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Pharmacists ‘caught in the middle’
Reimbursement, billing problems plague drugstores — and it might only get worse
By LINDA H. LAMB
Staff Writer
Busy pharmacists are on the front lines of the current Medicare quandary as seniors seek answers at the same counters where they get their medications.
In the Pee Dee, Lake City pharmacist Dan Bushardt said his staff of two pharmacists and four technicians logged 22 hours of continuing-education credit in seminars on helping people with the new benefit.
But nothing prepared them for perpetually busy phone lines that rendered them unable to confirm seniors’ enrollment, clarify their benefits and know whom to bill.
“It’s been very frustrating,” Bushardt said. “We’re trying to help our patients, and they need their medicines, and we’re just kind of caught in the middle.”
Some nights, Bushardt said, he has spent five or six hours on the Internet at home, studying drug plans and trying to figure out which might work for particular patients.
There are a couple of backup plans, including a Medicaid plan, to help people get their prescriptions when there’s a delay in their Medicare Part D benefits. However, regional Health and Human Services director Chris Downing conceded that some pharmacies have been providing medicines free to patients — and going in the hole financially.
“The patients are being taken care of. The pharmacies are the ones that are suffering,” said Tracy Russell, director of organizational affairs for the S.C. Pharmacy Association.
And while pharmacists might be harried now, she predicted they’ll be in worse trouble as the impact of the Medicare changes sinks in. Compared to their dealings with Medicaid, she said, there will be lower reimbursements, longer cycles between payments, and much smaller dispensing fees for the state’s approximately 935 pharmacies.
“It’s going to hurt the small, rural areas, with high Medicaid populations, more,” Russell said.
That would be places such as Estill, population 2,425.
“We have a lot of poor customers,” said Laurie Hanna, who runs an independent pharmacy in the Hampton County town with her husband, Chris.
“We have customers who are illiterate. Some people aren’t even sure of the status of their paperwork.”
Though Hanna agreed the worst part of the initial adjustment seems to be past, she’s worried about the reimbursements.
“It could put us out of business,” she said.
Hanna and her pharmacist husband are Estill natives who went to USC, then came back home. The nearest Wal-Mart pharmacy is 35 miles away in Georgia.
“Without stores like us here, who is going to take care of these people?” Hanna said.
Pharmacy Association president Lynn Connelly, who owns The Medicine Mart in West Columbia, estimates he filled $100,000 worth of Medicare Part D prescriptions in January and has yet to receive one dollar of reimbursement.
His group is pleading with federal officials to establish better reimbursement terms “and some compensation for what we had to put up with in January.”
Spokesman Frank Adams of the state Agency on Aging said overburdened S.C. pharmacists “are doing a great job.”
He added: “Everyone’s just working through this, one senior at a time.”
