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Bentley Establishes Alabama Medicaid Pharmacy Study Commission

Brandon Moseley

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By Brandon Moseley
Alabama Political Reporter

MONTGOMERY—On Thursday, Alabama Governor Bentley (R) signed Executive Order 40 which establishes the Alabama Medicaid Pharmacy Study Commission. According to the Governor’s announcement the commission members will review the Alabama Medicaid pharmacy delivery and reimbursement system. The commission is tasked with comparing Alabama’s handling of Medicaid pharmaceutical benefits with programs in other states and will study options to reduce Alabama Medicaid’s pharmacy costs while still maintaining a quality Medicaid program.

The Commission will include, the State Health Officer (who will chair the commission), the acting Alabama Medicaid Commissioner, the Chairman of the Alabama Senate Health Committee, the Chairman of the Alabama House Health Committee, the Chairman of the Alabama Senate Ways and Means General Fund Committee, and the Co-Chairman of the Alabama House Ways and Means General Fund Committee. The Governor will also appoint a hospital administrator, a pharmacist who has his or her own independent pharmacy, a doctor, and other member(s) of the committee as believe needed by the Governor.

Many of ‘Alabama Political Reporter’s sources believe that the state could benefit from contracting with a pharmacy benefit manager (PBM). A PBM is a private company that set up a network of pharmacies that accept the PBM’s terms and provide prescription medication to beneficiaries. PBMs are responsible for processing and paying prescription drug claims and developing and maintaining the drug formulary. They negotiate deals with the drug manufacturers for additional savings. More than 210 million Americans receive their drug benefits through PBMs. Some independent pharmacists are concerned that if Alabama Medicaid goes to a PBM that they will be left out of the network in favor of larger chain pharmacies, such as Wal-Mart, Publix, CVS, Wallgreens, and Winn Dixie.

The commission is expected to present their findings to Governor Bentley by December 1, 2013.

Also on Thursday, Gov. Bentley signed Senate Bill 340 into law. SB 340 is set to reform Medicaid by increasing efficiency through transferring risk to Regional Care Organizations (RCOs) while improving care for Medicaid beneficiaries by moving from a fee for service system to a managed care system. The state is working with healthcare providers to set up the regions which are scheduled to be announced in October.

Medicaid reform has been a long-term goal for Governor Bentley. In 2012 the Governor established the Alabama Medicaid Advisory Commission to evaluate the financial stability of Alabama Medicaid. The Alabama Medicaid Advisory Commission preceded SB 340 which is based on the recommendations of the Commission. It is anticipated that some sort of Medicaid Pharmacy benefit reform legislation will be introduced in the 2014 legislative session based on the commission findings. SB 340 called for studies of the Medicaid pharmacy benefits, long-term care benefits, and dental benefits to be prepared in 2015 for the 2016 legislative session.

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State Health Officer Dr. Donald Williamson served as chair of the Alabama Medicaid Advisory Commission and similarly will head the Alabama Medicaid Pharmacy Study Commission. Dr. Williamson said on Thursday, “I want to thank Governor Bentley, Senator Reed and Representative McClendon for their support of Alabama Medicaid.”

Acting Alabama Medicaid Commissioner Stephanie Azar will also serve on the new commission as well as Representative Jim McClendon (R) from Springville and Senator Greg Reed (R) from Jasper.

Commissioner Azar said, “The transformation that will take place over the next few years will be significant. Medicaid is ready to take on this challenge and help the state move forward to create a program that will help support the long-term sustainability of Alabama Medicaid. I want to thank Governor Bentley, Senator Reed, Representative McClendon and Dr. Williamson for their leadership on this important issue and for their commitment to the health and well-being of Medicaid recipients in this state.”

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Brandon Moseley is a senior reporter with eight and a half years at Alabama Political Reporter. You can email him at [email protected] or follow him on Facebook. Brandon is a native of Moody, Alabama, a graduate of Auburn University, and a seventh generation Alabamian.

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Elections

Coalition of attorneys general file opposition to Alabama attempt to ban curbside voting

The AGs argue that Alabama’s suggestion to the courts that curbside voting invites fraud is “unfounded.” 

