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Yost Wants State To Halt Plan To Change Pharmacy Benefit Manager Contracts

Aug 17, 2018

David Yost presents his report on pharmacy benefits managers working with the state’s five Medicaid managed care plans to the Joint Medicaid Oversight Committee
Credit Ohio Public Radio

A state auditor's report on Ohio's Medicaid prescription drug business says there needs to be more transparency on what taxpayers are getting for their money. 

And the auditor is urging lawmakers to tell the Ohio Department of Medicaid to halt its plan to change its contracts with two pharmacy benefits managers. Ohio Public Radio's Karen Kasler reports.

Auditor Dave Yost told a panel of lawmakers that he agrees with an Ohio Medicaid report showing the state paid $224 million more to CVS Caremark and Optum than they paid out to pharmacies. Yost also says he found those PBMs billed the state 31 percent more for generics, which make up 86 percent of Medicaid prescriptions. But he wants Ohio Medicaid to put a seven month hold on moving to a pass-through pricing model till more data is received.

“The pass-through model may end up costing us more money than what we’re doing now.”

Ohio Medicaid says a pass-through model will bring more transparency. CVS Caremark says in a statement its services to the five Medicaid managed care plans save the state $145 million a year.