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73 members (Calvin, Gobble4me757, catdoctor, Ridge Life, Mbrock, odocoileus, Red Fox, Luxfisher, booner, Guru, scrape, Tree Dweller, outdoorguy88, ImThere, Young20, JHL, dagwood, JSOG47, Ray_Coon, coosabuckhunter, Safetyman, metalmuncher, Remington270, Bmyers142, NotsoBright, RUGRAT45, GomerPyle, jericward, bug54, Showout, Cuz-Pat, blade, SurveyinAL, twaldrop4, dirtwrk, duckbuster, BigA47, Joe4majors, fur_n_feathers, Bsivley1978, M48scout, Dr595, canine933, ts1979flh, burbank, BPI, skoor, Auburn_03, Chancetribe, jtillery, Brian_C, XVIII, leroycnbucks, Daveleeal, Hornhntr, Tree Hanger, Ron A., jdstephen44, JLavender, CrappieMan, GHTiger10, Okatuppa, foldemup, Moss, WhoMe, Johnal3, grundan, Bigem1958, 5 invisible),
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Key:
Admin,
Global Mod,
Mod
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Joined: Jan 2013
Posts: 832
6 point
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6 point
Joined: Jan 2013
Posts: 832 |
So you are saying if I have insurance and pay a copay, I wont have to pay this additional fee???
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Joined: Jan 2013
Posts: 832
6 point
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6 point
Joined: Jan 2013
Posts: 832 |
Also If it doesnt affect medicare, medicaid, people with insurance copays and cash paying customers.....Who will be paying this?? who is left???
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Joined: Oct 2008
Posts: 1,401
8 point
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8 point
Joined: Oct 2008
Posts: 1,401 |
Also If it doesnt affect medicare, medicaid, people with insurance copays and cash paying customers.....Who will be paying this?? who is left??? It does not affect cash patients at all, Medicaid already has a dispensing fee figured in when we fill the medications. This bill in itself will not increase anyone’s copays. Whether part D or commercial plans try to recoup money through an increase in premiums or copays is to be determined.
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Joined: Jan 2020
Posts: 642
4 point
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4 point
Joined: Jan 2020
Posts: 642 |
Glad to see some guys involved in the industry on here disseminating information.
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Joined: Jul 2006
Posts: 6,903
14 point
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14 point
Joined: Jul 2006
Posts: 6,903 |
Also If it doesnt affect medicare, medicaid, people with insurance copays and cash paying customers.....Who will be paying this?? who is left??? The middleman (PBM) will be the one paying it. They control what we are paid per transaction.
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Joined: Jan 2002
Posts: 4,689
10 point
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10 point
Joined: Jan 2002
Posts: 4,689 |
Also If it doesnt affect medicare, medicaid, people with insurance copays and cash paying customers.....Who will be paying this?? who is left??? The middleman (PBM) will be the one paying it. They control what we are paid per transaction. Who pays the middleman?
"Any way you look at it, most of the problems facing baboons can be expressed in two words: other baboons" -
D.L. Cheney and R.M. Seyfarth
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Joined: Jan 2002
Posts: 4,689
10 point
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10 point
Joined: Jan 2002
Posts: 4,689 |
There’s so much misinformation you just stated. The ONLY way I can imagine that this would increase cost to the consumer would be if you do no have a set copay. Even then, you would be paying toward your deductible. I’m tired of getting paid phucking pennies to fill prescriptions. Often times, I run a prescription through and will get reimbursed less than a dollar to fill it. Yes, I went to school for 7 years, opened a business, front the overhead, accept the liability to make pennies. This bill would fix that and many other issues with PBM reform. The issue is NOT with high drug costs it is with PBMs bending us, the consumer and the employee over at every damn turn. You need to be more educated about a subject before making a statement Why not go to a cash-only business if you are not making money on insurance-covered prescriptions?
