Tennessee Medicaid Gets US Approval For Closed Formulary As Part Of ‘Capped’ Spending Program
Demonstration, which may not survive scrutiny from the Biden Administration, includes some protections, such as prohibiting Tennessee from excluding drugs described in the Medicare Part D protected classes policy.
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Tsai will likely participate in a decision on whether to allow Tennessee to move ahead with changes to its Medicaid program that might include the flexibility to exclude drugs from coverage.
Existing value-based contracts, which are voluntary for manufacturers, do not lower costs for states, National Association of Medicaid Directors executive director Matt Salo suggests.
Trade group’s new agenda offers few original solutions to tackle US drug costs, relying on old standbys and reminders of what medical innovation might be lost if industry is financially targeted by policy makers with a strong nod to drug manufacturers role the current pandemic.