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2016 Session

Budget Amendments - HB30 (Committee Approved)

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DMAS Analysis of Pharmacy Claims (language only)

Item 310 #4h

Item 310 #4h

Health and Human Resources
Department of Medical Assistance Services

Language

Page 276, after line 54, insert:

"K. The Director of the Department of Medical Assistance Services shall analyze pharmacy claims data from the past biennium in order to assess the value of payments made to the Medicaid Program's contracted managed care plans' network pharmacies and payments made to the Medicaid program's contracted managed care plans. The Director shall identify and report any difference in value of payments made to network pharmacies and to the contracted managed care plans and shall make recommendations to improve the cost effectiveness of Medicaid managed care expenditures for contracted network pharmacy payments to the Chairmen of the House Appropriations Committee and Senate Finance Committees by October 1, 2016."



Explanation

(This amendment adds language requiring the Department of Medical Assistance Services shall analyze pharmacy claims data to identify the difference in the value of payments made to contracted Medicaid managed care plans and their payments to contracted network pharmacies. The agency is directed to make recommendations to improve the cost effectiveness of Medicaid managed care expenditures for pharmacy payments to the Chairmen of the House Appropriations Committee and Senate Finance Committees by October 1, 2016.)