Tennessee Medicaid Closed Formulary, Capped Spending Experiment Rejected By CMS
Executive Summary
Biden Administration nixes Trump-era plan that would have allowed the state to exclude drugs from coverage even as it collected mandatory Medicaid rebates from manufacturers.
You may also be interested in...
Accelerated Approvals In Medicaid: Drug Coverage Exclusion Authority Sought In Oregon
If approved, Oregon would be the first state granted the authority to exclude coverage of accelerated approval drugs, even if manufacturers provide the statutory rebates required for Medicaid.
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.
Medicare Reimbursement For Part B Drugs Is 48% Above 340B Prices To Hospitals, MedPAC Finds
New study updates past commission analyses and highlights the significant margin between Medicare payments for drugs and the prices paid by 340B-eligible providers.