2023 Year In Review — Shelter Island Heights Pharmacy can process Medicaid prescriptions: Island patients were shut out for months

Medicaid patients can — finally — again get their prescriptions from the only drugstore in town, which for months had been unable to process all their prescriptions.

As of June 30, owners of the Shelter Island Heights Pharmacy, CXR Hospitality, LLC, were enrolled in the Medicaid program as a provider, according to New York State Department of Health Public Information Officer Monica Pomeroy.

In March 2022 the Soloviev Group added the business to its Shelter Island holdings and at first there was no problem with patients being able to have Medicaid pay for prescriptions.

But in December 2022, those covered by Medicaid began being told they would soon have to handle their prescriptions through CVS, which has stores on the North and South forks.

A CVS official said the company has a mail order service, but it would depend on what the specific Medicaid plan would cover. It would be up to Medicaid patients to check their  plans to see if they would cover the mail order service, according to Amy Thiebault, director of external communications for CVS.

The Department of Health division that handles Medicaid said the application to extend Medicaid coverage to the new owners was pending. Initially, the Reporter learned that approval of the application might take only days, but days turned into weeks and weeks into months.

Regular checks with the press office personnel for the State Health Department provided information that there were many pending applications and no determination about how long it might take to reverse course and restore the pharmacy’s ability to accept Medicaid payments for prescriptions.

Ms. Soloviev, who managed the purchase of the pharmacy, issued a statement through a spokesperson in March saying the application had an “expedited” status and she hoped the pharmacy would be able to serve Medicaid patients “in the near future.”

For months, the response remained the same from the Department of Health, forcing patients who had Medicaid coverage to take their prescriptions off-Island.

What had been a short trip to the local pharmacy now involved the added cost of ferry fare to the North or South forks, a trip that could take more than an hour each way, depending on traffic and ferry lines. For infirm patients unable to travel, it meant finding others to pick up prescriptions.

Department of Health statistics showed there were 302 Islanders registered with Medicaid as of March 2022. That represented 8% of the Island population and at least 58 of the Medicaid patients listed were children whose ages were anywhere from birth to age 17.

The full number of patients on the Island could be higher because the Department of Health only had statistics for those registered through the Affordable Care Act, not those enrolled by local social services departments.

Outreach to Assemblyman Fred Thiele Jr. (D-Sag Harbor) had his staff working to clarify the situation. The legislator said his staff learned that even if a pharmacy was cleared to process coverage through a Medicaid plan, it could limit the number of Medicaid patients it would serve.

That was in conflict with a statement from Ms. Pomeroy at the Department of Health who said a pharmacy certified to process Medicaid coverage had to accept those prescriptions.