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Mom Pop Pharmacy Near Me – An appeals court ruled Wednesday that Ojai Pharmacy and 21 other independent pharmacies are seeking drug compensation from mass pharmacy operator Optum Rx to force them out of business.

A panel of judges in San Francisco’s First Circuit Court of Appeals upheld an Alameda County Superior Court decision denying Optum’s offer to refer Mom and Pop Pharma’s complaints to statutory arbitration. The ruling opens the way for drugmakers to go to court to recover past losses and seek damages.

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“Guys,” Chris Platt, an Ojai pharmacist who helped organize the trial, said in a text message about the verdict. “David defeated Goliath!!!!”

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Pharmacy benefit managers negotiate payment rates with pharmacy service management organizations, which in turn contract with pharmacies. Optum Rx, based in Irvine and part of UnitedHealthcare, is one of the nation’s largest providers with nearly $100 billion in revenue last year. A spokeswoman did not respond to questions about whether the company would ask the California Supreme Court to reconsider the trial. The court accepts 3 percent of the applications sent to it.

Optum Rx officials have previously argued that their pricing and arbitration system for resolving disputes with pharmacies for reimbursement is fair.

But an appeals judge called Optum’s arbitration decision “inappropriate.” They said the terms were skewed in Optum’s favor and were not signed or accepted by the pharmacy.

“This procedure allows Optum Rx to unilaterally change the terms of the arbitration, denies the pharmacy drugs available to Optum Rx, imposes high arbitration costs on the pharmacy, and limits the pharmacy’s ability to engage in discovery,” the judge wrote.

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Mark Cuker, a Philadelphia attorney who represents independent pharmacies, said the ruling means the case will go back to a higher court. It also opens the door to discovery where pharmacists could ask a court to compel Optum to provide documents that reveal its pricing system. Independents say reimbursement is much lower than large chains and mail order pharmacies.

As part of a long list of charges, the pharmacist said he was unaware of the contract between Optum Rx and the pharmacy service management organization with its terms and conditions setting reimbursement rates. They claim that Optum took confidential patient information from pharmacies and gave it to its email division to put small shops out of business.

Cuker said the decision opens the courtroom door to other pharmacies that feel they are underpaid and mistreated by large pharmacy benefit managers.

However, the decision of the Court of Appeal was not published, that is, it did not establish a mandatory legal rule. Cuker said the referee could still consider the decision, but he had to follow the decision. He said he plans to ask the appeals court to reconsider reissuing the ruling.

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Although unpublished, the ruling is one of the most significant ever brought against a pharmaceutical benefits administrator, Cuker said.

“It really sends a message that they’re not going to let these mega-goliath companies crush this little guy,” he said.

The court battle stemmed from a dispute in Ventura in 2017 when Optum Rx served as the pharmacy benefits manager for Gold Coast Health Plan. The plan administers Medi-Cal coverage for about 250,000 low-income county residents.

Platt, co-owner of Medical Arts Pharmacy in Ojai, and other pharmacists have complained that Optum Rx is charging them such high rates that low-cost pharmacies are forced to close. Platt contacted Cuker, who participated in another lawsuit against Optum, and later helped rally other pharmacies across California. Complaining, they filed suit in Alameda County.

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Platt said his pharmacy and others will seek not only compensation for underpaid claims, but also millions in punitive damages. He said the decision ends Optum Rx’s ability to store information.

Tom Kisken covers health care and other news for the Ventura County Star. Contact him at tom.kisken@ or 805-437-0255. PORT ORCHARD—In 1968, the Vietnam War was still raging, Woodstock hadn’t happened, and modern conveniences like microwave ovens, cell phones, and personal computers didn’t exist. there are t To create.

At that time in Port Orchard, a 27-year-old pharmacist was living his dream. Fifty years ago this September, Ken Paskett opened South Park Pharmacy in South Park Village, off Mile Hill Drive.

The small and cozy store has the same retail space as when Paskett served its first customers. It is one of the few independent mom-and-pop drugstores on the Kitsap Peninsula.

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Ken, now 77, wears a “Buy Local” T-shirt and chunky shoes, and still works 30 hours a week filling out “scripts” behind the pharmacy counter in the back of the store.

“I always had the mindset that I wanted to help people,” says Ken, of his longevity in the industry. “Customers are people, friends. I always answer their questions: ‘What for, why am I taking this?'”

While Ken and a pharmacist partner run the pharmacy, the rest of the operation is managed by Jeff Paskett, Ken’s 51-year-old son, who has been working full-time since graduating from Washington State University with a business degree. 20.

“I’ve worked here most of my life,” said Jeff. After college, “I wanted to do something in the wider world, but this (retail) attracted me.”

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Ken believes his son has kept the store afloat against increasing competition from WalMart, Walgreens, Rite Aide, Fred Meyer and any number of grocers that have opened branches in the Port Orchard area in the past decade, each with a pharmacy. opens

“When you take a small town like this and add all the mass retailers you can think of,” Jeff says, “the independent (grocers) have a hard time. … We are a dying species.”

South Park, which has eight full-time employees, differentiates itself from wholesale discounters by offering Jeff’s “personal touch” with customer service and a variety of unique store offerings.

For example, pharmacies own post offices, service charging stations, and sell alcohol. The latter service dates back to when the government allowed a small number of shops in a given community to sell alcohol.

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South Park has so-called “contract sales,” meaning it can sell alcohol at its locations because the closest state-owned store is several miles away. “It’s a real draw,” Jeff said.

A voter-approved ballot initiative in 2011 allowed grocery stores and discount retailers such as Costco to sell alcohol, making it possible within the South Park area.

But Jeff says the postal service and gas stations pay are still “drivers & mldr; and because people come to the store.”

“We’ll thank the others,” Jeff said, pointing to a box of groceries on a shelf in the back of the store. “People don’t have to commit to a rigid payment plan. We’re very accommodating.”

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Walking around the Paskett branch, you are sure to see a long line, stretching the length of the building, filled with greeting cards.

Elsewhere, you can find jewelry, Majesty Bells, dolls, figurines, unusual socks, and all kinds of nostalgic signs of the 1950s. The old Andy Griffith show.

Not surprisingly, challenges abound as small pharmacies struggle to keep up with the big box and growing influence of online shopping.

In fact, its customer base—albeit loyal—is shrinking because of the competition it faces, and insurance premiums are “killing us,” says Ken.

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The seasoned pharmacist notes that he has filled more than 862,000 prescriptions — and a similar number of refills — in his years behind the counter, but the insurance industry is putting pressure on his bottom line.

“They pay us less than we do,” he said, “15 cents a refill. It’s getting worse.”

“Insurance is hard,” Jeff said. it is very difficult in the environment where we are small.

Supermarkets can make up for losses in pharmacy by selling in other departments, South Park cannot fill this gap. “We did everything we could,” Ken said.

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Jeff says that steering wheel is “hard to think about”. The store must continue to be “unique” and “a quality place where people visit”.

The Pasketts agreed that one investment that could help sustain the store is a new tenant in South Park Village. QFC moved out of the aging shopping center in August 2017, leaving a large vacancy.

“It changed everything,” said Jeff. “It affects traffic patterns. … You’d think with an economy like this, we’d have (retailers) there – a grocery store, a Trader Joe’s or something.

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