The Maryland Health Department will ban spread pricing in its Medicaid program next year after an audit found the practice cost the state $72 million in 2018, which at $6.96 per claim appears to be the biggest spread margin per prescription spread reported to date, according to 3 Axis Advisors. The department will mandate that Medicaid managed care plans use a pass-through pay model that requires PBMs to charge the exact amount they pay for prescriptions and dispensing fees. There...