State Audit Will Look At OptumRx’s Medi-Cal Reimbursements To Pharmacists
The review was called for by state lawmakers after complaints about Optum's payments as pharmacy benefit manager for the Medi-Cal Gold Coast plan.
Ventura County Star:
Medi-Cal Plan Faces Audit Over Pharmacy Controversies
Gold Coast Health Plan’s $100 million-plus annual pact with pharmacy giant OptumRx, reimbursements that independent pharmacists say are killing their businesses and alleged pricing errors will be scrutinized in a state audit that’s expected to take five months to complete.The 2,000-hour audit of the publicly funded health plan was called for in a 12-0 vote by state senators and Assembly members in the Joint Legislative Audit Committee this month. It’s the latest fallout from a yearlong controversy over reimbursement paid by OptumRx as pharmacy benefit manager for the Gold Coast plan, which administers Medi-Cal for about 200,000 low-income Ventura County residents. (Kisken, 8/16)
Trump Readies New Round Of Controversial Medicaid Changes
The Trump administration is preparing to let conservative-led states impose additional restrictions on the nation’s health program for the poor that could push tens of thousands of people off coverage, POLITICO has learned. The high-stakes changes, involving work requirements and questions about illegal drug use, have been the subject of intense behind-the-scenes lobbying in recent months by federal and state lawmakers in the latest chapter of the GOP’s long-running efforts to reshape Medicaid — a policy priority extending back to the Reagan era. (Diamond, 8/16)