[Congressional Record (Bound Edition), Volume 152 (2006), Part 2]
[House]
[Page 1953]
[From the U.S. Government Publishing Office, www.gpo.gov]




 MEDICARE PART D IMPLEMENTATION, MEDICAID REIMBURSEMENT, AND COMMUNITY 
                              PHARMACISTS

  Ms. HERSETH. Mr. Speaker, I ask unanimous consent to take my Special 
Order at this time.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from South Dakota?
  There was no objection.
  The SPEAKER pro tempore. Under a previous order of the House, the 
gentlewoman from South Dakota (Ms. Herseth) is recognized for 5 
minutes.
  Ms. HERSETH. Mr. Speaker, I rise today to discuss a problem of 
potentially catastrophic proportions. It is not a matter of foreign 
policy or national security, and it is not natural disasters like this 
past summer's hurricanes or the ongoing drought in States like my home 
State of South Dakota.
  No. This is a man-made disaster. This debacle is of government 
creation and, in particular, legislative irresponsibility. This is a 
crisis that we, as elected representatives, have an obligation and a 
duty to address. I rise to discuss the crisis facing our community 
pharmacists, particularly those who serve rural communities.
  As I mentioned on Tuesday of this week, of all the health care 
professionals struggling with the implementation of the new Medicare 
drug benefit, pharmacists appear to be the most negatively affected. 
This past weekend I spent several hours meeting with health 
professionals from South Dakota communities, small and large, to 
discuss their ongoing efforts to implement the new Medicare 
prescription drug benefit.
  These meetings proved incredibly beneficial to me and to my staff, 
and I have scheduled more of them in the near future. I encourage my 
colleagues to take the time to sit down with those administering the 
program in their districts. It is important that you hear from them 
first hand. But because of the urgency of this issue, I feel compelled 
to share with you now some thoughts on the crisis facing rural and 
community pharmacists.
  Here is what is happening: PHARMACIES large and small receive no or 
inadequate compensation for the time they spend filling prescriptions. 
This is particularly troubling for those serving ``dual-eligible'' 
beneficiaries, those who qualify for both Medicare and Medicaid; and 
those in assisted living facilities who take large numbers of pre-
packaged medication. Much of the responsibility of ensuring the drug 
benefit's implementation has been assumed by the pharmacist. To the 
extent that it is working at all, we have them to thank. In many ways 
for many of the pharmacists I spoke with, much of the damage has 
already been done.
  On the horizon, however, are significant cuts to the Medicaid program 
that will be achieved primarily by changing the way we reimburse 
pharmacies for prescription drugs. That is right. The choices we made 
during the budget reconciliation process once again targeted our 
Nation's pharmacists, without asking for corresponding sacrifices from 
the insurance companies or the pharmaceutical manufacturers, which is 
outrageous.

                              {time}  1230

  It is truly shameful. And the implications will be significant. After 
absorbing significant losses during the rollout of the Medicare drug 
program, pharmacists will soon be hit by changes to the Medicaid 
program, and many simply will not survive. This one-two punch is not 
only bad policy, it is inexcusable.
  Health and Human Services Secretary Mike Leavitt even praised 
pharmacists last week for their ``heroic'' efforts in shouldering the 
burden for implementing Medicare Part D. Their reward for their 
selfless and heroic behavior? Drastic pharmacy reimbursement cuts in 
the Medicaid program that will have a devastating impact on our 
communities, disproportionately impacting the poorest and sickest 
Americans and that will no doubt put hundreds if not thousands of small 
businesses out of business.
  I encourage my colleagues to talk to their pharmacists, learn more 
about this situation, and work with me in a bipartisan manner to ensure 
that we are not sacrificing the health of our Nation and the good-will 
of our community pharmacists by taking the path of least resistance and 
caving to large and powerful interests.

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