In recent months, controversy over the Ohio Medicaid program has provided a rare window into some of the fees paid to pharmacy benefit managers and the subsequent effect on prescription drug costs. Now, an audit finds a new twist: A managed care plan that contracted with the state program collected $20 million through a curious arrangement that has raised concern among state officials.
Specifically, the Buckeye Health Plan is one of a handful of managed care plans hired by Ohio Medicaid to provide prescription drug benefits. The plans, in turn, contracted with two PBMs — CVS (CVS) Caremark (CVS) and Optum Rx — to do much of that work. However, the plans were recently told to end the contracts over pricing practices that cost the state tens of millions of dollars.