Medicaid Policy & Strategy Improving Pharmacy Benefit Oversight in the Era of Medicaid Managed Care Explore effective approaches to improve pharmacy benefit management, enhance transparency, and streamline oversight in Medicaid managed care with innovative solutions tailored to state-specific needs. Key Takeaways When managed care organizations contract with pharmacy benefit managers, a layer of complexity and…
Program Integrity & Compliance State Strategies for PBM Oversight in Medicaid Managed Care: Navigating Complexity and Transparency Exploring state approaches to managing Medicaid pharmacy benefits, from heightened PBM regulations to single PBM and carve-out models for increased oversight and transparency. Key Takeaways As Medicaid Managed Care enrollment rises states face growing challenges in overseeing Pharmacy…
MeDicaid Policy & Strategy Managed Care Prior Authorization Denials Explore how state Medicaid agencies can strengthen oversight of prior authorization denials and improve access to care. Key Takeaways The growing scrutiny of Medicaid managed care prior authorization denials has placed increased responsibility on state Medicaid agencies to strengthen oversight, monitor compliance, and protect beneficiary access…