Eddie Burkhalter

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(STOCK PHOTO)

A coalition of 17 state attorneys general have filed an opposition to Alabama’s attempt to get the U.S. Supreme Court to ban curbside voting. 

In a friend-of-the-court brief, led by District of Columbia Attorney General Karl Racine, the attorneys general argue to that curbside voting is safer for those at greatest risk from COVID-19, and that a ban on the practice would disproportionately impact the elderly, the disabled and Black Alabamians.

They also argue that Alabama’s suggestion to the courts that curbside voting invites fraud is “unfounded.” 

“The Presidential Advisory Commission on Election Integrity, established by President Trump following the 2016 election, ‘uncovered no evidence to support claims of widespread voter fraud,’” the brief states, adding that there is no evidence that curbside voting in the many states that allow it invites fraud. 

“The practice is longstanding and widespread—as noted, more than half of states have historically offered curbside voting in some form,” the brief continues. 

Alabama Attorney General Steve Marshall on Oct. 13 said the state will appeal to the U.S. Supreme Court a federal appeals court ruling allowing curbside voting in the Nov. 3 election. 

A panel of federal appeals court judges on Oct. 13 reversed parts of U.S. District Judge Abdul Kallon’s Sept. 30 ordered ruling regarding absentee voting in the upcoming Nov. 3 elections, but the judges let the previous ruling allowing curbside voting to stand. 

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The lawsuit, filed by the NAACP Legal Defense and Educational Fund, Southern Poverty Law Center, American Civil Liberties Union, ACLU of Alabama and Alabama Disabilities Advocacy Program, was brought on behalf of several Alabamians with underlying medical conditions. 

“Curbside voting is a longstanding, secure voting option that local jurisdictions have made available to protect the health of vulnerable voters, including elderly, disabled, and voters with underlying health issues,” Racine said in a statement. “Curbside voting minimizes the risk to persons who are particularly susceptible to COVID-19, and local jurisdictions should be able to offer this common-sense accommodation to voters. State Attorneys General will keep fighting to ensure that voters can safely make their voices heard at the ballot box this November.”

The brief filed by the coalition of state attorneys general comes as the number of COVID-19 hospitalizations across Alabama has been ticking upward.

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Racine is joined in the brief by attorneys general from California, Connecticut, Delaware, Hawaii, Illinois, Maryland, Michigan, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Vermont, Virginia and Washington.

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Alabama revenues grew despite COVID pandemic, analysis shows

Tax revenue into the state’s General Fund was 7 percent higher this year the Education Trust Fund brought in an additional $209 million in 2020 compared to 2019. 

Eddie Burkhalter

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(STOCK PHOTO)

Alabama’s strong economy going into the COVID-19 pandemic, and billions in federal aid to address the health and economic crisis, has helped the state’s two largest budget funds to grow this year, according to a study released Thursday. 

According to an analysis by the Public Affairs Research Council of Alabama, tax revenue into the state’s General Fund was 7 percent higher this year than it was in 2019, and Alabama’s Education Trust Fund brought in an additional $209 million in 2020 compared to 2019. 

“According to Finance Department officials, Alabama ended 2020 with $330 million balance in the ETF and a $315 million balance in the General Fund,” wrote PARCA’s Tom Spencer in the report. “That was result both of revenues that exceeded the budgeted amounts and expenditures that were lower than what was appropriated.”

The growth came despite the spike in unemployment that began in March and hasn’t yet abated, and despite mandatory business closures in March and April and the restrictions still in place to protect against the spread of the coronavirus. 

The author of the report said the growth is due in part to the state’s strong economy before the pandemic hit. Unemployment was at a historic low between October and March, and prior to the pandemic, income tax receipts were up approximately 7 percent over the same period in 2019. 

Additionally, $4.1 billion in federal COVID-19 aid has been committed to individuals and municipalities in Alabama, and consumer spending shifted but didn’t stop, the author notes. 

The federal Paycheck Protection Program preserved payrolls, and unemployed workers received $600 per week in a supplement to unemployment insurance, which both helped prevent the state’s tax revenue from taking a bigger hit. 

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“Sales taxes dropped, then recovered and have been up and down in the months since. At the same time though, tax on internet purchases surged, offsetting the erosion in sales tax. Unlike some other states, Alabama’s sales taxes apply to groceries and medicine and thus it tends to be more stable,” Spencer wrote in the report. 

