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Pharmacy Benefit Manager Model Legislation: Questions and Answers

These questions and answers explain the role pharmacy benefit managers (PBM) play in the drug supply chain and highlight NASHP’s model PBM legislation that states can use to better oversee PBMs and protect consumers. What are pharmacy benefit managers? Pharmacy benefit managers (PBMs) contract with health plans to administer their pharmacy benefits. Depending what a health […]

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  • Medicaid pays a large share of treatment costs for children with behavioral health conditions. In 2011, more than 4 million children enrolled in Medicaid had a diagnosed behavioral health condition. The National Academy for State Health Policy (NASHP) has developed an informational fact sheet summarizing Medicaid provisions that cover behavioral health treatment for children. The […]

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    July 27, 2018 | Filed under: All, Behavioral Health, Children's Health, Medicaid
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    July 13, 2018 | Filed under: All
  • Feds Send Mixed Responses on States’ Efforts to Control Medicaid Drug Costs

    The Centers for Medicare & Medicaid Services (CMS) had a mixed response to two states’ innovative efforts to control Medicaid drug costs in June. The agency denied Massachusetts’ 1115 waiver request to create a closed Medicaid drug formulary, but it approved Oklahoma’s State Plan Amendment that authorizes supplemental rebates for value-based purchasing arrangements with pharmaceutical […]

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    July 10, 2018 | Filed under: All, Drug Pricing, Front Page, Front Page-Rx, Medicaid
  • The National Academy for State Health Policy (NASHP) seeks an experienced professional to join our Center for State Rx Drug Pricing team to provide in-depth policy analysis and technical assistance to states on multiple strategies to reduce pharmaceutical costs. The senior policy fellow also supports a working group of state officials by providing technical expertise to […]

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    June 19, 2018 | Filed under: All
  • State Strategies to Advance Medical Homes for Children and Youth with Special Health Care Needs

    Medical homes are critical components of comprehensive care systems for children and youth with special health needs (CYSHCN). They can reduce costs and improve outcomes and care experiences for CYSHCN and their families. This new report, State Strategies to Advance Medical Homes for Children and Youth with Special Health Care Needs, examines effective strategies used […]

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  • The Roadmap Ahead: New York’s Value-Based Payments Reward Communities and Providers for Addressing the Social Determinants of Health
    State Health Policy Blog

    Medicaid payment models in many states are shifting away from rewarding providers for the quantity of care they provide to models that reward high-quality, coordinated care that addresses some of the broader social factors that influence health and well-being. One example is New York’s Value-Based Payment (VBP) Roadmap, which rewards Medicaid providers and community-based organizations […]

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    May 24, 2018 | Filed under: All
  • Wednesday, August 15th 4:30pm – 5:30pm We are taken inside Wall Street to understand what motivates investors and drives where health care dollars are spent. What exactly lies ahead in a new health care world of technological advances and emergence of new players like Amazon and Berkshire Hathaway? What else is waiting for us? Speaker Ana […]

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    April 20, 2018 | Filed under: All
  • State Health Policy Blog

    On Dec. 21, Congress passed a continuing resolution (CR) bill to keep the federal government operational through Jan. 19, 2018, and it includes new, short-term federal funding for the Children’s Health Insurance Program (CHIP). Specifically, the CR: Provides $2.85 billion in new federal allotments to states for CHIP for the period from Oct. 1, 2017, […]

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