Legislative leaders to scrutinize state medical health insurance plan, pharmacy profit managers [Northeast Mississippi Daily Journal, Tupelo]


Jun. 10—JACKSON — Leaders of the Capitol’s two insurance committees hope to search out long-term solutions to the recent money crunch in Mississippi’s insurance plan, which covers the nearly 200,000 state employees and retirees.

The House and Senate Insurance Committees are scheduled to conduct a joint hearing on July 19-20 on each the state’s managed care insurance program and the drug middlemen often called pharmacy profit managers.

“The elephant within the room is that our state medical health insurance plan is bleeding money straight away,” Senate Insurance Chairman Water Michel told the Every day Journal.

Michel, R-Madison, said state employees filed around $120 million in claims related to COVID-19 last yr, which put a big strain on the system and caused lawmakers to make use of one-time money to plug the outlet.

To temporarily stop the hemorrhaging, lawmakers agreed to complement the recent loss with American Resource Plan Act dollars they received from the federal government.

“We just wish to make certain we’re staying ahead of the curve with the plan,” Michel said.

The plan is overseen by the Department of Finance and Administration, but advantages are administered by Blue Cross & Blue Shield of Mississippi, which works with one other PBM to deliver drugs to enrollees.

Pharmacy profit managers, or PBMs, are subcontractors often hired by health plans or employers to administer drug advantages, negotiate drug pricing with manufacturers, and reimburse pharmacists. A part of PBMs’ job involves negotiating rebates and other discounts from drugmakers. In exchange, they supply a drugmakers’ product with preferred placement.

But this rebate and negotiation process is commonly cloaked in secrecy and has caused a litany of states like Ohio, Oklahoma, Georgia, Recent Mexico, Kansas and Arkansas to scrutinize the practice.

The hearing comes after State Auditor Shad White’s office in March inked an agreement with an information analytics firm to reap a big swath of information from any PBM that has a contract with the state.

When asked if the investigations by the auditor’s office could have any relevance to the upcoming hearings, Michel deferred to House Insurance Chairman Hank Zuber, who he said is the most important official organizing the hearing.

Zuber, R-Ocean Springs, said the hearings are scheduled to happen, however the agenda for them has not been finalized.

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