2017 Session

Budget Amendments - HB1500 (Member Request)

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Chief Patron: Hodges
MCO Reporting on Medicaid Pharmacy Claims (language only)

Item 306 #29h

Item 306 #29h

Health and Human Resources
Department of Medical Assistance Services


Page 311, after line 41, insert:

"WWWW. The Director, the Department of Medical Assistance Services, shall include language in all managed care contracts, for all department programming, requiring the plan sponsor to report quarterly to the department for all pharmacy claims: the amount paid to the pharmacy provider per claim, including but not limited to cost of drug reimbursement; dispensing fee; copayments; and the amount charged to the plan sponsor for each claim by its pharmacy benefit manager. In the event there is a difference between these amounts, the plan sponsor shall report an itemization of all administrative fees, rebates, or processing charged associated with the claim."


(This amendment adds language directing the Department of Medical Assistance Services to include language in all its managed care contracts requiring quarterly reports on details related to pharmacy claims.)