« Ind. Decisions - Supreme Court disciplinary order re attorney fees | Main | Stage Collapse - More on: The State Fair Commission has posted a number of contracts and other documents online; constitutional issue with new fund? »

Wednesday, September 14, 2011

Ind. Decisions - Federal Judge Pratt reverses her own TRO blocking Indiana from cutting the fees it pays pharmacists for dispensing Medicaid prescriptions by 38 percent.

Here is the short version:

The Court must reverse its decision on the TRO and DENY Plaintiffs' Motion for a Preliminary Injunction (Dkt. 12 ). Plaintiffs' Motion for a Preliminary Injunction (Dkt. 12) is DENIED. The State is free to implement and enforce the Fee Reduction. **SEE ENTRY**. Signed by Judge Tanya Walton Pratt on 9/14/2011. (JD)
This ILB entry from July 9 includes a copy of Judge Pratt's original order.

Here is today's 24-page opinion in Community Pharmacies v. Indiana FSSA. It begins:

Recently, the State used an emergency rulemaking procedure to lower the Medicaid “dispensing fee” reimbursed to pharmacies for filling prescriptions from $4.90 to $3.00 – a 38% decrease (the “Fee Reduction”). The impetus for the Fee Reduction was budgetary; the State simply needed to tighten its belt. The Fee Reduction went into effect on July 1, 2011. This lawsuit immediately followed, and, on July 8, 2011, the Court granted a temporary restraining order (“TRO”) in favor of Plaintiffs. The parties have now re-briefed the issues in a more comprehensive fashion, and the Court held oral arguments on August 24, 2011.

Since the inception of this case, Plaintiffs’ overarching argument has remained the same: The Fee Reduction is in violation of state and federal law and will cause irreparable harm. Plaintiffs maintain that even before the Fee Reduction, the dispensing fee was borderline inadequate for Indiana pharmacies. Thus, the Fee Reduction will make a bad situation worse and will force many pharmacies to seriously reevaluate whether the provision of Medicaid services is compatible with a viable business model. So, not only will the Fee Reduction hurt Plaintiffs financially, it could drive many pharmacies out of Medicaid altogether, thus harming certain Medicaid patients by restricting their geographic access to pharmacy services. The State counters that these apocalyptic scenarios are purely speculative, and, in any event, the Fee Reduction complies with state and federal law.

While the Court certainly sympathizes with Plaintiffs, the State’s position best aligns with the law at this stage of the proceedings. For the reasons set forth below, the Court must reverse its decision on the TRO and DENY Plaintiffs’ Motion for a Preliminary Injunction.

Posted by Marcia Oddi on September 14, 2011 05:37 PM
Posted to Ind Fed D.Ct. Decisions