Pharmacists in State Government — The Medicaid Perspective

Abstract

The practice of pharmacy offers a myriad of career opportunities. This article presents one individual's experiences in a somewhat unique practice setting: administration of a state Medicaid pharmacy program. Medicaid programs, jointly funded by the federal and state governments, finance the provision of medically necessary services to a defined recipient population. States can optionally cover "prescribed drugs" as part of their program. In one form or another, all have chosen to do so. It is in the design, maintenance and enhancement of the drug benefit program that the pharmacist can use his or her experience—clinical, business and personal—to assure the most cost-efficient and medically appropriate administration of these tax-funded programs. The magnitude of Medicaid programs, and the attendant administrative challenges they present, offer a wide variety of opportunities for a pharmacist's professional growth. The pharmacist in this position deals extensively with formularies and state and federal drug laws. It is not uncommon for the pharmacist to participate in various administrative policy committees and be an integral part of agency decision making pertaining to the Medicaid pharmacy benefit. Federal budget law in 1990 mandated the creation and use of drug utilization review boards by all state Medicaid agencies. Oversight of the functions and coordination with these boards is generally the pharmacist's responsibility.