In order to effectively implement provisions of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) finalized, on January 21, a rule detailing reforms to the rebate and reimbursement systems for Medicaid prescription drugs. The reforms will save federal and state governments an estimated $2.7 billion over 5 years.
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The ACA substantially reformed Medicaid payments for prescription drugs, increasing rebates and setting limits on federal reimbursements.
The new “Covered Outpatient Drugs” final rule ensures those reforms will be effectively implemented by providing further detail on how those reimbursements and rebates are calculated.