Drug Costs

Trump Administration Encourages States to Seek Waivers to Opt Out of Medicaid Drug Rebate Program

On June 27, the Centers for Medicare and Medicaid Services partially approved Massachusetts’ Medicaid waiver proposal, but among other provisions, rejected a proposal to impose a “closed formulary” for prescription drugs under which the state could entirely exclude coverage of certain drugs in ways not permitted under current law.  Instead, CMS expressed openness to approving […]

CMS to Freeze Risk Adjustment Payments to Health Insurers

MedPage Today By: Joyce Frieden The federal government will stop making risk adjustment payments to health insurers that have sicker-than-average patients, raising the specter of more premium increases by insurers to make up for the shortfall. … Withholding the payments will have both short-term and long-term effects, according to Edwin Park, JD, of Georgetown University. […]