The Ohio Department of Medicaid (ODM) recently released a request for proposals to move the agency’s managed care to a single pharmacy benefit manager (SPBM). Once implemented, Medicaid’s pharmacy benefits strategy will ease provider administrative burdens, reduce operational costs, and strengthen the state’s fiscal oversight of this vital health care benefit.
Currently, each of Ohio Medicaid’s six managed care organizations (MCOs) contracts with one or more pharmacy benefit managers (PBM) to manage prescription drug benefits. As a result, health care providers are subject to meeting unique, time-consuming processes required by each MCO to prescribe important, and sometimes life-sustaining, medications. ODM Director Maureen Corcoran called the move to a single pharmacy benefit manager, “Another important step in providing quality care for our members, transparency in operations, and responsible stewardship of Ohio taxpayer dollars.”