Valley pharmacies closing their doors amid Medicaid changes
Fri, 02 Mar 2012 04:39:17 GMT —
A new billing system went into effect Thursday for Valley pharmacies and clinics accepting Medicaid.
The doors of the Family Care Pharmacy in Pharr closed down for good, thanks to new changes to Medicaid.
A letter on one of the windows explained why, "They have drastically reduced the amount of money they pay us for our services and therefore we cannot continue."
They referred to the Texas Health and Human Services Commission ad their role in managing health care.
But the changes are not just impacting pharmacies.
"Although we've been working on this for a year there's already challenges we need to overcome," Veronica Alonso is the administrator at Risas y Rayones Rehab Services Clinic in Pharr.
Her challenges stem from Medicaid shifting to an HMO plan.
Under the plan, starting March first, all Medicaid recipients and their doctors will work with one of five health maintenance organizations, instead of the state.
"So now it TMs a much bigger challenge because now you have four to five different HMO TMs and insurances to deal with where before it was just one," he said.
Legislators approved the changes to Medicaid in their last session, amid a large budget shortfall.
They hope changes will save almost $470 million over the next two years.
Alonso said the cuts come at a price to clinics like hers, where Medicaid recipients make up almost 95 percent of her patients.
"We TMve cut down on hours, we TMve had to cut down on benefits," Alonso added.
But that is not the only concern for them.
Noelia Cavazos, the clinic's billing supervisor, said the transition to working with the HMO TMs is different than what she was told.
"We're kind of having a lot of trouble on that, just getting the authorization, she said. No authorization, we cannot provide services for the patient."
Cavazos said that authorization is key and delaying it takes precious recovery time away from patients.