Fee-For-Service Archives - Syrtis Solutions Test

11 Mar MICHIGAN MOVES AWAY FROM RX CARVE-OUT

Posted at 14:00h in 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 considering the policy, the State has...

27 Jan MEDICAID MANAGED CARE Rx BENEFITS HELP STATES

Posted at 15:10h in Medicaid

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 costs and improve oversight. However,...

25 Nov MICHIGAN MEDICAID PBM RX CARVE OUT

Posted at 08:22h in Medicaid

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 Services (MDHHS) announced that outpatient...

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...

20 Aug DHCS SEEKS FFS Rx BENEFIT MANAGEMENT

Posted at 13:52h in Medicaid, Medicaid Managed Care

In January, California’s newly elected Governor, Governor Gavin Newsom signed an executive order to drastically reform health care in the state. Executive Order N-01-19 introduced a number of actions and budget proposals to reduce the cost of prescription drugs and health care. One measure, in...

17 May HB 3388 SEES SIGNIFICANT CHANGES

Posted at 10:42h in Medicaid

2019 has been a busy year for healthcare legislation in Texas and one bill, in particular, aimed to carve out PBM’s entirely. House Representative J.D. Sheffield (R) introduced HB 3388 on March 6th in an attempt to reform the delivery of prescription drugs to a...

17 Apr THE IMPACT OF MEDI-CAL’S PHARMACY CARVE OUT

Posted at 13:57h in Medicaid

At the beginning of the year, California’s governor signed an executive order directing DHCS to adopt a fee-for-service model for Medi-Cal. Under the order, California would consolidate its purchasing power and leverage the state’s population size to achieve lower drug costs by purchasing in...

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