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You can find basic information about each state’s requirements and procedures on your state’s Medicaid website. But to check your state’s specific drug coverage, visit the state government’s Medicaid program website. These pages typically house each state’s formulary—a list of covered drugs—and other information.
Currently, PBMs can charge DIR fees for a variety of reasons, including performance metrics, drugutilizationreviews, and medication therapy management. PBMs will be required to provide more detailed information about the fees they charge, including the amounts charged and the reasons for the charges.
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