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Managed Care Organizations Say Reimbursement Problems Are Resolved, But Pharmacists Disagree

Kentucky's Medicaid Managed Care Organizations say they have fixed a number of issues with reimbursements to pharmacists.CoventryCares, WellCare and Kentucky Spirit took over management of the state's Medicaid system last year. Since then, doctors and pharmacists have come forward to say the organizations are poorly managed and the reimbursements for care are too low.Executives from the organizations told a legislative committee today that the early kinks have been worked out of the system. But there were pharmacists in attendance who disagreed.“How many of you are paid less than what it costs you for drugs?" asked Senator Vernie McGaha. Most of the pharmacists raised their hands.Lawmakers on the committee seemed to side with the pharmacists. Representative John Will Stacy—who co-owns pharmacies himself—argued with CoventryCares executive William Strein over drug reimbursements.Stacy questioned Strein over what he considered a fair reimbursement rate to pharmacists on drugs. When Strein did not give a solid answer, Stacy argued that Strein should reveal how much money his organization makes if they can't reveal what a fair price is. Strein says his business does not make money off setting reimbursement rates.The argument continued until chairman Jim Higdon called "timeout" between the two.Despite meeting for more than two hours, not all presenters were given time to speak. The discussion will continue at the committee's next meeting.There is one other Medicaid management organization in Kentucky. Passport has been in operation in the Louisville area for several years.