For Government & State Agencies
Verified against your state's official PDL. No patient data. WCAG 2.1 AA accessible. Government pricing available.
Data Sourcing
FormCheckRx sources its verified formulary data exclusively from official state Medicaid Preferred Drug Lists — the same documents your agency publishes. Every verified state's data is reviewed by a licensed PharmD against the current PDL before it goes live. No drug coverage status is published as verified without pharmacist sign-off on the source document.
The platform monitors state PDL sources every 6 hours for changes. When updates are detected, affected formulary entries are flagged for pharmacist review and users are notified. This creates a faster feedback loop between PDL publication and clinical staff awareness than any manual distribution process — particularly relevant for off-cycle PDL updates, which states issue for urgent formulary changes.
01 — SOURCE
Official State PDL
Published by the state Medicaid authority. Same source your agency uses.
02 — VERIFY
PharmD Review
Licensed pharmacist reviews data against source document. Every state, every update.
03 — MONITOR
6-Hour PDL Check
Automated monitoring flags changes. Pharmacist review triggered. Users notified.
Government Procurement
The single most common procurement bottleneck for healthcare software — PHI handling — does not apply here.
No BAA Required
FormCheckRx never receives patient data. Under 45 CFR §160.103, no Business Associate Agreement is required. This eliminates the vendor security assessment, legal review, and compliance certification that typically add 60–120 days to government IT procurement timelines.
Your agency's legal and IT teams do not need to treat FormCheckRx as a covered entity or business associate — because it is neither. The procurement review is the same as procuring any non-PHI reference tool.
Accessibility
The platform is designed to meet WCAG 2.1 AA accessibility standards — a requirement for many federal and state government systems under Section 508 of the Rehabilitation Act. Government agencies deploying technology to frontline staff need tools that meet accessibility mandates.
WCAG 2.1 AA audit is currently in progress. Full compliance documentation will be provided upon request.
Audit Trail
Every administrative action is logged with timestamp, user, and action details. Formulary data changes are recorded in an immutable audit trail. All administrative access is logged and attributable.
Government programs require accountability at every level of operation. FormCheckRx is designed with that requirement in mind — every search, every export, and every administrative change is recorded and available for review.
The Scale
79.6 million Americans are enrolled in Medicaid and CHIP (MACPAC, 2024). 42 states contract with managed care organizations for Medicaid service delivery as of July 1, 2024 (KFF, 2024). 74.6% of Medicaid beneficiaries are enrolled in comprehensive managed care — meaning the MCO formulary, not fee-for-service, determines their drug coverage.
Medicaid prescription drug spending increased 46% between federal fiscal year 2019 and FY2024 (KFF, March 2026). As states manage rising pharmacy costs, accurate formulary data becomes mission-critical for agencies, MCOs, and the frontline staff serving beneficiaries.
A 2023 HHS OIG review found Medicaid MCOs had a PA denial rate of 12.5% — more than double the Medicare Advantage rate. 89% of Medicaid enrollees never appeal a denial, and most state Medicaid agencies do not routinely review the appropriateness of those denials. Only 15 of 39 MCO states provide access to an independent external medical review when a denial is upheld (KFF, 2024). FormCheckRx maps 224 Medicaid MCOs across all 50 states and DC — designed to serve the scale of American Medicaid as operational infrastructure, not a pilot.
Government Access
State Medicaid agencies, CMS regional offices, county health departments, tribal health programs, and government health programs are eligible for government pricing and the 60-day no-cost evaluation.