescription drugs, one the costliest aspects of the state’s $7.3 billion TennCare program.
“It’s real simple,” Bredesen said. “TennCare’s the biggest financial problem we’ve got in the state. Drugs are the biggest financial problem we’ve got in TennCare. Any tool we can have to control those drugs we need to use.”
The debate concerns a state law allowing any pharmacist willing to offer drugs or medical supplies at the lowest cost negotiated by the state to do so.
Last month, a Memphis chancellor ruled the city had violated the “any willing provider” law by requiring city employees and retirees to use mail-order drugs. The chancellor found the law applies to all government programs, which includes TennCare.
Bredesen’s bill would change the law by specifying “any willing provider” does not apply to TennCare. But he’s not planning to set up an exclusive network of pharmacies, he said.
Instead, he said, he wants to ensure his administration can contract with mail-order companies to provide TennCare enrollees with drugs and medical supplies.
“I’m not saying we would go to mail order, but I think we need to ask pharmacies in state and pharmacies outside the state ‘what will you do for us?’ I can’t possibly justify paying $50 for something you might be able to buy for $30 somewhere else, whether it be drugs or pencils or anything else,” Bredesen said.
During negotiations Monday night, the administration offered an amendment to that effect but pharmacists rejected it, saying it was too broad.
Tennessee Finance Commissioner Dave Goetz said the administration is particularly interested in getting mail-order supplies for TennCare enrollees with ongoing medical needs — like diabetics — who will be enrolled in a disease management program. In addition to their medication, enrollees could buy months worth of syringes, test strips or other supplies by mail order rather than getting prescriptions for those items filled at their local pharmacy.
“We ought to be able to buy those at the lowest possible cost,” Goetz told senators Tuesday.
Pharmacists say they have no problem with that goal and tried to get the administration to accept a change to restrict the mail-order authority to such specified instances. But Bredesen did not like the arrangement.
Baeteena Black, a lobbyist for the Tennessee Pharmacists Association, said pharmacists support the governor’s efforts to fix the beleaguered TennCare program.
“We’re not asking for an extraordinary advantage. We just want a level playing field,” Black said.
About 1,800 of 45,000 pharmacies in Tennessee serve TennCare enrollees. They’re pummeling lawmakers with complaints about the governor’s proposal. Sen. Larry Trail, D-Murfreesboro, said he’s received seven calls from a pharmacist in his area.
Sherry Hill, a Rockwood pharmacist who heads the association, said TennCare enrollees often need a pharmacist’s help understanding their prescriptions. “They need that face-to-face contact,” she said.
About 65 percent of her clients are on TennCare and many are illiterate, including one man who can’t write his name.
“He comes in and says ‘I need my little white tablet.’ We know he wants his blood-pressure medication. And we have kept him out of the hospital, because we know if it’s time for him to get his blood-sugar prescription refilled and we sometimes check his level to make sure he’s been taking it,” Hill said.
“If he even has a phone, I’m not sure he’d be able to communicate with a mail-order company.”
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On the Net:
TennCare Bureau: http://www.state.tn.us/tenncare