The consultant will work with Ohio Medicaid to establish pharmacy prices and conduct fiscal oversight of the single pharmacy benefit manager, Gainwell Technologies, that is replacing the different contractors used by the different insurance companies.
In 2019, the Ohio General Assembly instructed Ohio Medicaid to adopt this change after a consultant’s report on how these contractors were paid $224 million in overhead by Medicaid.
The new single pharmacy benefit manager system could save around $150 to $200 million a year, though final net cost change still needs calculated. Those savings are anticipated for the first full year of operations.
Myers and Stauffer’s oversight is designed to eliminate potential conflicts of interest, prevent prescription drug steerage, and guard against other potential financial mechanisms that could reduce public confidence, increase cost, and obscure visibility into the operations of the program.
“Ohio Medicaid will work hand-in-hand with Myers and Stauffer to create rigorous checks and balances needed to make sure we are using dollars wisely,” stated Maureen Corcoran, Ohio Medicaid director.
This pharmacy change is part of the DeWine administration’s larger project overhauling the Ohio Medicaid program, provides benefits for more than 3 million Ohioans. The newly designed program is expected to launch in early 2022.