Introduction Rising prescription drug costs continue to plague state budgets. As states have expanded Medicaid, their enrollments have risen, as has their spending on Medicaid prescription drug benefits. Regardless of whether a state has expanded Medicaid per the
Syrtis Solution's March 2020 Medicaid News Recap: A roundup of Medicaid news, legislation, and industry developments relating to Medicaid integrity, cost avoidance, improper payments, fraud, waste, and abuse. Medicare And Medicaid Administrator Addresses U.S. Health Care Response To
After COVID-19 was declared a national emergency on March 13th, the Centers for Medicare and Medicaid Services (CMS) was able to waive stipulations in federally funded programs to help States respond to the pandemic. To date, CMS has approved Medicaid
From Carve-Out to Single PDL Back in September, Michigan proposed policy 1936-Pharmacy to carve-out the State’s Managed Medicaid outpatient pharmacy drug coverage and transition to a Fee-for-Service (FFS) model. However, plans to carve-out pharmacy benefits have recently been updated. After
Syrtis Solution's February 2020 Medicaid News Recap: A roundup of Medicaid news, legislation, and industry developments relating to Medicaid integrity, cost avoidance, improper payments, fraud, waste, and abuse. Minnesota's Medicaid program made up to $29 million in improper
Medicaid prescription drug spending has been on the rise and some states have opted to carve out prescription drug benefits and transition to a Fee-For-Service (FFS) model. In theory, this delivery system helps states assert their purchasing power to reduce
Last week, the Supreme Court announced that it would review the verdict from Rutledge v. PCMA, a case from Arkansas dealing with the state’s legal right to regulate reimbursements from pharmacy benefit managers (PBMs). Their ruling could significantly impact prescription
Government healthcare reforms along with reducing prescription drug prices have been at the top of President Donald Trump’s agenda. A feud between the top health officials at HHS is delaying the administration’s healthcare initiatives. Over the past year, tensions have
To reduce costs in its Medicaid Health Plan (MHP), Michigan is carving out pharmacy benefit managers (PBMs) and transitioning to a fee for service (FFS) model for the delivery of prescription drugs. In October, Michigan’s Department of Health and Human
Over the past ten years, Medicaid has become one of the fastest and largest growing items on state budgets. In 2015, the program accounted for 20 percent of state budget spending and in 2018 it had grown to 30 percent.
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