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Florida pharmacists accuse state of shutting them out of Medicaid

The Florida Pharmacy Association announced today that it has filed a lawsuit in Leon County's Circuit Court in an attempt to nullify state procedures they say is beginning to leave Florida pharmacists out of the business of fullfilling prescriptions for Medicaid patients.

The state's Agency for Health Care Administration has been entering into contract with HMOs and managed care companies to provide services to Medicaid patients, and those companies have been requiring clients to use mail-order pharmacies, the lawsuit alleges. That is leaving Florida-based pharmacies out of the equation and causing them to lose thousands of customers, the association said.

“In the last several sessions and special sessions, the Florida Legislature has worked tirelessly to enact multiple laws to assure Florida’s Medicaid program was not handed over to HMOs without strict oversight, regulation and accountability," Lori Weems, general counsel and governmental consultant for the Florida Pharmacy Association, said via a news release announcing the lawsuit.

"We have recently learned that over at least the last two-and-a-half years the agency has secretly been entering and awarding contracts that amount to just such a hand-off to HMOs in what we believe to be a full and illegal privatization of Medicaid for the majority of Medicaid patients," she said.

The association also believes that AHCA has violated its own Medicaid State Health Plan by "denying Medicaid patients the pharmacy access and freedom of provider choice that is rightfully theirs.”

Two Medicaid patients and a handful of independent pharmacies are named in the lawsuit. Among them is Lisa Oberly, a Medicaid patient in Orlando with cystic fibrosis, who said she is fearful AHCA will force her into an HMO.

An AHCA spokeswoman said the agency has not yet received a copy of the complaint.

Download FPA Press Release & Lawsuit