A Look At CMS' Proposed Medicaid Drug Rebate Changes

Law360 (July 9, 2020, 4:39 PM EDT) -- On June 17, the Centers for Medicare & Medicaid Services issued a proposed rule that, if finalized, would modify significantly the current Medicaid Drug Rebate Program regulations, which have been generally (but not entirely) long favored by drugmakers.

The proposed rule puts forth new regulatory policies, as well as provides clarification with regard to already established polices, intended to encourage drug manufacturers and states to participate in value-based purchasing arrangements, or VBPs.

Significantly, the proposed rule impacts best-price reporting in VBPs, excludes pharmacy benefit managers accumulator programs from best-price and average-manufacturer-price determinations, and updates the definitions of several relevant terms to...

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