 Update on the Pricing Discussion Webinar
The primary purpose of the upcoming SPBM/Pharmacy Pricing Audit Consultant (PPAC) webinar is to discuss the dispensing fee methodology and reimbursement rates under the Next Generation pharmacy program. We hoped to host this discussion in May; however, work is ongoing to complete validation of the fiscal projections used in setting the SPBM dispensing fees.
This analysis will be finished soon, and ODM will schedule the pricing webinar with the pharmacy community for later this month.
ODM understands the importance of communicating rate information as soon as possible, keeping in mind provider contracting timelines as well as ensuring providers have sufficient time to complete any additional modeling.
Thank you for your interest and participation in the Next Generation pharmacy program! We look forward to working with all providers to create an innovative, equitable, and transparent pharmacy program.
Pharmacy resources, guides, and manuals now available
On May 3, ODM and Gainwell Technologies launched the state Medicaid program’s new SPBM website.
The release of the SPBM website targets Ohio pharmacies and pharmacists. The site provides information about Medicaid’s Next Generation pharmacy program and the work underway for the October 2022 implementation. Pharmacy stakeholders and providers can visit the website to access important program information and updates or to download useful guides including the SPBM Pharmacy Reference Guide (Provider Manual). The website will continue to be updated with information for members, pharmacies, and prescribers.
To learn more about Ohio Medicaid’s Single PBM, visit Ohio Medicaid Single Pharmacy Benefit Manager (SPBM) | Ohio Medicaid Managed Care. Additionally, questions can be submitted to MedicaidSPBM@medicaid.ohio.gov.
Frequently asked questions have also been updated
Thanks to everyone who has submitted questions about the SPBM program. We have received dozens and are pleased to share answers with you. Click here to access the latest SPBM FAQ. We will continue to develop this document as additional questions arrive, so check back to see what’s new.
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