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The Medicaid Drug Rebate Program is a program in the United States that was created by the Omnibus Budget Reconciliation Act of 1990 (OBRA'90). The program establishes mandatory rebates that drug manufacturers must pay state Medicaid agencies related to the dispensing of outpatient prescription drugs covered by Medicaid.
Misclassification under the Medicaid Drug Rebate Program: False Claims Act: 2010 14 (tie) 13 Trileptal: Novartis [18] $465,000,000 $390 million ($465 million with co-defendant settlements) Off-label promotion/kickbacks False Claims Act/FDCA 2008 17 14 Actiq/Gabitril/Provigil: Cephalon [19] $425,000,000 $375 million civil ($425 million with ...
Misclassification under the Medicaid Drug Rebate Program: EpiPen (epinephrine) False Claims Act: 2006 Schering-Plough [21] $435 million Off-label promotion, kickbacks, Medicare fraud Temodar, Intron A, K-Dur, Claritin RediTabs: False Claims Act, FDCA 2004 [22] Pfizer $430 million Off-label promotion Neurontin: False Claims Act, FDCA 2008 ...
The report says about 44% of state residents — including 60% of those in New York City — are covered by Medicaid or the Essential Plan, seven points above any other state. The programs take up ...
About 17% of women ages 18 to 49 on Medicaid who needed treatment for drug or alcohol use failed to receive it in 2021, the report added. ... David Robinson is the New York State Team health care ...
State Medicaid programs must administer their coverage of prescription outpatient drugs in a manner that accounts for participation in the 340B Drug Pricing Program. Typically, state Medicaid programs obtain rebates for dispensed outpatient prescription drugs through the Medicaid Drug Rebate Program. However, duplicate discounts are prohibited.
The Medicaid drug rebate for brand name drugs, paid by drug manufacturers to the states, is increased to 23.1% (except for the rebate for clotting factors and drugs approved exclusively for pediatric use, which increases to 17.1%), and the rebate is extended to Medicaid managed care plans; the Medicaid rebate for non-innovator, multiple source ...
One of the 2010 law’s primary means to achieve that goal is expanding Medicaid eligibility to more people near the poverty level. But a crucial Supreme Court ruling in 2012 granted states the power to reject the Medicaid expansion, entrenching a two-tiered health care system in America, where the uninsured rate remains disproportionately high ...