Do You Purchase Medications for People with Disabilities You Support? MACPAC Recommends Removing Caps on Medicaid Rebates

ANCOR is sharing this article on the Medicaid rebate caps by FierceHealthcare because of its potential applicability to organizations that provide supports to people with intellectual / developmental disabilities (I/DD), including medically fragile individuals or individuals in intermediate care facilities (ICFs).

As written by Fierce HealthCare:

“In a bid to help states address growing drug prices, Congress should eliminate the cap on drug rebates paid to state Medicaid programs, the Medicaid and CHIP Payment and Access Commission (MACPAC) recommended during its meeting Thursday.

The savings from higher rebates would allow states to provide the same level of drug coverage at lower costs and continue to exert downward pressure on price increases, they said. If enacted, the change could save the federal government between $15 billion and $20 billion over 10 years, the Congressional Budget Office (CBO) estimated.

MACPAC, which is the nonpartisan committee that advises Congress on Medicaid, also recommended Congress allow states to restrict coverage of new drugs or new drug formulations for up to 180 days after they have been approved by the Food and Drug Administration.”

Understanding Rebates More: For members interested in learning more about Medicaid rebates, ANCOR has identified two resources explaining the topic and its policy implications more.

• A program overview by the Centers for Medicare and Medicaid Services (CMS).
• A three-part blog by the Georgetown Center for Children and Families (CCF).