TennCare Preferred Drug List Partially Implemented
TennCare, Tennessee's Medicaid managed care program, has implemented the first 10 of 30 categories of drugs under its new preferred drug list, the Tennessean reports (de la Cruz, Tennessean, 10/15). The preferred drug list, which was approved by the state Legislature in May and has been gradually implemented since July, combines the individual preferred drug lists of TennCare's seven managed care plans and the state's other health plans. The single list will allow the state to receive up to a 20% rebate on medications from drug companies instead of the much smaller rebates that the seven managed care companies' pharmacy benefits managers receive (Kaiser Daily Health Policy Report, 7/11). The state expects that the list will help reduce its prescription drug spending by $150 million through the rebates. The new list is also expected to reduce from about 8,000 per month to about 500 per month the number of appeals filed by beneficiaries regarding prescription coverage, according to TennCare officials. Under a recent settlement in a federal lawsuit filed by advocates against the program, TennCare officials will give a beneficiary who was denied coverage for a prescription a three-day supply of the medication, rather than a 14-day supply under the previous policy. In an effort to encourage use of more generic rather than brand-name medications, the program will offer pharmacists a 10-cent bonus for every prescription they fill if 90% of the total number of medications they prescribe beneficiaries are on the preferred list, Dr. David Hollis, chief medical officer for TennCare, told members of the joint TennCare Oversight Committee on Tuesday (Tennessean, 10/15).
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