"Any way you look at it, most of the problems facing baboons can be expressed in two words: other baboons" -
D.L. Cheney and R.M. Seyfarth
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Joined: Oct 2009
Posts: 6,252 Likes: 1
12 point
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12 point
Joined: Oct 2009
Posts: 6,252 Likes: 1 |
There’s so much misinformation you just stated. The ONLY way I can imagine that this would increase cost to the consumer would be if you do no have a set copay. Even then, you would be paying toward your deductible. I’m tired of getting paid phucking pennies to fill prescriptions. Often times, I run a prescription through and will get reimbursed less than a dollar to fill it. Yes, I went to school for 7 years, opened a business, front the overhead, accept the liability to make pennies. This bill would fix that and many other issues with PBM reform. The issue is NOT with high drug costs it is with PBMs bending us, the consumer and the employee over at every damn turn. You need to be more educated about a subject before making a statement I don't have a copay on prescriptions. It's a negotiated rate. My prestigious are all different cost depending on the medication. They will just raise this $10.
"And the days that I keep my gratitude
Higher than my expectations
Well, I have really good days" Ray Wylie Hubbard
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Joined: Jul 2006
Posts: 6,903
14 point
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14 point
Joined: Jul 2006
Posts: 6,903 |
There’s so much misinformation you just stated. The ONLY way I can imagine that this would increase cost to the consumer would be if you do no have a set copay. Even then, you would be paying toward your deductible. I’m tired of getting paid phucking pennies to fill prescriptions. Often times, I run a prescription through and will get reimbursed less than a dollar to fill it. Yes, I went to school for 7 years, opened a business, front the overhead, accept the liability to make pennies. This bill would fix that and many other issues with PBM reform. The issue is NOT with high drug costs it is with PBMs bending us, the consumer and the employee over at every damn turn. You need to be more educated about a subject before making a statement Why not go to a cash-only business if you are not making money on insurance-covered prescriptions? We are only 10% cash so giving up all insurances is not an option. We obviously do not lose on all insurance claims but a significant percentage. The PBM sits back and alters the reimbursement on a whim it seems. This bill would alter that.
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Joined: Jul 2006
Posts: 6,903
14 point
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14 point
Joined: Jul 2006
Posts: 6,903 |
Also If it doesnt affect medicare, medicaid, people with insurance copays and cash paying customers.....Who will be paying this?? who is left??? The middleman (PBM) will be the one paying it. They control what we are paid per transaction. Who pays the middleman? It is my understanding that it is employers.
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Joined: Jul 2006
Posts: 6,903
14 point
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14 point
Joined: Jul 2006
Posts: 6,903 |
There’s so much misinformation you just stated. The ONLY way I can imagine that this would increase cost to the consumer would be if you do no have a set copay. Even then, you would be paying toward your deductible. I’m tired of getting paid phucking pennies to fill prescriptions. Often times, I run a prescription through and will get reimbursed less than a dollar to fill it. Yes, I went to school for 7 years, opened a business, front the overhead, accept the liability to make pennies. This bill would fix that and many other issues with PBM reform. The issue is NOT with high drug costs it is with PBMs bending us, the consumer and the employee over at every damn turn. You need to be more educated about a subject before making a statement I don't have a copay on prescriptions. It's a negotiated rate. My prestigious are all different cost depending on the medication. They will just raise this $10. I don’t have much to say to you after being called a socialist democrat in another thread. Hard to believe that is the case when all we want is transparency and fairness. Sounds like I’m the capitalist.
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Joined: Jul 2020
Posts: 8,855
14 point
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14 point
Joined: Jul 2020
Posts: 8,855 |
This is nothing more than spin. You cannot add a cost into the distribution stream and it not pass thru to the customer. This is the same stupid line of reasoning they toss out when they talk of taxing a corporation. As though any entity is going to just give up profit margin because a bunch of dumb politicians want to pass a bill so they can spend more $.
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Joined: Jul 2020
Posts: 8,855
14 point
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14 point
Joined: Jul 2020
Posts: 8,855 |
Also If it doesnt affect medicare, medicaid, people with insurance copays and cash paying customers.....Who will be paying this?? who is left??? The middleman (PBM) will be the one paying it. They control what we are paid per transaction. Who pays the middleman? It is my understanding that it is employers. So that's less salary dollars they pay in wages. As the main HR person in my office, a person costs a lot more than just their salary. There is health insurance, life, disability, retiremebt match plus 7.65 percent to SS and Med. The biggest expense in a lot of business is HR. So if they have to pay out more, then they don't give raises or they raise prices. No one is coughing up $10 a script for free.
