\n\tIndiana\u2019s Family and Social Services Administration could end Medicaid drug reimbursement for qualified health care providers across the state.<\/p>\n
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\n\tLast month, the administration posted notice<\/a> of plans to discontinue Medicaid reimbursement for drugs purchased under the federal 340B drug pricing<\/a> program.<\/p>\n
\n\tThe proposed change would eliminate the ability of safety net health care providers to claim drug discounts for medication used by poor and low-income populations.<\/p>\n
\n\tUnder that program, certain clinics and hospitals get medication from pharmaceutical companies at a reduced price. Those health centers can then submit Medicaid insurance claims for the drugs and have them reimbursed at full price.<\/p>\n
\n\tThe savings from those funds are then reinvested into providing care to uninsured patients, covering facility costs, or other services.<\/p>\n
\n\tUnder the proposed change, the state would claim those drug rebates for itself.<\/p>\n
\n\tSpeaking in front of the state budget committee last December<\/a>, FSSA Secretary Mitch Roob told lawmakers the funds would go directly into the state\u2019s Medicaid budget, equalling approximately $63 million annually.<\/p>\n
\n\tRoob said he had concerns about how health organizations are investing savings.<\/p>\n
\n\t\u201cWe have no idea how those dollars are used at all,\u201d Roob said. \u201cWe also lose out on the rebate.\u201d<\/p>\n
\n\tThis isn\u2019t the first time officials and lawmakers have raised concerns about how 340B drug savings are being invested. Last year, lawmakers considered language that would have stopped healthcare organizations from claiming reimbursements<\/a> on drugs that were higher than they would have paid for them.<\/p>\n
\n\tSpeaking during the budget committee, Sen. Chris Garten (R-Charlestown) suggested that there may be some organizations abusing the funds. But he asked Roob whether ending access to the program could harm clinics and hospitals effectively using those dollars, and end up costing the state more money.<\/p>\n
\n\t\u201cIf we don\u2019t know what services are provided with these dollars, then how can we say it\u2019s cheaper?\u201d Garten asked. \u201cWhat services is it going to directly affect?\u201d<\/p>\n
\n\tRep. Ed Delaney (D-Indianapolis) asked Roob if ending reimbursements through the drug program could endanger the business model of hospitals or clinics using it.<\/p>\n
\n\t\u201cIf you\u2019re telling me a hospital is going to close because it lost 340B pricing, they were going to close anyway,\u201d Roob responded.<\/p>\n
\n\tHealth centers said the change will have damaging impacts, reducing their ability to provide care to the poorest Hoosiers.<\/p>\n
\n\tAlan Witchey is the President and CEO of the nonprofit Damien Center, and said they save about $5 million under the program, which allows them to provide medicine free or at reduced cost.<\/p>\n
\n\t\u201cBy doing this, they will reverse that, and there will be less options for Hoosiers to get their medications, less options for Hoosiers to get medical care, and it will likely lead to far more people accessing emergency care,\u201d Witchey said.<\/p>\n
\n\tThe Damien Center, the state\u2019s largest HIV care provider, isn\u2019t alone in worrying how the change could impact them.<\/p>\n
\n\tRen\u00e9 Kougal is the president and CEO of HealthNet, which operates 10 health centers across the state. She said the change will cost them $3 million every year.<\/p>\n
\n\tKougal said the change is yet another way funding for services for poor and low-income Hoosiers is being pulled, pointing to expected cuts to the state\u2019s Medicaid population<\/a>.<\/p>\n
\n\t\u201cBy our mission, we provide care regardless of someone’s ability to pay, but that care is not reimbursed, and so programs like Medicaid and savings from the 340B drug pricing program are what allow health centers to keep serving patients when they can’t afford to pay,\u201d she said. \u201cIf both of those supports weaken at the same time, it creates real financial instability for safety net providers.\u201d<\/p>\n
\n\tA spokesperson for the FSSA did not respond to a request for comment.<\/p>\n
\n\tPeople can submit a written comment on the proposed plan. The change is expected to go into effect July 1.<\/p>\n