The Centers for Medicare and Medicaid Services (CMS) has issued a notice of proposed rulemaking (NPRM) that would increase transparency into what Medicare is charged for prescription drugs.
The Department of Health and Human Services (HHS) issued the proposal through the CMS to "further drive down prescription drug costs in Medicaid," according to a DHS May 23 news release. The agency states the NPRM "would shed light on the actual cost of drugs covered by Medicaid. Under this proposal, Medicaid would have increased ability to hold drug manufacturers accountable for what Medicaid programs pay for drugs."
CMS Administrator Chiquita Brooks-LaSure said the proposed rule showcases CMS as a "good steward" of Medicaid funds while also bolstering the program's integrity and the management of pharmacy benefits.
"We’re committed to preserving access to life-saving treatments and securing fiscal sustainability for the Medicaid program," Brooks-LaSure said in the release, “which remains a lifeline for millions of people.”
The proposal builds on President Joe Biden’s Oct. 14 executive order on lowering prescription drug costs, according to the news release. The Medicare Prescription Drug Inflation Rebate Program orders drug companies must now pay rebates to Medicare when their prescription drug prices increase faster than the rate of inflation for certain drugs dispensed to people with Medicare, according to the order.
The NPRM would give CMS more information on what drugs actually cost to manufacture and distribute; improve transparency into the costs of administering drug benefits in Medicaid-managed care plans; and address possible misclassification of drugs to ensure states are reimbursed at the correct rate for brand name drugs versus generics.
“President Biden is not only committed to protecting Medicaid, but continues to take bold actions to strengthen the program,” HHS Sec. Xavier Becerra said in the news release.
“With today’s proposed rule, we are advancing unprecedented efforts to increase transparency in prescription drug costs, being good stewards of the Medicaid program, and protecting its financial integrity," Becerra said. "This proposed rule will save both states and the federal government money.”
