Kentucky Medicaid Releases Report on Pharmacy Benefit Program
The
"This report represents the first step in introducing transparency to the pharmacy program. We have additional steps that we will need to take in order to make this program fully transparent," said Commissioner
Various state Medicaid programs have raised questions about PBMs, particularly the percentage of pharmaceutical manufacturers' rebates retained as profit versus the percentage of dollars used for reimbursement of pharmacy services and quality assurance.
The PBMs negotiate rebates for various pharmaceutical drugs on the Medicaid approved list, as well as discounts for products and work needed to develop and maintain approved lists of drugs for health insurers. In
MCO beneficiaries fill almost 25 million prescriptions per year in
In 2017, DMS received almost
Among other things, the report states that many of the concerns affecting independent pharmacies cannot be seen in an analysis of this type. Direct and indirect remuneration fees, or after point of sale fees, are not captured accurately. Pharmacy organizations within the Commonwealth have reported that these retroactive fees assessed by PBMs to independent pharmacies are hurting their current practices.
"PBMs provide valuable services to the MCOs they serve and to Medicaid beneficiaries," concluded Commissioner Steckel. "It is important that we are able to monitor these services and payments in response to our fiduciary responsibility to
The report was developed after analyzing the data newly available under Senate Bill 5, legislation passed in 2018 that provided for more transparency in
The
Insured Hurricane Michael Losses Likely Higher Than Estimated
Home Insurance Market to Witness Huge Growth by 2025 : AFLAC, Allstate, Geico, Liberty Mutual, Farmers Insurance Group, Allianz, BUPA
Advisor News
Annuity News
Health/Employee Benefits News
Life Insurance News