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The Medicaid Drug Rebate Program provides for mandatory rebates on innovator drugs (e.g., brand drugs), blood clotting factors, drugs Food and Drug Administration-approved exclusively for pediatric indications, and non-innovator drugs (e.g., generic drugs). [1] The maximum rebate is capped at 100% of the Average Manufacturer Price (AMP).
Elderly Pharmaceutical Insurance Coverage (EPIC) [1] [2] [3] ("New York State's Senior Prescription Plan") [4] was designed so that personal/out-of-pocket costs for medicines are reduced or largely paid for program participants by the state. [1] Members are also given assistance with Medicare Part D. [5]
The New York Times, [9] Federal Trade Commission, [27] [28] and many states' Attorneys General [12] [13] argue pharmacy benefit managers unfairly raise prices on drugs. A report by House Committee on Oversight and Accountability chairman, Kentucky Rep. James Comer , found that PBMs use utilization schemes to increase pricing for payers and ...
That includes the $7.5 billion effort approved this year in New York, where health officials will be approving a range of proposals for addressing how Medicaid reduces health disparities and ...
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 ...
It required pharmaceutical manufacturers to provide rebates for medication purchases, based on sales to Medicaid beneficiaries, as a condition of having their products covered by Medicaid. [3] The amount of the rebates paid to the states were based on a "best price" calculation that did not take into account the discounted prices that ...
The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS).
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