CMS Launches Medicaid Drug Payment Model with Participating States
CMS announced participating states in a new Medicaid drug payment model aimed at reducing prescription drug costs for Medicaid beneficiaries. The model will test alternative reimbursement methodologies for prescription drugs in Medicaid programs. Participating states will implement the model beginning in 2027, with CMS providing technical assistance and evaluating outcomes over a multi-year period. The initiative targets cost reduction while maintaining access to necessary medications for Medicaid enrollees.
States and managed care plans will need to adapt pharmacy benefit structures and contracting arrangements to align with new federal reimbursement methodologies and reporting requirements.
Pharmacy · Managed Care · Finance
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