NASHVILLE, Tenn. – Tennessee is abandoning plans for a major change to its Medicaid program’s pharmacy benefits after federal health officials raised concerns.
TennCare, Tennessee’s Medicaid program, said it will abandon a proposal to impose limits on some prescription drugs following pressure from the federal government. The state last year received approval from former President Donald Trump’s administration for a TennCare overhaul that included the change. Officials argued the overhaul could produce flexibility and savings that would then fuel additional health coverage offerings, including prescription drug limits aimed at rising costs.
But advocacy groups expressed concerns the change would limit low-income patients to one drug per therapeutic class and thereby hamper access to some medications.
Advocacy groups also argued the prescription drug limitations, known as a closed formulary, would have violated an agreement under a Medicaid rebate law. Last month, the Biden administration asked the state to drop the idea and further change TennCare’s block grant plan.
The block grant plan has drawn concerns from various medical and patient groups about how it could affect care for the state’s most vulnerable patients. The backlash over the block grant sparked questions about whether President Joe Biden would outright spike the program, which received federal approval just before former Trump left office.