U.S. proposes new rule to increase transparency of prescription drug
costs for Medicaid
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[May 24, 2023]
(Reuters) - The U.S. health department on Tuesday proposed a rule
aimed at cutting costs of prescription drugs for the Medicaid healthcare
program for the poor by increasing transparency around how much those
drugs actually cost.
The proposed rule would also hold drugmakers accountable for providing
the correct discounts to the state-based Medicaid plans for drugs.
The Centers for Medicare and Medicaid Services (CMS) proposed that
contracts between states, health insurers and third-party contractors
such as pharmacy benefit managers show how much those PBMs are paying
for the drugs to avoid discrepancies in what they charge Medicaid and
what they reimburse pharmacies.
The agency, part of the U.S. Department of Health and Human Services
that oversees the health programs, said the proposed rule follows
President Joe Biden's executive order requiring all agencies to work to
lower drug prices in the U.S., which are the highest in the world.
![](http://archives.lincolndailynews.com/2023/May/24/images/ads/current/chittick_sda_PROMGRAD_2023.png)
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![](http://archives.lincolndailynews.com/2015/May/02/images/ads/current/guzzardo_lda022609.png) The proposal also includes
provisions to ensure states receive appropriate rebates or
after-market discounts to which they are entitled since they receive
a higher rebate for brand-name drugs compared with the generic
versions.
With increased transparency, states would be able to determine if
manufacturers have appropriately classified their covered outpatient
drugs, and if they have not, give CMS the ability to take action to
correct the misclassification.
![](http://archives.lincolndailynews.com/2023/May/24/images/ads/current/rohlfs_sda_PROMGRAD_2023.png)
The proposed regulation also includes the provision for a drug price
verification survey, which would result in greater transparency into
manufacturers' drug prices.
(Reporting by Mariam Sunny in Bengaluru; Editing by Caroline Humer
and Anil D'Silva)
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