Medicaid drug payment rule change could lead to savings

Jan 30 2012

The Centers for Medicare and Medicaid Services estimates that the federal government could save as much as $17.7 billion over the course of five years as a result of a rule change that shifts more costs to drug makers and pharmacies.

Bloomberg: Medicaid Prescription Drug Rule Saves $17.7 Billion, U.S. Says
Medicaid spending on prescription drugs will fall about $17.7 billion over five years under a rule that shifts more of the cost to drugmakers and pharmacies, the Centers for Medicare and Medicaid Services said. The rule issued today carries out provisions in the U.S. 2010 health care law that raised the rebates that drugmakers led by Pfizer Inc. (PFE) pay each time their products are dispensed to Medicaid patients. … The rebates also apply to drugs sold by managed-care insurance plans that administer Medicaid benefits (Wayne, 1/27).

Modern Healthcare: CMS Seeks Savings Through Changes In Medicaid Drug Payments
The CMS said the federal and state governments would save about $17.7 billion over five years with adjustments to the way Medicaid pays for prescription drugs. A proposed rule, which implements provisions of the Patient Protection and Affordable Care Act, seeks to make Medicaid reimbursement for medications more transparent and more closely aligned with what pharmacies pay for the drugs, according to a CMS news release (Blesch, 1/29).