Medicaid Outpatient Drug Rule

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January 2016

The Centers for Medicare & Medicaid Services released its long-anticipated final rule on Medicaid-covered outpatient drugs on January 21, 2016. Originally proposed in 2012, this final regulation implements and clarifies provisions of the Patient Protection and Affordable Care Act and revises other requirements related to covered outpatient drugs, including key aspects of payment.

This presentation provides a refresher on Medicaid payment for drugs and the Medicaid drug rebate program, and highlights major provisions of final rule, including important dates, definitional changes and clarifications, payment limits, and state requirements.

Publication Type: Presentations

From: January 2016 MACPAC Public Meeting

Tags: payment, prescription drugs