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CMS letter on supplemental Rx rebates

Executive Summary

States seeking to undertake a prior authorization program for Medicaid are expected to submit a state plan amendment to the Centers for Medicare & Medicaid Services for review, CMS says in Sept. 18 1letter to state Medicaid directors. If the rebates gained through a prior authorization program benefit a non-Medicaid population, "the state should be prepared to demonstrate through appropriate evidence that the prior authorization program will further the goals and objectives of the Medicaid program," the letter says. In an amicus brief filed with the Supreme Court the same day, HHS urged the court to find the Maine Rx program "invalid because it is not designed to serve the interests of the Medicaid program" (2"The Pink Sheet" July 1, In Brief)...

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