The Association for Community Affiliated Plans (ACAP) enlisted The Menges Group to prepare a report on the ways in which state Medicaid agencies have opted to regulate Medicaid MCO PDL content.  Most states afford MCOs wide latitude in establishing their PDLs.  Conversely, a few states require MCOs to use the statewide Medicaid fee-for-service PDL, and a few others have taken a middle ground regulatory position.  The paper emphasizes that utilizing the lowest-cost, clinically effective medication is one of the most important avenues available to achieve Medicaid savings, and concludes that wide MCO latitude over PDL content is the most appropriate policy.