✦ Michigan is planning to shift the management of Medicaid beneficiaries’ pharmacy benefits from managed care back to the state. In a Sept. 30 proposed policy draft, the Michigan Department of Health and Human Services (MDHHS) wrote that as of Dec. 1, all pharmacy drug coverage will be transitioned to fee-for-service Medicaid, arguing that the move “will result in cost savings through a combination of increased pharmaceutical rebates and elimination of related MHP [Medicaid Health Plan] administrative capitation costs.” CVS Health Corp., UnitedHealth Group’s OptumRx, MedImpact Healthcare Systems, Inc. and “a handful of other PBMs stand to lose business based on the state’s proposed policy,” Citi analyst Ralph Giacobbe advised investors. The move to a single Medicaid formulary, which is opposed by the Michigan Association of Health Plans, was tried by former Gov. Rick Synder (R) in 2015, but he ultimately reversed course amid industry opposition, Crain’s Detroit Business noted. See https://bit.ly/2orUYT5 and https://bit.ly/2ASyDkd.
- Datapoint, Medicare and Medicaid
- Abstract, Health Plans
- Datapoint, Drug Benefits
- Abstract, Medicare and Medicaid
- People on the Move