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Too Much Leeway? OIG Gives CMS Broad Advice For Medicaid Pricing Reg

Executive Summary

CMS retains broad latitude in determining how average manufacturer price will be calculated after the HHS Office of the Inspector General did not make specific recommendations in a May 30 report

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States undecided about AMP

Most states remain undecided about whether to use AMP to determine Medicaid drug reimbursement, the Office of the Inspector General finds in a report posted May 4. States began receiving AMP data from CMS in 2006, but concerns remain regarding its accuracy and validity. OIG reiterates its recommendation that "CMS explicitly detail AMP's definition and calculation, including the definition of retail pharmacy class of trade" in its final AMP rule, which is due by July 1 (1"The Pink Sheet" June 5, 2006, p. 23). Four states plan to use AMP-based Medicaid reimbursement but have not implemented the changes, and three states do not plan to use AMP...

States undecided about AMP

Most states remain undecided about whether to use AMP to determine Medicaid drug reimbursement, the Office of the Inspector General finds in a report posted May 4. States began receiving AMP data from CMS in 2006, but concerns remain regarding its accuracy and validity. OIG reiterates its recommendation that "CMS explicitly detail AMP's definition and calculation, including the definition of retail pharmacy class of trade" in its final AMP rule, which is due by July 1 (1"The Pink Sheet" June 5, 2006, p. 23). Four states plan to use AMP-based Medicaid reimbursement but have not implemented the changes, and three states do not plan to use AMP...

Pharmacy Groups Urge Pilot Project Approach To AMP Disclosure

Given the relative novelty of Medicaid average manufacturer prices for multi-source drugs, the National Association of Chain Drug Stores suggests that a pilot program approach to disclosure would help ensure price data accuracy

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