Industry Experts Weigh In on Medicaid Best Price Waiver Proposal
During a Sept. 17 virtual session of the America’s Health Insurance Plans (AHIP) National Conference on Medicare, Medicaid & Dual Eligibles, health insurance industry leaders were cautiously optimistic about the impact of CMS’s recent proposed rule seeking to promote value-based purchasing (VBP) for prescription drugs, despite mixed reviews from some industry stakeholders (RDB 7/9/20, p. 1).
In the regulation, which was proposed this summer, CMS outlined an updated interpretation of Medicaid “best price” rules — which dictate how rebates are calculated in the Medicaid Drug Rebate Program — by clarifying best price reporting requirements and enabling new structures including year-to-year scheduled prices that could change in relation to patient outcomes (RDB 6/5/20 p. 1).
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