The middlemen who manage pharmacy benefits for Ohio Medicaid could be facing legal action from Ohio Attorney General Mike DeWine.
The middlemen, called pharmacy benefit managers, have been criticized by some lawmakers and pharmacists who say they are taking too large of a cut of the tax money they manage for the state and are paying low reimbursements that are driving some pharmacists out of business.
DeWine, who also is campaigning for Ohio governor, said in a statement that since the end of 2017, his office has been reviewing and investigating issues regarding pharmacy benefit managers, which do contract work with not only Ohio Medicaid but also other Ohio agencies, such as the Ohio Department of Medicaid, the Ohio Bureau of Workers’ Compensation, the Ohio Department of Administrative Service.
“It is clear that the conduct by PBMs (pharmacy benefit managers) in these areas remains a major concern, and we anticipate that our investigation will result in major litigation against PBMs,” DeWine stated.
DeWine said he was “putting the PBMs on notice” that “any action that can be taken and proven in court will be filed” to protect taxpayers.
CVS Health’s subsidiary CVS Caremark manages pharmacy benefits for four of the five privatized Medicaid plans in the state. In response to DeWine’s statement, the company highlighted that a recent report showed Ohio Medicaid saves $145 million a year by contracting out the pharmacy claims work to private companies like CVS.
“Ohio taxpayers, Medicaid members and our PBM managed care clients benefit from the substantial value and savings that our PBM services provide to Ohio’s managed Medicaid plans,” CVS Health stated.
The Dayton Daily News has been producing exclusive and in-depth coverage over the past year about pharmacy benefit managers and prescription drug issues.
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