A nearly across-the-board increase of Medicaid fees was announced yesterday by D. C. Mayor Walter E. Washington, ending the two-week-long refusal by many independent pharmacists to fill prescriptions for the city's poor.
Although city officials had insisted the city could not afford higher fees, the mayor told a news conference that a computer review of the Medicaid fund showed $1.08 million would be available during the next six months to pay the city's share of the new rates.
The increases will be granted next Saturday to physicians, dentists optometrists, podiatrists and pharmacists. All the groups had sought high er fees, but the withdrawal of many independent pharmacists from the Medicaid program clearly triggered the Mayor's announcement.
Pharmacists are now reimbursed for the actual cost of each prescribed drug plus a $1.80 service fees. The fee will be raised to $2.59, the amount they sought.
"We will (now) be happy, willing and able to fill all prescriptions in the city," Morton Hauer, a partner in the New Hampshire Pharmacy and a leader of the D. C. Pharmaceutical Association, told the mayor's news conference.
Hauer claimed that three-quarters of the city's 75 independent pharmacies had withdrawn from Medicaid because they could no longer afford the low fees.
The Medicaid program serves 156,000 D. C. residents, about one-quarter of the city's population.
Dale Morton, another pharmacist; told reporters he thought the mayor acted because of pressure from Rep. Charles C. Diggs Jr. (D-Mich), chairman of the House District Committee. Diggs met with a group of the pharmacists before leaving for a tour of Africa a week ago, and wrote the mayor voicing his concern.
The mayor, overhearing Morton's statement, denied it. He said he told Albert P Russo, director of the Department of Human Resources, to recommend a comprehensive overhaul of the outdated fee schedule, not one applying only to the pharmacists.
Russo produced the fee scheduled announced yesterday by the mayor, and said more money would be needed in the 1979 budget to pay for the increases. He had no estimate. The D. C. costs are matched, roughly dollar for dollar, by payments from the U.S. Treasury.
Of the various medical groups, the pharmacists are the only ones who had received any previous fee increases in the 10 years of the Medicaid program. Following are the changed fees approved for the other groups:
Physicians. Fees that now range from $4.80 to $28.80 for office visits and procedures will go to a range of $13 to $32. Surgical fees will be increased 57 percent. Optometrists. Fees for refractions and related services will rise from $12 to $16.50, with a corresponding rise in the allowable cost of eyeglass frames.
Dentist. Fees will go from 63.7 percent of the average the city's dentists receive from private patients for each procedures to 75 percent.
Podiatrists. The $4.80 fee for an office visit will rise to $7, will the cost of foot surgery going from 44 percent of the citywide average received from private patients to 60 percent.
In 1977, the city paid $10 million in Medicaid fees, broken down as follows: $7.2 million to 1,437 physicians, $1.2 million to 152 pharmacies, $1 million to 110 dentists, $369,000 to 56 optometrists and $138,000 to 44 podiatrists. Hospitals and other institutions are reimbursed for cost under another formula, and were not included in the increases announced yesterday.
Reminded that it was the third news conference he had called in one week to announce improved city programs, Mayor Washington responded, "Yeah, the gooodies are coming."
But he did drop one hint that he might take to the campaign trail with a campaign for another term, something he has not yet announced.
It came when Dr. Jerome J. Mayer, a podiatrist, thanked the mayor for the higher fees in behalf of "the foot-sore people of D. C." The mayor grined, and quipped: "I may need it, too."
Earlier this week, supporters of Democratic mayoral candidate John L. Ray had announced plans to hold a rally at the District Building this morning to protest DHR's handling of Medicaid prescriptions. The Rev. Hosea Browne, one of the protest organizers, said the rally would be held despite the mayor's action yesterday.
"I think he heard about us," Browne said. "But we're going to give him hell anyway."*