Hmmm...Still Ohio's Favorite Plan?? HAHAHA
Ohio's largest Medicaid provider cuts ties with Walgreens
By Marty Schladen
Posted Oct 25, 2019 at 2:45 PM
Updated Oct 25, 2019 at 7:13 PM
Walgreens, the country's second largest d–g retailer, is leaving the network of the state's largest Medicaid provider. It's sparking worries about access to care - and about leaving CVS in a dominant postition in the marketplace. (AP Photo/M. Spencer Green)▲
More than half of Ohio's Medicaid recipients will lose access to Walgreens pharmacies on Jan 1. CareSource, Ohio's largest Medicaid provider, is cutting ties with the state's second-largest pharmacy retailer.
Walgreens, Ohio's second-largest pharmacy retailer, will no longer service the state's largest Medicaid provider as of Jan 1, raising concerns about creating pharmacy "deserts" in parts of Ohio.
The news, which wasn't announced by the Ohio Department of Medicaid, comes a week before open enrollment in the insurance program is to begin.
It also raises worries about access for Medicaid patients and about the health of the marketplace. And it raises questions about how well the administration of Gov. Mike DeWine has reformed the way the state Medicaid department reimburses Ohio pharmacies as it spends $3 billion a year on d–gs.
"CareSource has decided to move forward with a network that does not include Walgreens for Ohio managed Medicaid patients in 2020," Walgreens said in an email Friday, referring to Ohio's largest Medicaid managed-care organization, which serves more than a million recipients.
Despite promises by CareSource earlier this year of transparency, the company didn't say whether Walgreens was departing its pharmacy network. It also wouldn't say how many of its Ohio clients use Walgreens as their pharmacy. Nor would it say whether Walgreens was leaving its networks in other states.
Since last year, The Dispatch has written numerous stories raising questions about whether CareSource's current pharmacy-benefit manager, CVS Caremark, was providing lowball reimbursements to the corporation's retail competitors, including Walgreens. In April, CareSource announced that it was dumping CVS Caremark in all the states where it operates and instead was hiring Express Scripts to provide pharmacy benefit manager services such as billing for d–gs, reimbursing pharmacies, establishing lists of covered d–gs and negotiating rebates from d–gmakers.
Despite long-standing complaints that Medicaid reimbursements were so low that they were driving independent pharmacists out of business, Express Scripts in June sent out proposed contracts offering to pay them a dispensing fee of only 15 cents per pr-scrip-ion. The state's own surveys showed that pharmacists needed $10 to break even. Express Scripts quickly withdrew the proposed contracts. The company declined to comment for this story.