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Wednesday, August 10, 2022
HomeNewsArchivesTerritory Hires Private Company to Manage Medicaid Prescriptions

Territory Hires Private Company to Manage Medicaid Prescriptions

The territory has hired CIGNA, a private health care services company, to manage its Medicaid prescription drug program, a move that will reduce costs and improve care to the territory’s neediest residents, according to Government House.

The Department of Health will launch the new Pharmacy Benefit Management Program Friday. The program is meant to increase efficiency and accountability in providing prescription drugs through the Medical Assistance Program, which helps the territory’s low-income population.

"Bringing in a private company to manage our Medicaid drug program is something we have been working on for a couple years," Gov. John deJongh Jr. said in a statement. "We have negotiated a favorable rate with CIGNA, and this transition will save money and improve care for the territory’s neediest citizens,” deJongh said.

The Medical Assistance Program is the territory’s implementation of Medicaid, which helps low-income Virgin Islanders with limited resources obtain medical care. Costs are split evenly between the local and federal government.

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Until now, the program’s prescription drug benefits have been managed on a paper system, with little oversight of pharmacies. CIGNA’s management frees up the Medicaid program from processing paper claims and also reduces costs by monitoring and encouraging more affordable drugs and treatments, according to Government House.

The transition to private management also allows for better compliance with federal regulations, putting the territory in a more favorable position to receive federal funding for Medicaid, according to Government House.

According to the release, the savings should allow the V.I. government to expand benefits, making more drugs available through the program, including some prenatal over-the-counter medications.

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