More than 75% of Medicaid beneficiaries receive their health care services from Medicaid managed care plans. Therefore, it is important to ensure that pharmacy benefits in these plans are operated efficiently and provide quality services to Medicaid beneficiaries. As part of the Final Rule, CMS requires that states, via their managed care contracts, instruct Medicaid managed care plans to assign and exclusively use a Medicaid-specific Bank Identification Number/Processor Control Number (BIN/PCN) combination and group number on Medicaid managed care beneficiaries’ cards, to help ensure the appropriate scope of benefits are delivered and help avoid duplicate discounts under the 340B Drug Discount Program. Learn more.
