Valley Pharmacists Criticize Altered Medi-Cal Program

San Fernando Valley pharmacists Sunday criticized a cost-cutting pilot program that will dramatically alter the way 87,000 Medi-Cal recipients in the Valley get medical care.

About 75 pharmacists attended a meeting in Van Nuys to voice their concerns to Michael W. Murray, executive director of the California Medical Assistance Commission, the agency responsible for the experiment, which begins Jan. 1.

The intent of the Expanded Choice Program is to reduce by 5% a year the cost to the state of treating the poor on Medi-Cal. The method is a requirement that a majority of Medi-Cal recipients enroll in a participating health maintenance organization, or HMO, which is a group of physicians and other health professionals who provide comprehensive medical services for a fixed fee paid in advance.

Most of those covered by the plan will no longer be reimbursed by Medi-Cal for treatment by their own physicians, or for prescriptions filled at neighborhood drugstores.

3 Areas Covered

The pilot program covers San Diego and the San Fernando and Santa Clarita valleys, but Gov. George Deukmejian hopes to put the plan into effect statewide.

Pharmacists predict that the plan will drive neighborhood druggists out of business because HMOs will provide their own drugs or contract with large drugstore chains.

“It’s a question of survival for most practicing pharmacists,” said Ira Freeman, president of the Pharmacist Professional Society of the San Fernando Valley. Pharmacists also say they are worried about their customers, particularly the elderly on Medi-Cal, who have depended on them for many years. They said they serve as insurance for their customers by checking to see that physicians have prescribed the right medicines.

The pharmacists like to cite a Gallup poll that ranked them below only rabbis and priests as the most trusted professionals in America.

If the plan is implemented, “you will need the pharmacists all the more” to ensure that quality is not being sacrificed to cost considerations by the HMOs, contended pharmacist Mort Farina.

Checks Built Into System

Murray, however, told the pharmacists that ample checks will be built into the program to make sure that the HMOs provide sound medical treatment.

“I don’t know how else we’re going to test it out except by doing it,” Murray said.

Some pharmacists at the meeting said they favored court action to block the proposal. John T. Skhal, an official with the California Pharmacists Assn., said a lawsuit would be filed if the pharmacists cannot obtain changes in the program through the Legislature this year.

The association will seek legislation that would require HMOs to subcontract with a certain number of neighborhood pharmacists.

Murray, however, said the state is already encouraging pharmacists and physicians to form their own HMOs so that they can continue to see their old patients and customers.

‘A Lot of Scared People’

Meanwhile, Freeman said, Medi-Cal recipients are growing anxious as the inauguration of the program grows nearer. Beginning Jan. 1, recipients will have 90 days to chose an HMO that is participating in the plan. Treatment from the HMOs will begin April 1.

“There are a lot of people who are very, very scared,” Freeman said.

A Valley office of the state Medical Assistance Commission is scheduled to open at 15760 Ventura Blvd. this week to aid the pilot program.