The Ohio Department of Medicaid has released a request for proposals for a company to act as a single pharmacy benefit manager, advancing its plan to reshape the state’s pharmacy benefit management system, the Journal-News reported.
Ohio’s House and Senate leaders agreed on a plan last July to restructure the state Medicaid department’s pharmacy benefit management by contracting with a single PBM.
Proposals to become the Medicaid department’s sole PBM are due Sept. 4.
The PBM chosen will be required to disclose to the state how much it pays for drugs and how much it reimburses pharmacies. The contract will be rebid every four years, and PBMs could be fined for noncompliance.
The restructuring came as Ohio Medicaid’s former PBMs, CVS Caremark and OptumRx, came under scrutiny for a lack of transparency and a study found they had billed the department $244 million more than they paid pharmacies.
The state also created a single, transparent list of preferred medications, which streamlines the prior authorization process for many drugs, the newspaper reported.
Maureen Corcoran, the Ohio Medicaid Department’s director, told the Journal-News that “the move to a single pharmacy benefit manager is another important step in providing quality care for our members, transparency in operations and responsible stewardship of Ohio taxpayer dollars.”
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