BURLINGTON, Vt. (WCAX) – It’s been over two weeks since a cyber attack impacted how patients use Medicaid for prescriptions. Without access to what’s known as Change Healthcare, some pharmacies and their customers are scrambling to pay for prescriptions.
“It’s outrageous right now, it’s not fair, and what they’re doing right now, it needs to be fixed. This is crazy,” said Kevin Patterson, a father of three kids who all need expensive, life-saving medication. On Medicaid, it wasn’t an issue. But since the cyber attack, Patterson said he’s been falling behind on bills. “Kids’ medication is $100+. Just to get their medication, and this is with their Medicaid card.” He says each medication is $40 to $60 more than what he used to pay.
“No member should ever be paying out of pocket for a prescription that the state would otherwise be covering,” said Alex McCracken with the Vermont Department of Health Access. McCracken says pharmacies charging patients full cost for their Medicaid prescriptions is against federal law. But since the cyberattack, mix-ups like Patterson’s are continuing to happen.
“The DHA has been informed of a handful of situations where this has happened. And in these cases, we’ve reached out to the pharmacies directly to ensure they are complying with the guidance from the state.”
The state has worked out a supplemental payment system for pharmacies to keep costs low for patients. At Vermont Family Pharmacy in Burlington, owner Lynne Vezina says the most important thing is that her customers get the medication they need. “We’ve been having them pay what they had previously been paying,” she said. But this policy means the pharmacy is losing money. The temporary system doesn’t totally cover the time and money Vezina is sinking into the issue. “If it goes on for a long period of time, it could be a problem, for sure.”
Meanwhile, the state is working hard to keep the public informed, prescriptions filled, and pharmacies reimbursed. “There should not be an issue with access, there should not be an issue with payment. Those things we’re working very hard as a department to make sure those things are not issues,” McCracken said.
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