legislative

CVS paid itself far more than some major competitors

CVS paid itself far more than some major competitors

CVS used its role as a pharmacy middleman for the Ohio Medicaid program to pay some of its biggest retail competitors far less than it pays its own stores, according to a section in a state report that CVS is fighting in court to keep secret.

Pharmacy Payment Model Needs to be Simplified

Pharmacy Payment Model Needs to be Simplified

Douglas Hoey, CEO of NCPA outlines the need for a simplified payment model for pharmacy and how independent pharmacy is competing to stay profitable and relevant in the face of unclear payment practices.

West Virginia’s System Possible Model for Cheaper Medicaid Drug Prices

West Virginia’s System Possible Model for Cheaper Medicaid Drug Prices

Ohio is struggling to bring transparency to the $2.5 billion its Medicaid system spends through its managed-care plans on prescription drugs each year. As it does that, one of its neighbors decided to take a drastically different path: Cut out the plan managers altogether. West Virginia’s model puts health care outcomes over profits by using the West Virginia University School of Pharmacy to recommend drugs for patients. That saved the state $30 million in one year.

CMS’ Proposed DIR Fee Reform Garners Industry Support

CMS’ Proposed DIR Fee Reform Garners Industry Support

The latest effort from the Centers for Medicare and Medicaid Services is garnering industry attention. CMS on Tuesday unveiled a proposed rule, titled “Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses,” which includes provisions focused on direct and indirect remuneration, or DIR, fee reform.

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