CMS issues proposed rule on value-based drug payment in Medicaid
The Centers for Medicare & Medicaid Services yesterday released a revising requirements for value-based purchasing agreements between states and manufacturers for drugs covered by Medicaid.
, the rule would change how manufacturers calculate average manufacturer price for brand name drugs with an authorized generic, and determine whether to include the value of their patient assistance programs when calculating 鈥渂est price.鈥 It also would revise definitions and reporting requirements for the Medicaid Drug Rebate Program; coordination of benefit and third-party liability rules for certain care and payment in Medicaid and the Children鈥檚 Health Insurance Program; and set minimum standards for state Medicaid Drug Utilization Review in an effort to reduce opioid-related fraud, misuse and abuse, among other changes.