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

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

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.