Medicaid Inflation Rebates Would Apply To More Products Under Line Extension Proposal
Proposed rule also addresses impact of copay ‘accumulator’ programs on reporting Medicaid best prices and lays out more stringent requirements for manufacturers to be able to exclude such assistance from calculations.
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CMS final rule narrows definition of new formulations potentially subject to much higher Medicaid rebates and delays effective date of provisions targeting health plan copay accumulator programs.
Medicaid should go back to the drawing board on a key part of its proposal aimed at circumventing best price reporting obstacles to value-based purchasing.
In the latest reminder of how badly industry lost the argument over the value of incremental improvements in formulations, US is proposing enhanced Medicaid rebates on virtually all new formulations of existing brands.