Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Independent pharmacies warn Medicaid reimbursements are unsustainable, urge PBM transparency
Summary
Independent pharmacy owners and the Washington DC Pharmacy Association told the Committee on Health that low Medicaid and managed-care reimbursements — amplified by pharmacy benefit manager (PBM) practices — are forcing neighborhood pharmacies to close and reducing access in the District’s most vulnerable communities.
Independent pharmacy owners and pharmacy advocates told the District’s Committee on Health on March 5 that low Medicaid and managed-care reimbursements and opaque pharmacy benefit manager contracts are driving neighborhood pharmacies out of business, reducing access for residents in Wards 7 and 8 and other underserved areas.
"In Q4 of 2024, my pharmacy alone lost over $43,000 in negative reimbursement just due to billing the MCOs and the district and DC Medicaid," said William Fadel, owner and CEO of Grubbs Pharmacy Southeast in Anacostia. Fadel told the committee that three independent pharmacies in his immediate area closed in recent months and that one nearby pharmacy on Capitol Hill stopped accepting Medicaid and MCO plans on Oct. 1, 2024.
The Washington DC Pharmacy Association’s executive director, Carolyn Rochelle Price, said district-level data show a…
Already have an account? Log in
Subscribe to keep reading
Unlock the rest of this article — and every article on Citizen Portal.
- Unlimited articles
- AI-powered breakdowns of topics, speakers, decisions, and budgets
- Instant alerts when your location has a new meeting
- Follow topics and more locations
- 1,000 AI Insights / month, plus AI Chat
