Our Policymakers need to realize how their decisions effect the most vulnerable population in our state. Please click the button below and see #4, on page seven, of the 2018 State Controllers Report. State after state has found PBM’s keeping millions of dollars in spread pricing, and that does not take into account other fees and rebates they receive; with no oversight, low reimbursement fees, rebates, and after the sale adjustments the state needs to know where the money goes, and a flat fee needs to be charged with full transparency. The PBM’s not only own and manage pharmacies, they control the reimbursements to their competition.
Below is a portion taken from the Report:
“Policymakers have historically squeezed provider
reimbursement rates as a cost control method for Medicaid,
while expanding Medicaid
eligibility rules. One outcome of
this approach is that some health
care providers, including the most
talented, refuse to accept Medicaid
patients. The result is growing
demand for Medicaid services
as eligibility rules have widened
while the supply of providers
within the network has contracted.
The resulting supply shortage
has fueled widespread reports
of Nevadans who nominally
have coverage through Medicaid but who cannot get care. Thus, the
increased competition for care wrought
by eligibility expansion harms the
most vulnerable populations who were
previously eligible and who now face
reduced access to care.”
