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Cordray, DeWine back Medicaid pharmacy reforms

A major reform to the way the Ohio Department of Medicaid buys billions of dollars worth of prescription drugs seems likely to continue regardless of who wins the governor's race Nov. 6 (Source: “Richard Cordray, Mike DeWine back state Medicaid reform on prescription-drug middlemen,” Columbus Dispatch, Oct. 22, 2018).

The department announced in August that it would tell the state's five Medicaid managed-care plans to update their contracts with pharmacy middlemen that allowed the middlemen to charge taxpayers $224 million a year more than they were paying pharmacies for prescription drugs. The Medicaid department conducted its investigation after The Dispatch used confidential pharmacy data to conduct its own analysis that showed somewhat higher markups.

The Medicaid department's revamp require managed-care companies to move on Jan. 1 from the current "spread pricing" model to a "pass-through" model, under which pharmacy middlemen will be paid a straight administrative fee and forced to bill the state the same amount they pay pharmacists.