Health Affairs June 22, 2020
Rachel Sachs

On Wednesday, June 17, the Centers for Medicare and Medicaid Services (CMS) proposed a series of reforms to the way that pharmaceutical prices are reported to the Medicaid program, in an effort to encourage the use of innovative contracting models throughout both Medicaid and the private sector.

The proposed rule would not represent a major change to prescription drug pricing or policy in the way that some of the administration’s other proposals had envisioned. However, it is a thoughtful tweak to existing regulations that would help mitigate uncertainty for pharmaceutical companies interested in entering into these agreements.

In this post, I describe the problem the proposed rule seeks to solve, review the details of the proposal, and situate it within...

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Topics: CMS, Govt Agencies, Healthcare System, Insurance, Medicaid, Payer, Pharma / Biotech, Pricing / Spending, States
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