Ohio Medicaid Orders Managed Care Plans To Break Contracts With PBMs Using "Spread Pricing"
In a letter to the managed care plans, Ohio Medicaid director Barbara Sears says they must stop working with CVS Caremark and Optum, which are using a “spread pricing” model. Sears says the managed care plans have until January 1 to work out deals with PBMs that will agree to a pass through model, where the plans pay the PBMs’ fees. Sears says that model will be more transparent and won’t cost taxpayers extra money. A report commissioned by Ohio Medicaid showed the spread between what the state paid the PBMs and what they paid pharmacies added up to $224 million last year, which the state initially declined to say was a good or bad deal. A court battle continues over the release of that report, which the PBMs say contains trade secrets.
Copyright 2018 The Statehouse News Bureau