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Texas to Modernize Medicaid Rx Benefits, Curb Pharmacy Overpayments
Date:12/14/2011

WASHINGTON, Dec. 14, 2011 /PRNewswire-USNewswire/ -- To help reduce state Medicaid spending, the Obama administration has approved Texas' plan to shift one million recipients into private health plans by 2013. Despite strong opposition from the drugstore lobby, the waiver includes a provision to modernize the state's prescription drug benefits to be operated more like affordable and efficient pharmacy benefits in Medicare and the private sector. Currently the Texas Medicaid program pays more than triple the pharmacy fees that Medicare and private insurers pay.

"By making greater use of PBM tools and administering Medicaid drug benefits more like those in Medicare and the private sector, Texas will save hundreds of millions without cutting benefits to those in need," said Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt. "Currently, the program uses fewer generic drugs and pays drugstores more than triple the fees that Medicare or private insurers pay."

Voters would rather modernize Medicaid pharmacy than cut benefits for patients or payments to doctors and hospitals. In addition to Texas, Governors Chris Christie (R-NJ) and Andrew Cuomo (D-NY) have already enacted similar changes to reduce prescription drug spending in their own states.

Transitioning to a more efficient and affordable pharmacy benefit model would save states across the country billions without limiting access the National Center for Policy Analysis (NCPA) announced in a new white paper, "Increasing the Cost-Effectiveness of Medicaid Drug Programs." NCPA, based in Dallas, Texas, is a nonprofit, nonpartisan public policy research organization that develops private, free-market alternatives to government regulation and control that rely on the strength of the competitive, entrepreneurial private
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SOURCE Pharmaceutical Care Management Association
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