NCPA applauds guidance that eliminates spread-pricing in Medicaid

by NCPA | May 15, 2019

CMS on Wednesday issued guidance for Medicaid and CHIP managed care plans clarifying that the amount retained from a pharmacy benefit manager under “spread pricing” must be excluded from the amount of actual claims used in calculating Medicaid and CHIP managed care plans’ Medical Loss Ratio. NCPA CEO Douglas Hoey said the guidance shows that CMS and the Trump administration recognize that PBM practices have led to increased costs for states and taxpayers. Read NCPA’s statement here.