Magazine article Drug Topics

California R.Ph.S Fight Single Benefit Manager for MediCal

Magazine article Drug Topics

California R.Ph.S Fight Single Benefit Manager for MediCal

Article excerpt

With their eyes on the $1 billion prize, California pharmacists have proposed a way to keep the MediCal contract out of the clutches of a single pharmacy benefit manager.

The California Pharmacists Association is trying to sell legislators on the concept of a two-year demonstration project to show that comprehensive pharmacy services can save the state MediCal program big bucks. By forging a partnership with the department of health services to share the risks, chain and independent pharmacists would be paid for enforcing MediCal's formulary through therapeutic interchange under protocols.

CPhA officials estimate that their plan would save MediCal at least the $33.9 million projected by backers of the single Rx benefit manager approach. They argue that a third-party squeeze on the Rx benefit would make costs balloon elsewhere in the system.

Based on their experiences with other contracts, community R.Ph.s believe that a manager would take MediCal to a closed network with low reimbursement. …

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