I had a chance to speak with the PR folks from RiteAid this morning, who were responding to my request for additional information about RiteAid’s decision to terminate its relationship with work comp PBM FirstScript.
RiteAid is still participating with other work comp PBMs, just not with FirstScript. Sources also indicate that California-based work comp PBM WorkComp Rx has also been terminated by RiteAid for the same reason – processing comp scripts through group health contracts.
As this is a contracting matter, RiteAid will not comment on it publicly, and I won’t characterize my conversation with their corporate PR staff.
However, other internal sources have confirmed that RiteAid has term’ed their relationship with FirstScript. And I’m also hearing that FirstScript has told at least some of their payer customers that they should have their claimants start using other pharmacy chains. FS is obviously doing this in an effort to force RiteAid back into their network; by threatening to pull customers out of stores, FS is trying to hit the big retailer where it hurts most.
Other PBMs are watching very, very closely – as are other retail chains. If RiteAid backs down (which to date it has shown no intention of doing) expect other PBMs to start using group health contracts to process work comp scripts. If they hold firm, and if other chains follow their lead rather than seeking to benefit from RiteAid’s principled position, order will be restored to the market, rule-abiding PBMs will no longer be penalized, and rule-ignoring PBMs will get their comeuppance.
Hang in there, RiteAid. And to the rest of the chains, do the right thing.
May
27
I am actually quite suprised. It is usually Walgreens that steps up in situations such as this. Rite Aid?!?! Good for them. I am shocked that Walgreens hasn’t done the same.
The premise of your previous article is incorrect. It may cost more to dispense a workers comp prescription however a card issuing PBM actually reduces that cost by taking the mystery of the payer out of the picture. Other pharmacies understand this. I also think you will find if pharmacies wish to make it an issue they may find state that are trying to reduce workers comp costs weighing in.
Bob, it still costs more $$ b/c even with a card eligibility is up in the air with wc (ex: does claimant have a compensable claim). In group health all “lives” are already in the system. They are not in wc.