Keyword Analysis & Research: wisconsin medicaid pharmacy benefit manager

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Frequently Asked Questions

What does preferred drug list mean for Medicaid?

Preferred Drug List (PDL): A list of outpatient drugs that states encourage providers to prescribe over others, as a mechanism to negotiate higher supplemental rebates. A state may attach a higher copay or require prior authorization for drugs not on the PDL.

Who are the third party administrators for Medicaid?

Pharmacy benefit managers (PBMs): Third party administrators that perform a variety of financial and clinical services for Medicaid programs and help states administer the pharmacy benefit.

What do States negotiate with drug manufacturers for supplemental rebates?

Supplemental rebates: States may negotiate with drug manufacturers for supplemental rebates on certain drugs in addition to the federal statutory rebates they receive from the Medicaid Drug Rebate Program (MDRP). These drugs often receive preferred status. For more on the MDRP, please see this brief.


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