Several sectors of Alabama’s economy have done well during the pandemic, including the state’s Alcohol Beverage Control Board, which contributed an additional $17 million to the General Fund, an increase of 14 percent. 

But still other sectors suffered, including lodging tax. The tax on hotels and vacation rentals was down 15 percent for the year, and collected almost $9 million less for the General Fund.

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“For the current fiscal year, FY 2021, Finance officials are relatively confident that revenues will more than cover the budgets. Lawmaker scaled back spending plans in light of the pandemic,” Spencer wrote in the report. “As long as there aren’t additional unforeseen shocks to the economic system, the Alabama economy should generate the revenue needed to make the budgets as adopted this spring.”

If the state’s economy were to take a larger hit, Spencer noted, the state still has rainy day funds for both funds. 

RESERVE FUND BALANCES

  • ETF Budget Stabilization Fund – $373,269,077
  • ETF Rainy Day Account – $465,421,670
  • GF Budget Stabilization Fund – $27,297,483
  • GF Budget Rainy Day Account – $232,939,781

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Opinion | Electing Tuberville could cost Alabama billions

If your conscience or decency isn’t enough, vote your wallets.

Josh Moon

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Sen. Doug Jones, left, and Senate candidate Tommy Tuberville, right.

Money matters in Alabama. Oh, I know that we’re not supposed to say that out loud. That we’re supposed to promote our image of southern grace and hospitality, of churchiness and care, of rich people never getting into heaven. 

But the truth is greed is our biggest character flaw in this state. 

Every problem we have can be traced back to our unending thirst for dollars. Our ancestors didn’t keep slaves because they hated black people. They did it because they loved money and the difference in skin color gave them an excuse — a really, really stupid excuse — to mistreat other humans to take advantage of the free labor. 

Our rivers and lakes and dirt aren’t filled with poisons from factories because we’re too dumb to understand how this works. They’re that way because our politicians are paid off to turn a blind eye to the dumping of toxic waste. 

Our schools aren’t terrible because we have dumb kids or bad teachers. It’s because we’re too cheap to pay for them. 

You see what I mean? It’s our lust for the almighty dollar. Every time. 

We love money. 

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Which makes me seriously wonder why so many people in this state are going to vote for a man who will cost us all — and especially our biggest businesses — so much of it. 

Tommy Tuberville will be like a money vacuum for Alabama. Billions of dollars will vanish for this welfare state that relies so much on federal contracts, federal programs and federal dollars. 

If you doubt this, don’t simply take my word for it. Just Google up the press releases from Sen. Richard Shelby’s office from the last, say, six years — the most recent span in which Republicans have controlled the Senate. 

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Almost every single release is about Shelby securing millions or billions of dollars in federal funding for this project or that project, getting the state’s share of dollars from a variety of different programs and initiatives implemented by Congress. 

Shelby and I obviously have different political viewpoints, but it’s hard to argue that the man has been successful in securing money for Alabama. Lots and lots of money. 

Money for airports and roads. Money for defense contractors in Huntsville. Money for the port in Mobile. Money for car manufacturers. Money for farmers. 

Money. Money. Money. 

Shelby can do that because of three things: He’s on the right committees, he’s a member of the party in power and he’s liked by the right people.

Tuberville will be none of those things. 

Most pundits are predicting that Democrats will take over the Senate, tipping the balance of power and giving the party control of both houses and the White House. 

That automatically means that a first-time senator in the opposition party will have little to no say in any decisions. 

But what’s worse for Tuberville, and for Alabama, is that other Republicans don’t like him either. 

Establishment Republicans essentially openly campaigned against Tuberville in the primary, tossing tens of millions of dollars behind his opponent, Jeff Sessions. They even favored third-place finisher Bradley Byrne over Tuberville. 

It’s not hard to understand why — he’s clueless. 

I know that’s a Doug Jones talking point, but this one happens to be true. Let me give you an example: On Thursday, Tuberville tweeted out what was meant to be a shot at Jones, claiming that Alabama’s current senator wouldn’t meet with Trump’s Supreme Court nominee because Jones knows “he won’t have much time in the Senate to work with her.”

