TennCare "best price" exemption
Health Care Financing Administration's Nov. 18 approval of Tennessee's Medicaid managed care reform plan includes a waiver "to enable the state to exempt drug providers from the best price requirements for contract" with managed care programs. The waiver allows managed care providers "to implement more stringent control on coverage of drugs through establishment of their own formularies and by limiting the authorized formulary based on cost, therapeutic equivalent, and clinical efficacy." Slated for implementation in January 1994, the TennCare program will enroll as many as 1.3 mil. Medicaid-eligible, uninsured and uninsurable state residents into managed care programs during the first year of the five-year demonstration project.
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