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Joined: Jul 2006
Posts: 6,903
14 point
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14 point
Joined: Jul 2006
Posts: 6,903 |
It is my understanding that the minimum reimbursement will be $10.64. If we are already getting that much no increase will take place. Also, I know employers are likely paying much more than the fee the bill is requesting. PBMs pay us based on one price and charge the employer based on another. This is called spread pricing. They are corrupt to the core. I’d feel better and cleaner if I was pimping out women and trafficking cocaine. The cluster of big pharma, PBMs and other entities involved are that dirty. This bill is simply trying to require a fair reimbursement and make them be transparent.
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Joined: Jul 2006
Posts: 6,903
14 point
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14 point
Joined: Jul 2006
Posts: 6,903 |
This is nothing more than spin. You cannot add a cost into the distribution stream and it not pass thru to the customer. This is the same stupid line of reasoning they toss out when they talk of taxing a corporation. As though any entity is going to just give up profit margin because a bunch of dumb politicians want to pass a bill so they can spend more $. Politicians did not come up with this bill. It was drafted by the APA (Alabama Pharmacy Association) and APCI (American Pharmacy Cooperative Initiative). It is asking the PBM to take some out of their pocket to make the pharmacy whole. It would also allow us to talk to the customer about cheaper alternatives or possibly not putting the prescription on insurance.
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Joined: Aug 2016
Posts: 279
4 point
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4 point
Joined: Aug 2016
Posts: 279 |
Republicans are not about smaller government and dang sure are not about being fiscally conservative. Most of these are Republicans and they doing what Republicans do.. they give ya'll some false hope that they will reduce govt but that has really never happened. But the core will always vote for them because they come across as Pro Life... so they can do what they want to do in regards to spending and taxes.
You will vote for them again and again. This!!! Alabama has been run by republican for as long as I can remember. We are one of the poorest states and most taxed.
All you need to know is. Dead deer don't grow!
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Joined: Dec 2015
Posts: 914
6 point
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6 point
Joined: Dec 2015
Posts: 914 |
I'll have to change from local independent pharmacy to one across line in Mississippi if it passes. Sure other local people will do the same.No way will I believe the increase will not be passed down to customers.
Last edited by Luxfisher; 03/13/24 07:57 PM.
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Joined: Jul 2014
Posts: 5,631
12 point
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12 point
Joined: Jul 2014
Posts: 5,631 |
with my meds and my bride's meds, our standard drug bill will go up $1,200 a year ...
paulfish4570
Joshua 1:9
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Joined: Feb 2007
Posts: 21,981
Freak of Nature
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Freak of Nature
Joined: Feb 2007
Posts: 21,981 |
Will Trump fix what’s happening? Trump Will Bring America First Drug Prices by Knocking Out the Middlemen, Making Europe Pay Its Fair Share https://www.breitbart.com/politics/...dlemen-making-europe-pay-its-fair-share/
“Socialism only works in two places: Heaven where they don't need it and hell where they already have it.” ― Ronald Reagan
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Joined: Feb 2019
Posts: 4,987 Likes: 1
12 point
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12 point
Joined: Feb 2019
Posts: 4,987 Likes: 1 |
This is trying to save the smaller pharmacies, the larger pharmacies are already getting theirs. The larger pharmacies have a greater voice, thus, they have a better return rate on the prescriptions. The smaller guys just want to make the investment the same.
Next time you go to the doctor and a friend goes that has a different insurance but having the same thing done. Look at the Eob for each of you. You will see what the doctor charged and what the provider actually paid. Why do you think some doctors have quit taking medicare or medicaid patients, the reimbursement isn't worth it to them.
Small pharmacies don't really have that luxury, same as why small hospitals and doctors offices are closing, they can't keep the lights on because of the reimbursement.
“If you do not conquer self, you will be conquered by self.” Napoleon Hill
The most difficult thing to understand during conversation is silence. Thoreau
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