PBM Tag

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...

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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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09 Oct HEALTHCARE MEGA-MERGERS

Posted at 14:19h in Medicaid

Over the last year, there has been a wave of PBM and healthcare provider mega-mergers. These acquisitions have undergone intense review and the approvals suggest that government regulators are more comfortable with vertical integration as opposed to horizontal. Here is an overview of these mergers. CVS...

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