Wisconsin Pharmacy Carve-Out Last year, the Wisconsin Department of Health Services carved out prescription drugs from the Family Care Partnership Program and transitioned to a Fee-for-Service (FFS) delivery model. The carve-out ensured compliance with the 2020 Medicaid and CHIP Managed Care Final Rule and eliminated the...
The Medicaid Managed Care Final Rule, CMS-2408-F, was finalized this November. The new rule implements proposals from the Notice of Proposed Rule Making from last year. Provisions from the rule will begin taking effect as early as December 14, 2020. According to Medicaid enrollment data from 2018, 66...
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,...
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...
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...
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...
In September, The Globe Gazette reported that Iowa representatives have turned in waiver requests with the federal government as a part of Gov. Terry Branstad's strategy to switch Medicaid to a privately run managed care system effective Jan. 1 - a shift they anticipate will deliver...