Reference Guides | May 19, 2017
Use Of Pharmacy Lock-In Programs By State Medicaid Programs: An OPEN MINDS Reference Guide
Pharmacy lock-in programs are programs used by Medicaid fee-for-service (FFS) and managed care programs to restrict pharmacy usage, as well as other, health care services due to the over utilization or misuse of health care services. Lock-in programs go by a number of names and while they always restrict pharmacy services, other health care services may also be restricted under the program. Alternate names for pharmacy lock-in programs include recipient restriction programs, coordinated services programs, pharmacy management programs, or benefit restriction programs.
While the programs have shown success in decreasing utilization of health care services . . .