If you’re unaware, the Senate doesn’t “work with” the Supreme Court. They’re separate entities. 

Combine that with his other nonsensical answers on COVID relief, school reopenings, the Voting Rights Act, senate committee assignments, education, foreign affairs — really, the list is almost endless — and it shows how little work he’s put in over the last two years to understand this job he’s applying for. 

Now, that might be just fine with Alabama voters who care more about the party affiliation and owning the libs, but it’s not OK with grownups who take the job of running the country seriously. 

And those people — both Rs and Ds — don’t like Tuberville or his here-for-an-easy-check-like-always approach to one of the most serious jobs in the world. 

He will be frozen out of the most sought after committee assignments. His voice will carry zero weight. His presence will be all but forgotten. 

And in the process, so will Alabama. Especially in two years, when Shelby retires and his senior status is lost. 

In the meantime, Jones is highly respected by senators on both sides of the aisle. He already has a presence on top committees, and is so well liked within the Democratic Party that he’s on the short list to be Joe Biden’s AG, should he not be re-elected. 

The choice seems pretty simple. On the one hand is a competent, prepared and serious statesman who knows how to maneuver his colleagues to get the most for the state. On the other hand is an unprepared, uncaring, lazy carpetbagger who doesn’t understand any process. 

If your conscience or decency isn’t enough, vote your wallets.

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Health

At least 248 COVID deaths reported in Alabama in October

The cumulative death toll in Alabama has risen by 248 to 2,788 in October and by 124 in the last week alone.

Brandon Moseley

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(STOCK PHOTO)

We’re a little more than halfway through the month of October and the Alabama Department of Public Health has already reported at least 248 deaths from COVID-19.

The cumulative death toll in Alabama has risen by 248 to 2,788 in October and by 124 in the last week alone.

At least 378 deaths were reported in the month of September, a rate of 12.6 deaths per day over the month. In the first 17 days of October, the rate has been 14.6 deaths per day, a 15.9 percent increase from September.

Deaths were higher in July and August. The cumulative death toll increased by 582 in August and 630 in July, the worst month of the pandemic for the state.

On Saturday, ADPH reported that 1,288 more people in the state were confirmed positive with the coronavirus, and on Sunday the count increased by 964. The number of confirmed cases in Alabama has risen to 172,626.

There have been 17,925 new cases Alabama in October alone. The state is averaging almost 996 cases per day in October, which is up from September.

The state had 28,643 new coronavirus cases in September, 38,335 cases new cases in August, and 49,678 cases in July. Public health officials credit Alabama Governor Kay Ivey’s statewide mask order on July 15 with slowing the spread of the virus in the state, but the virus has not gone away.

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ADPH reported 823 hospitalizations for COVID-19 on October 17, the most recent day for which we have data. While hospitalizations for COVID-19 are down from the peaks in early August in Alabama have risen from Oct. 1 when 748 Alabamians were hospitalized, a 10 percent increase from the first of the month.

The state of Alabama is continuing to struggle to protect its most vulnerable citizens. At least 6,497 residents of long term care facilities in Alabama have been diagnosed with the coronavirus, 247 of them in October.

There have also been 3,362 cases among long term care workers in Alabama, including 197 in the month of October. Some 9,819 Alabama health care workers have also contracted the coronavirus.

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Most people who test positive for the novel strain of the coronavirus, SARS-CoV-2, are asymptomatic or have only minor symptoms, but in about one out of five cases it can become much more severe.

For older people or people with underlying medical conditions like obesity, heart disease, asthma, cancer, diabetes or HIV, COVID-19 can turn deadly. COVID-19 is the abbreviated name for the medical condition caused by the SARS-CoV-2 virus.

Some 1,115,600 people worldwide have died from COVID-19 worldwide, including 224,284 Americans. There are 8,972,704 known active cases in the world today.

Public health officials warn citizens that coronavirus remains a present danger in our community. Social distancing is the best way to avoid spreading the virus. Avoid venues with large groups. Don’t shake hands or hug persons not living in your household.

Avoid leaving your home as much as possible and wear a mask or cloth face covering when you do go out. Avoid touching your face and wash your hands with soap frequently. Hand sanitizer is recommended.

A coronavirus vaccine may be available in the coming months, but we don’t yet know when or how effective it will be.

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