Skip to Main Content

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 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.

Unlock this article by subscribing to STAT+ and enjoy your first 30 days free!

  • Good investigation work Ed !!!! Yes, it would be a wise move for The Inspector General in every state to look into every PBM in this country. I’ll bet you 10 cents
    that they will uncover hundreds of millions , maybe even a billion dollars of fraud by the PBM’s !

Comments are closed.