Managed Healthcare Executive August 23, 2024
Don Sapatkin

CMS will provide key logistical support to states that participate in its outcomes-based funding model for gene therapy treatment for sickle cell disease.

Acknowledging the enormous complexity of not just developing and administering gene therapy treatments but also financing them, CMS is offering states up to $9.55 million to states that participate in an outcomes-based funding model.

Under the Cell and Gene Therapy (CGT) Access Model, the federal government will negotiate outcomes-based agreements with gene therapy manufacturers to provide states with additional Medicaid rebates if the cell or gene therapies do not perform as expected. The approach will initially target sickle cell disease.

CMS posted the Notice of Funding Opportunity on Aug. 15.

The model will test “whether a CMS-led...

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Topics: CMS, Govt Agencies, Insurance, Medicaid, States
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