NACDS continues to engage with congressional stakeholders following the Centers for Medicare & Medicaid Services’ (CMS) release of the Covered Outpatient Drugs Final Rule–or Medicaid AMP Rule–on January 21, which would significantly change pharmacy reimbursement for both brand and generic drugs dispensed to the Medicaid population.
NACDS will continue to work with stakeholders and keep them updated on any relevant developments surrounding the issue.NACDS has been communicating the most up-to-date NACDS analysis of the Final Rule to congressional allies, including the offices of Sens. Johnny Isakson (R-GA) and Mark Warner (D-VA) and Reps. Chris Collins (R-NY) and Dave Loebsack (D-IA). That group of lawmakers spearheaded bipartisan Senate and House letters last year to Health and Human Services Secretary Sylvia Burwell urging at least a one-year transition period to implement the AMP-based federal upper limits (FULs), and to preserve access prescription medications for Medicaid patients by supporting accurate reimbursement of retail pharmacies that dispense prescription drugs.
NACDS will continue to work with stakeholders and keep them updated on any relevant developments surrounding the issue. In order to keep members in the loop on the issue, NACDS hosted a webinar this week focused on the provisions included in the Final Rule that are specific to retail community pharmacies and the reimbursement for prescription drugs dispensed to Medicaid beneficiaries.
In another development, CMS released a letter to State Medicaid Directors with guidance on implementing the Final Rule. The guidance included allowable methods for states to calculate actual acquisition cost; how the new federal upper limits should operate under the Final Rule; and state plan amendment filing requirements under the Final Rule.