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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 .
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.
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 ...
(Under federal law, Medicaid doesn’t pay list price for drugs, getting substantial rebates; other payers also negotiate discounts.) Globally, more than 4,000 children have been treated with ...
The Inflation Reduction Act's Medicare Prescription Drug Inflation Rebate Program has lowered prices for dozens of prescription drugs and annual out-of-pocket costs for prescription drugs are now ...
The lowered prices of the first 10 drugs picked for Medicare negotiations will go into effect at the start of 2026 and the Medicare rebate program yielded temporary savings on dozens of ...
A figure reported by the manufacturer to CMS in quarterly reports under the Medicaid Rebate Program, it is used to calculate the Medicaid reimbursement rate. It is defined as the lowest price available to any wholesaler, retailer, provider, health maintenance organization (HMO), nonprofit entity, or the government.
The now-dead funding deal would have required PBMs to provide more information on the rebates they negotiate and retain, as well as what they pay for drugs and how much they compensate pharmacies.
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