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Imagine you run across a multimillion-dollar scheme that could both violate Ohio law and rip off taxpayers.

Now imagine the plot is just too complicated to completely unravel, meaning the suspected violators go unpunished and Ohioans are never made whole.

Welcome to Maureen Corcoran’s nightmare.

After taking several months to decide whether to pursue questionable maneuvers by pharmacy benefit managers — middlemen in the prescription drug supply chain — the Ohio Medicaid director is now raising the possibility that a new state probe may not get to the bottom of the mess.

Just three PBMs occupy close to 80% of the benefit pharmacy manager market.

At issue is money the PBMs “claw back” from pharmacies across the US weeks or months after a state considers a Medicaid prescription adjudicated — the technical term for a closed transaction. Clawbacks are allowed in “generic effective rate” contracts offered on a take-it-or-leave-it basis by the major PBMs, which control nearly 80% of the market.

But the after-the-fact clawbacks mean a state not only has falsely inflated drug payments on its books, but also throw off all calculations based on that false information — including the amount taxpayers are assessed for the federal-state health insurance program for the poor and disabled.

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