(Dec. 11) Attorney General Liz Murrill is taking an animus against pharmacy benefit managers way too far. Consequently, hundreds of thousands of Medicaid recipients might be moved into coverage they think is less optimal than their current plans.
This is bad governance. And though Murrill self-identifies as a rock-solid conservative, there is nothing conservative about it.
The whole scenario, as described below, might at first sound complicated, but bear with me. The essential state of play will be clear soon enough.
Here’s the news: In concert with Murrill and apparently at her behest, newly appointed Louisiana Medicaid Director Seth Gold on Dec. 2 sent a letter to United Healthcare saying the state won’t renew the company’s contract that (as of Nov. 1) serves 333,246 Louisiana Medicaid enrollees. Louisiana Health Secretary Bruce Greenstein told the Louisiana Illuminator, which first broke the story, that his department intends to move United’s enrollees to one of four other providers in the next two weeks, using a computer algorithm to try matching recipients with the company best able to handle their cases.
Gold originally sent a similar dismissal letter to another provider, Aetna, but this newspaper reported on Tuesday that Aetna’s contract will be renewed after all. Murrill had told the Illuminator that her office was near a settlement with Aetna’s parent corporation, CVS, in a multipronged legal dispute she and Gov. Jeff Landry have waged against it and against United for how they operate pharmacy benefit managers (PBMs).
PBMs essentially are middlemen, for prescription drug coverage, between pharmaceutical companies and insurers.
Murrill confirmed to the Illuminator that the PBM-related lawsuits are driving the current decisions. She also said United is somehow not compliant with state law and “has engaged in frivolous attacks on the AG’s contracting authority as well.” She did not specify which laws allegedly are being broken.
OK, after that convoluted background, here’s where the situation actually gets simple.
Essentially, Murrill is cutting out United in a fit of pique.
Here’s how: As this newspaper reported, health chief Greenstein told a Nov. 20 state legislative hearing that the Landry administration supported extending the contracts for all six companies currently providing Medicaid coverage in Louisiana. Greenstein specifically argued that cutting the number of providers would be a disservice to recipients. Lawmakers complied by voting to extend the contracts.
The very next day, the Louisiana First Circuit Court of Appeal sided with United in the lawsuit Murrill is waging against the company. Within 11 days, the administration completely reversed course and canceled the very contract extension for which it had requested approval….. [The full column is at this link.]
