Blog
Medicaid formulary coverage, prior authorization, drug policy, and pharmacy workflow — written for the professionals who navigate them every day.
39 PA requests per physician per week. 13 hours of staff time. 29% of physicians report a PA delay caused a serious adverse patient event. The data is in — here is what it means operationally.
Read article → SecurityAt $10.22 million per breach and 49 days to negotiate a BAA, the procurement cost of PHI-handling vendors is rarely visible on a spreadsheet. A growing category of clinical tools eliminates it entirely.
Read article → FormularyBilling a carve-out drug through the MCO is one of the most common sources of rejected Medicaid pharmacy claims. What carve-outs are, why they exist, and how to identify them before the claim goes out.
Read article → Drug CoverageGLP-1 coverage in Medicaid is inconsistent across indications, states, and plan types. Michigan's January 2026 PA changes, concurrent DPP-4 restrictions, and what to check before prescribing.
Read article → WorkflowSurescripts estimates 20 minutes per PA request. Formulary lookup is the step before the PA. Across 11 MCOs, 8 patients a day, that math adds up to something most practices have never put a number on.
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