On May 23, 2023, the Centers for Medicare and Medicaid Services announced a new proposed rule related to the Medicaid Drug Rebate Program (MDRP) and other Medicaid drug pricing, reimbursement and data collection issues. While much of the proposed rule focuses on regulatory changes conforming to legislation affecting the MDRP enacted in recent years as […]
On Wednesday, April 26, 2023, the Health Subcommittee of the House Energy and Commerce Committee will hold a legislative hearing discussing numerous health bills including H.R. 2666 — the “Medicaid VBPs for Patients Act.” This bill would codify for five years a technical rule finalized late in the Trump Administration that, among other provisions, allowed […]
As part of its fiscal year 2024 budget, the Biden Administration proposed several Medicaid and CHIP policies related to the Medicaid Drug Rebate Program, which I covered in a recent blog. But over the last few months, there have been two other Medicaid drug rebate developments that are worth highlighting: Puerto Rico joins the Medicaid […]
Under the highly effective Medicaid Drug Rebate Program (MDRP), drug manufacturers must provide substantial rebates to the federal government and states as a condition of having their drugs covered by Medicaid. For brand-name drugs, the rebates apply to both fee-for-service and Medicaid managed care and consist of two mandatory components. First, under a basic rebate, […]
Editor’s Note: An amended version of the bill (H.R. 485) was reported by the Subcommittee on Health of the House Energy and Commerce Committee on March 8, 2023. The revised language addresses some of the concerns discussed in this blog post. A House bill (H.R. 485) which was one of the bills discussed at a […]
As I have previously explained, under the highly effective Medicaid Drug Rebate Program, drug manufacturers must provide substantial rebates to the federal government and states as a condition of having their drugs covered by Medicaid. The rebates apply to both fee-for-service and to managed care. A groundbreaking 2021 Congressional Budget Office study found that compared […]
