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State Ending Contracts With Pharmacy Benefit Managers

Aug 15, 2018

Credit State of Ohio
The Ohio Department of Medicaid is ending the state's contracts with the pharmacy benefit managers that bill taxpayers more than they reimburse pharmacists for filling prescriptions. 

The state says it's moving to a more transparent pass-through pricing model January 1. Under that model, PBMs would receive administrative fees and must bill the state the same amount they pay pharmacists.A state-commissioned report shows PBMs billed taxpayers nearly 224 million dollars more for prescription drugs each year than they reimbursed pharmacies to fill those prescriptions. CVS Caremark, the PBM for four of Medicaid's five managed-care plans, is working to update its contracts.