No Closed Formularies In Medicaid Without Forgoing Rebates, CMS Tells Massachusetts
US agency decision is a relief to manufacturers worried that the Massachusetts plan would lead to reduced drug access and heavier rebate burdens.
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Tsai will likely participate in a decision on whether to allow Tennessee to move ahead with changes to its Medicaid program that might include the flexibility to exclude drugs from coverage.
Existing value-based contracts, which are voluntary for manufacturers, do not lower costs for states, National Association of Medicaid Directors executive director Matt Salo suggests.
Demonstration, which may not survive scrutiny from the Biden Administration, includes some protections, such as prohibiting Tennessee from excluding drugs described in the Medicare Part D protected classes policy.