MEDICAID

disclosure. She said that although her state job involved setting reimbursements for drugs, she didn’t disclose her contacts with CVS because the reimbursements affected CVS and other pharmacies equally.

CVS’s business with the state is coming under scrutiny because pharmacists have accused the company — the seventh-largest in the United States — of using its business handling billions of state Medicaid dollars to drive out retail competition. CVS has denied the accusation, saying there is a strict wall between its retail business and its contracts as a pharmacy-benefit manager for Ohio Medicaid managed-care companies.

Scott had described her job with the Department of Medicaid on her LinkedIn page as “Pharmacist, PBM Contract Manager” until she left state employment in October. In November, she was working as a clinical adviser for CVS, a position in which she advises care providers that use CVS as a pharmacy-benefit manager on how to provide better service.

Scott also worked as a part-time retail pharmacist for CVS from the time she was hired by the state in 2004 until 2016, she said.

Asked for documentation of the outside employment, the state Department of Medicaid said Scott did not have the required form on file — although she did file a different one in 2004 with the Ohio Department of Job and Family Services, the agency that then oversaw Ohio Medicaid.

“We have reached out to the Ohio Ethics Commission to ensure our policies were followed,” department spokeswoman Melissa Ayers said in an email. She also pointed out that “Employees ... are not permitted to participate in employment that is a conflict of interest, raises the appearance of impropriety or violates state ethics law.”

Ayers didn’t answer directly when asked whether the department was aware that Scott was negotiating her current CVS employment while still with the Ohio Department of Medicaid.

A CVS spokeswoman, in an email Wednesday, said, “We do not comment on individual employees or our hiring practices.”

For her part, Scott said she wasn’t in a position to give an advantage to the company while she worked for the state.

“I didn’t have any oversight of the PBM business,” she said, referring to pharmacy benefit managers.

CVS holds four of the five PBM contracts in Ohio’s $3 billion annual pharmacy business under the Medicaid program. But those contracts are with private managedcare companies and not directly controlled by state officials. Scott said she was involved in rate-setting, but that those rates affected CVS the same as other retailers.

However, a pharmacist who dealt with the department said Scott had access to pricing information that might be of interest to CVS.

“I think it could be a potential conflict,” said Dominic Bartone, a southwestern Ohio pharmacist. “I don’t know what access to pricing data she had on the CVS side, but she had total access to data on the Medicaid side.”

Bartone operated two Lebanon-area pharmacies that were sold to CVS last month amid declining reimbursements.

Scott said she never provided CVS with any Medicaid data. But she said company representatives would accompany managed-care organizations to meetings at the department where such data were discussed.

Scott also was a point of contact at the department for pharmacists who wanted to complain about Medicaid reimbursements from CVS.

“She was not readily accessible at all,” said Bartone. “Phone calls, email. She was not good at answering back.”

Scott declined to respond to that criticism.

In an unrelated matter, three patients in an Ohio HIV program on Wednesday sued CVS in U.S. District Court in Ohio, saying that CVS disclosed their private health information. The suit claims that CVS, pharmacy-benefit manager to the HIV program, sent out letters to 6,000 patients in envelopes that were marked “new prescription benefits” and the letters “HIV” appeared above the addressees’ names, the suit says.