By Marty Schladen
The Columbus Dispatch
The Columbus Dispatch
Posted
at 11:20 AM Updated at 11:25 AM
A group
of Ohio legislative leaders and the state auditor say CVS appears to be abusing
its dominance of two parts of the pharmacy marketplace and they’re demanding
more transparency to determine whether that’s the case.
They
gathered in the Statehouse on Wednesday to announce next steps to understand
whether CVS is using its control over the vast majority of Medicaid
reimbursements to pharmacies to drive independent and other competitors out of
business.
“We
need certain data that we just don’t have yet,” said House Speaker Cliff
Rosenberger, R-Clarksville.
Rep.
Scott Lipps, R-Franklin, said he’s already filed two bills seeking transparency
from “pharmacy-benefit managers” such as CVS. Those companies, known as “PBMs”
contract with Ohio Medicaid managed-care plans to create formularies, negotiate
prices, reimburse pharmacies and bill the state-funded plans. CVS Caremark,
which didn’t immediately respond to a request for comment Wednesday, controls
80 percent of that $3 billion business in Ohio.
In Ohio
and elsewhere, the company is suspected of over-billing the state and underpaying
retail pharmacies in an attempt to drive them out of business. CVS has denied
the accusation, but Lipps is suspicious.
He said
he’s gotten calls from “several pharmacists in my district on the sudden, sharp
decline in reimbursements, specifically through the Medicaid managed care
program.”
Whether
CVS Caremark is abusing its power is hidden behind a veil of secrecy, Lipps and
the other lawmakers said. They said they want to push for legislation that
Auditor Dave Yost can use to pierce that veil and conduct an audit that
lawmakers can use to craft legislation to address the twin problems of rising
Medicaid drug costs and independent pharmacies being driven out of business.
http://www.dispatch.com/news/20180314/yost-lawmakers-demand-transparency-from-cvs-on-possible-abuse
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