Wednesday, March 14, 2018

Yost, lawmakers demand transparency from CVS on possible abuse

By Marty Schladen
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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