Prescription drug fees for poor halted after uproar

Pharmacists decided who could afford to pay prescription fees under the new program.

Published: Sunday, January 4, 2004 at 6:01 a.m.
Last Modified: Saturday, January 3, 2004 at 11:54 p.m.
TALLAHASSEE- The state has ended a new program, just a day after its inception, that forced private pharmacists to decide whether poor and medically needy patients should pay a fee for prescriptions that have been free.
Late Friday, state officials ordered a temporary halt to the fees after questions were raised about whether they violated the law by failing to notify patients of the charges.
A number of chain pharmacies and independent drug stores reported they were charging the co-payments before being told to stop at 8 p.m.
The prescription fees were part of a legislative compromise last year that restored funding for the medically needy program in the state budget. State figures show Medicaid expected to collect $27 million from the co-payment.
Health advocates and state lawmakers said the system was illegal and could have forced thousands of poverty-stricken people to pay fees they can't afford - or, at worst, deny lifesaving drugs to critically ill patients.
"We've made pharmacists the gatekeepers," said state Rep. Anne Gannon, D-Delray Beach. "They're deciding whether people live or die."
Under the system, which went into effect Thursday, Medicaid and medically needy patients were to be charged a co-payment of 2.5 percent of the prescription price for drugs costing up to $300, and a flat charge of $7.50 for medication costing more than that.
"They say, I can't give you the pills you need to stay alive. Reach in your pocket and pull out seven bucks. It's wrong," said Mary Ellen Ross, executive director of the Florida Transplant Survivors Coalition. "I'm getting phone calls from across the state from people saying, 'I don't have the money to pay.' "
Gannon said she never heard of the plan to let pharmacists decide who can afford to pay for drugs. She said she intends to demand answers.
"Why is the state giving the pharmacists authority to decide that?" Gannon asked. "I mean, why do we even do a budget if the pharmacists decide?"
State health officials defended the arrangement, saying pharmacists are better equipped than the state to decide who can afford to pay.
"How else would you do that?" asked Steve Griegas, the state's assistant deputy secretary for Medicaid operations.
He said having the state decide would be too difficult because the status of patients changes.
"That would be an incredible burden on the system," Griegas said. "That would just not be a viable solution."

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