FACT:

Medicaid prescriptions represented 13% of the managed
care total in 2003.

FACT:

Over 50% of Medicaid recipients receive their healthcare through managed care organizations.

FACT:

The approval process for securing state Medicaid contracts
differs from state to state.

Each state has its own contract approval process. A number of states use pharmacy benefits management/administration organizations (PBMs) to administer their Medicaid formulary benefits programs. However, some states have pharmacy benefits management staff within their government departments. Each state has some form of pharmacy board involved in the approval formularies for Medicaid recipients. 

FACT:

The Medicaid market demands knowledge of decision-making
protocols that differ from the managed care market.

While the basic contracting process itself does not differ greatly, the decision makers and protocols do. In Medicaid, the decision makers involved represent the state public sector versus the commercial sector for managed care. In addition, the contracting process and protocols vary greatly from account to account and state to state.