Miss. SC: Pharmacist reimbursement change was illegal

Kathy Woods Nov. 15, 2009, 12:29pm

Randy Pierce

JACKSON, Miss. (Legal Newsline)-The Mississippi Supreme Court has upheld a chancery judge's ruling that the Division of Medicaid had no authority to change the way in which pharmacists were paid for prescriptions for those enrolled in the program.

In 2008, the Medicaid program tried to change the way pharmacies were reimbursed. The pharmacies sued, arguing that state law gives the Legislature sole authority to change the reimbursement plan unless there was a federal mandate.

Under the Medicaid pharmacy program, states reimburse pharmacies for the costs of medicine provided to patients that are on the program. There are three methods in state law to determine how much a pharmacist would be reimbursed for dispensing generic drugs.

A Hinds County judge, at trial, said Medicaid went beyond their authority by trying to add a fourth without the Legislature amending state law.

On Thursday, the state's high court upheld the ruling.

The state attorney general's office had argued before the justices in September that legislators had given the Medicaid Division flexibility to define costs and reimbursements back in 2003. He argued that the proposed rule change was just that.

"This court takes no issue with Division of Medicaid's desire to cut costs during economic uncertainty," Associate Supreme Court Justice Randy Pierce wrote for the high court.

He added: "While we recognize the particularly difficult financial position in which Medicaid finds itself, this court will not allow the plain language of the law to be swept away in the interest of cost containment. The formula for reimbursement was established by statute, and cannot be varied by the Division of Medicaid."

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