September 2019

20 Sep Medicaid Third Party Liability Report From GAO

Posted at 09:51h in Third Party Liability

Identifying third party liability continues to be a challenge under the coordination of benefits for Medicaid plans. By law, plans are payers of last resort so whenever beneficiaries have other active coverage (OHI), those third parties should pay first. Currently, Medicaid plans are required to...

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11 Sep CONCERNS OVER CA’s Rx CARVE OUT

Posted at 14:24h in Medicaid

California’s Governor, Gavin Newsom, signed an executive order at the beginning of the year to move all pharmacy services for Medi-Cal from managed care to a FFS model. The consolidated purchasing power would leverage the state’s population size to negotiate drug prices with pharmaceutical...

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