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Kentucky highlights single PBM model and oversight; some rebate mechanics flagged for follow-up
Summary
DMS officials described the single pharmacy benefit manager model (MedImpact) created under Senate Bill 50 and said the contract centralizes reporting and rebates to the department; officials will verify whether any rebates are not captured in DMS reporting.
Department for Medicaid Services officials told the Health Budget Review Subcommittee that Kentucky now uses a single pharmacy benefit manager (PBM) model to manage pharmacy benefits for managed-care and fee-for-service Medicaid members.
Jennifer Dudinsky and Commissioner Lisa Lee described the current arrangement: "We do have one single PBM. It's MedImpact," Lee said, referencing the post-Senate Bill 50 procurement that consolidated pharmacy management. Under the model, DMS said MedImpact administers…
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