Medicaid AMPs – PBMs out, mail order in
Calculation of average manufacturer prices for Medicaid will generally exclude discounts to pharmacy benefit managers, CMS says. Final AMP rules will be published in the July 17 Federal Register. In Dec. 22, 2006 proposed rules, CMS expressed interest in including PBM discounts in AMPs and sought input on the feasibility of tracking them (1"The Pink Sheet" Jan. 1, 2007, p. 21). As proposed, AMPs will include sales to mail-order pharmacies. Also included are sales to home infusion and specialty pharmacies...
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CMS wants to include a broader array of pharmacy benefit manager price concessions in calculating Medicaid average manufacturer prices for reimbursing outpatient prescription drugs
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