Independent pharmacists in Illinois hope for resolution in the fall

A bill written to address Illinois independent pharmacists' concerns over recent Medicaid managed care change was not approved in the final days of the Illinois General Assembly's spring legislative session, but an appropriation designed to provide relief to small pharmacies was included in the state budget approved by the General Assembly and rece

A bill written to address Illinois independent pharmacists' concerns over recent Medicaid managed care change was not approved in the final days of the Illinois General Assembly's spring legislative session, but an appropriation designed to provide relief to small pharmacies was included in the state budget approved by the General Assembly and recently signed by the governor. "This is going to be a long fight," says Garth Reynolds, executive director of the Illinois Pharmacists Association. Illinois has been transitioning to Medicaid managed care, meaning private insurers administer Medicaid benefits for the state. The program went statewide in April. Medicaid managed care organizations reimburse pharmacies for medications at lower rates than traditional Medicaid. Illinois House Bill 3479 would require Illinois Medicaid managed care organizations to provide fair and reasonable reimbursement to pharmacies and require more transparency from PBMs. Independent pharmacists support the legislation. "We have an issue here that needs government oversight to make sure taxpayers dollars are well spent," Reynolds says. But the spring legislative session ended without a vote on the bill as legislators focused on passing a state budget. But the budget does include $10 million in relief for pharmacies that operate 10 or fewer locations and operate in communities of 50,000 or fewer people. Reynolds hopes for passage of House Bill 3479 during the fall veto session.