Tennessee Medicaid Gets US Approval For Closed Formulary As Part Of ‘Capped’ Spending Program
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.
You may also be interested in...
Biden Administration nixes Trump-era plan that would have allowed the state to exclude drugs from coverage even as it collected mandatory Medicaid rebates from manufacturers.
If approved, Oregon would be the first state granted the authority to exclude coverage of accelerated approval drugs, even if manufacturers provide the statutory rebates required for Medicaid.
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.