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How pharmacy benefit managers factor into the Centene investigation in Mississippi

Did Centene and it’s subsidiaries overcharge Mississippi taxpayers as they managed billions in health insurance benefits?  The investigation is ongoing, with a focus on pharmacy benefit managers, or PBM’s.  Robert Dozier–Director of the MS Independent Pharmacies Association–explained that these are the guys running the prescription drug business.  “These are the middlemen in between the payer and the pharmacist,” he told SuperTalk Mississippi during an interview on The Gallo Radio Show.  

He told us the Association has been saying they need to carve pharmacy out of managed care.  “The Division of Medicaid has a great staff within the pharmacy department, they do a good job.  They’re doing all of the work as far as pharmacy is concerned.  We have these three managed care companies not really doing a whole lot of work,” he continued.

The state legislature addressed PBM’s a couple of years ago, stepping in to prevent gag clauses in their contracts that prevented pharmacists from telling patients about cheaper ways to pay for their medication.

Ohio Attorney General David Yost announced his lawsuit against Centene in March:

https://www.ohioattorneygeneral.gov/Media/News-Releases/March-2021/Ohio-Sues-Multiple-Centene-Entities-for-Breach-of

The company has fired back:

https://www.dispatch.com/story/news/2021/04/05/health-care-colossus-centene-dismissal-ohio-pbm-lawsuit-dave-yost-medicaid/7088381002/

Centene argues that  the claims are unfounded.  They’re vowing to defend the integrity of the pharmacy services provided.

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