Proposed rules would allow states to tailor Medicaid benefits for different populations and to implement cost-sharing to encourage beneficiaries to use lower-cost preferred drugs. The proposed rule sets copays at $4 for preferred drugs and $8 for nonpreferred drugs.
States' essential health benefit plans exceed the minimum drug coverage proposed by the Obama administration, according to an Avalere Health study. The plans cover on average 62% of drugs across nine classes, but four states out of the 16 plus the District of Columbia that submitted benchmark plans cover more than 85% of drugs, the study reported.
A new report released by the Pharmaceutical Care Management Association (PCMA) examines how recent congressional hearings and government investigations have raised serious questions about opaque business practices and pricing strategies within the independent drugstore industry.