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Athos Alexandrou, director of Maryland's Medicaid pharmacy program, says the state will benefit fiscally from the health care reform legislation's drug rebate program, by getting a share of rebates for pharmaceuticals dispensed by managed care organizations (MCOs). On the other hand, money will be lost on the fee-for-service side.

Fiscal Fitness: How States Cope: Rebates are net gain for some states, but outlay of funds needed to increase necessary staffing