As States Carve Out Medicaid Drug Benefits, MCOs Push Back With Chart: States Take Varied Approaches to Rx Benefits in Medicaid

Beginning in April, California and New York will join a growing list of states that have opted to carve out prescription drug benefits from their Medicaid contracts with insurers, wagering that the state can do a better job at negotiating drug prices with manufacturers than managed care organizations and their contracted PBMs.

While it remains hotly debated whether such moves offer a net benefit for states and their Medicaid enrollees, health policy experts tell AIS Health that MCOs should be prepared for the carveout trend to continue.

© 2022 MMIT
Leslie Small

Leslie Small

Leslie has been reporting and editing in various journalism roles for nearly a decade. Most recently, she was the senior editor of FierceHealthPayer, an e-newsletter covering the health insurance industry. A graduate of Penn State University, she previously served in editing roles at newspapers in Pennsylvania, Virginia and Colorado.

Related Posts

workers-prepping-infusion-drug
May 12

Major PBMs Look Ahead to 2023 for Biosimilars Boom

READ MORE
wall-street-sign
May 12

Centene Plans to Sell Magellan Rx, PANTHERx Rare for $2.8 Billion

READ MORE
pills-and-dollars
May 12

Study: With High Prices, Rebate Revenue Is Growing for PBMs

READ MORE

GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND

Sign up for publications to get unmatched business intelligence delivered to your inbox.

subscribe today