S.431A / A.187 – Drug Synchronization – Medicaid

This legislation, S.431-A/A.187, seeks to allow for Medicaid program the synchronization of multiple prescriptions to be picked up at once at the retail pharmacy, and for retail pharmacies to collect the full dispensing fee for partial medication fills.  The New York Health Plan Association (HPA) opposes this legislation as it is currently drafted as it would negatively impact efforts to reduce the cost of prescription drugs.

This legislation would allow Medicaid recipients to consolidate their prescription drug refills to a single trip to the retail pharmacy.  The intent of the legislation is to promote adherence to prescription drugs by making it easier for the recipient to get all of their prescription drugs in one fill.  While that is a laudable goal supported by the plans, the bill goes further.  The dispensing fee the retail pharmacy would collect would still be set at the full thirty day level regardless of the shortened timeframe.

While HPA understands the concept of synchronization, the reimbursement of retail pharmacies for the full dispensing fee for a period less than thirty days is of concern.  There are no limits on how many times the recipient can utilize synchronization.  For those consumers that take medications that require frequent dosage changes, this would result in additional fills resulting in another dispensing fee being paid to the retail pharmacy at the maximum thirty day level.

The bill needs to be amended, at a minimum, to align the reimbursement for the dispensing fee for a partial fee to a prorated level.  Without amendments to address these concerns, HPA opposes S.431-A/A.187.