Section 99

Section 99 Medicaid Pharmacy Benefit Manager Transparency Report

The secretary of health and human services shall investigate and develop a report regarding methods for increasing transparency on pharmacy services provided by pharmacy benefit managers to Medicaid managed care organizations and Medicaid accountable care organizations.

The report shall include, but not be limited to: (i) an analysis of pharmacy benefit manager services transparency; (ii) any findings of price spreading between pharmacy reimbursement and overall costs to the Medicaid program including, but not limited to, a description of any price spreading for brand name, generic or specialty drugs; (iii) potential conflicts of interest related to affiliations between retail pharmacy chains and Medicaid pharmacy benefit managers and any reported reductions to pharmacy reimbursements; (iv) an analysis of the impact of reductions in pharmacy reimbursement on access to care; and (v) a description of the ways pharmacy benefit managers are used within Medicaid managed care organizations and Medicaid accountable care organizations.

The report shall provide recommendations on ways to increase transparency on pharmacy services provided by pharmacy benefit managers to Medicaid managed care organizations and Medicaid accountable care organizations, including any recommended reporting information or drafts of proposed legislation necessary to carry those recommendations into effect.

The secretary shall file the report with the clerks of the senate and house of representatives, the joint committee on health care financing and the senate and house committees on ways and means not later than March 1, 2020.