Louisiana appears to be shelling out millions of dollars more for Medicaid patients’ prescription drugs than it pays to pharmacies, with the extra money pocketed by private companies managing the patients’ care.
A task force created by lawmakers is searching for waste in Louisiana’s $12.5 billion Medicaid program and wants more details on how those deals work—and how much money the state is steering to middle-managers above what the pharmacists receive.
The task force wrote to the health department Wednesday, questioning whether pharmacists are getting low Medicaid reimbursements to help boost profits for private companies that coordinate health services for 90% of Louisiana’s Medicaid patients.
The letter cited a recent independent audit done for the Department of Health that identified at least $42 million in drug charges for Medicaid patients that were kept by private companies after pharmacists were paid for filling prescriptions.
“When the state chooses to do business with profit-driven entities, great effort should be made to ensure that money is not being wasted,” task force leaders said in a letter to Jen Steele, Louisiana’s Medicaid director.
The letter was signed by Legislative Auditor Daryl Purpera, Senate Health and Welfare Chairman Fred Mills and Rep. Tony Bacala, whose legislation created the task force.
Mills, a St. Martin Parish pharmacist, says the questions are aimed at learning what the Department of Health is doing to regulate the private companies that run much of the state’s Medicaid program.
Louisiana contracts with five managed-care companies to coordinate health services for most of its Medicaid patients. The deals are worth billions and cover nearly 1.5 million people.
