Iowa has reached a $44 million settlement with Centene, one of the largest Medicaid insurers in the country and one of Iowa's three managed care organizations, to resolve claims that the company overcharged for pharmacy services. Iowa Attorney General Tom Miller has joined several state's attorneys general in pursuing settlements against Centene after accusing it of overbilling the state's Medicaid programs for prescription drugs and pharmacy services. The St. Louis-based Centene operates Iowa Total Care, a managed-care organization in the state Medicaid program that administers benefits to more than 340,000 Iowans who are low-income or who have disabilities. In total, nearly 800,000 Iowans rely on Iowa's Medicaid program, according to state data.
Des Moines Register
Late last week, Iowa Governor Kim Reynolds signed a new PBM law, HB 2384, to regulate pharmacy benefit managers across the state. HB 2384 requires PBMs to update weekly their list of reimbursement rates to pharmacies, allows pharmacies to disclose or sell lower-cost prescriptions to covered individuals, and creates a framework for the state insurance commissioner to gather data on PBMs’ activity in Iowa. HB 2384 unanimously passed both chambers of the House and received Gov. Reynolds’s approval. With its passage, independent pharmacists hope to see greater transparency and better reimbursements.
Sioux City Journal
SF 296 will now allow Iowa pharmacists to test patients on-site for viruses such as the flu, COVID-19, and strep throat - and also treat them immediately. This "test and treat" law will expand access to health care and create a more convenient way for patients to get the care that they need in a timely manner. Especially in rural areas, there may be limited access to certain healthcare services - but 90% of Americans at least live within 5 miles of a community pharmacy. Pharmacists will be able to use their clinical expertise to go beyond simply testing for common viruses, and now also be able to recommend treatment to the patient to get them on the road to recovery.
Iowa News Now