Independent pharmacists say low rates are bleeding them dry

Frustrated that their demands for renegotiated reimbursement rates have not been met, local pharmacists say cuts in payment for prescriptions through the Gold Coast Health Plan continue to cripple them.

After months of complaints from independent pharmacists over reimbursement provided by Gold Coast’s contracted partner, OptumRx, governing commissioners told staff in early December to find consultants who can analyze the rates. Gold Coast is the publicly funded entity that administers Medi-Cal health insurance for nearly 200,000 low-income Ventura County residents. 

Pharmacists said the rates fell dramatically in the summer when OptumRx, part of the UnitedHealth Group, launched its program as Gold Coast’s new pharmacy benefit manager. They say the new rates in some cases don’t cover the cost of medications and could force many stores out of business. [Read more from VC Start]