- Medicaid rebates can and should be improved. The Affordable Care Act changes how Medicaid rebates are administered, and one outcome could be better oversight of drug industry rebate calculation and payment. The current system is rife with fraud, and the lack of a national database of drug prices has made it difficult for states to negotiate uniform pricing. The Affordable Care Act changes the way rebates must be calculated at both the state and federal levels, increasing the amount of rebates for some drugs and establishing through regulation a national price list from which rebates can be calculated.
- Implementing the Affordable Care Act provides states with new levers to promote a variety of prescription drug policies. "Obamacare" includes a variety of provisions relating to pharmaceutical policy, including Medicaid drug pricing and reimbursement, benefit management and marketing. There are potentially opportunities for legislators to expand some existing state programs and look for alternative ways to implement other policies such as pharmacy benefit manager (PBM) transparency, disclosure of gifts and payments to physicians, datamining, academic detailing and more. States get to set the rules for the insurance exchanges and the federal government is promoting state flexibility, so states should investigate opportunities to promote better prescribing and pharmacy benefit practices.
See Also:
| Planning a State Legislative Agenda for 2013 | more |
