OH Medicaid Orders All Ohio MCOs to Terminate PBMs Using Spread Pricing; Must Switch to Pass Through Pricing PBM Contracts. Creates Big Improvement Opportunity for MCO Pharmacy Reimbursement

Ohio Attorney General Mike DeWine is ramping up his investigation into the costly practices of pharmacy middlemen, hiring outside counsel to assist with a probe he expects to lead to litigation. The study said PBM fees should be in the range of 90 cents to $1.90 per prescription. CVS Caremark billed the state about $5.60 per script; Optum charged $6.50 — three to six times higher.

Anti-Prescription Clawback Fees and Pharmacy "Gag Orders" PBM Regulation Bill Passed the Ohio House of Representatives Unanimously! Next step is the Senate! HB 479 is now moving to the Senate for action. PBMs and insurers are working to water down the bill over in the Senate, so your activism in the next chapter is even more important than before. Please take the time to contact your Senator and urge them to support the bill's passage.

Gag Order/Clawback Bill Expected For Vote in Ohio House TOMORROW . Keep Up the Momentum For Passage of Anti-Prescription Clawback Fees & Pharmacy "Gag Orders" PBM Regulation Bill. Issue: Clawback is a tool Pharmacy Benefit Managers (PBM) use to over-inflate the cost of prescription medications at the point-of-sale transaction. Essentially, a PBM clawback forces some pharmacies to charge customers more than the pharmacy's cash price. The PBM then "claws back" from the pharmacy the money the patient was overcharged.

Contact State Leadership Committee TODAY Urge them to Support HB 3479. Time Critical Action Needed for Amendments to MCO Prescription Reform Bill. IPC, the Illinois Pharmacists Association and other industry stakeholders' efforts to end Illinois Medicaid's MCO's prescription below costs payments, with a legislative fix by IL State Rep. Sara Feigenholtz (D-Chicago) (HB 3479) continues today. This strong PBM regulation amendment is up in the powerful Senate Executive Committee today at 3:45 p.m. in the State Capitol.

MCO Below Cost Prescription Payments Reform Bill (HB 3479) CLEARED for Senate Floor Action- Contact Your Senator TODAY to Support The Bill!