Medicare And Medicaid In Brief
Executive Summary
CMS plans AMP guidance: CMS says it will issue guidance on the definition of average manufacturer price, which is used as the basis for reimbursement of drugs in Medicaid. The definition of AMP was adjusted in the Medicaid funding bill, H.R. 1586, signed into law on Aug. 10. The AMP calculation was revised in the Patient Protection and Affordable Care Act to limit it to drugs sold through retail pharmacies, but it failed to account for specialty drugs not distributed through those pharmacies (1"The Pink Sheet" DAILY, May 17, 2010). The corrective language makes an exception to the AMP calculation for drugs that are inhaled, infused, instilled, implanted or injected and are not generally dispensed through a retail community pharmacy. A previous CBO score of the corrective language estimated that it would cost the pharmaceutical industry $2.1 billion over 10 years (2"The Pink Sheet" DAILY, June 25, 2010)