The Centers for Medicare and Medicaid Services (CMS) have proposed a rule that would increase transparency in prescription drug costs for Medicaid beneficiaries. The rule would require manufacturers of high-cost drugs to submit detailed pricing information to CMS, including the cost of manufacturing and distributing the drugs. This information would be made public, which would allow states and beneficiaries to better understand the factors that drive drug prices. The proposed rule is part of the Biden-Harris Administration’s efforts to reduce prescription drug costs.
The Centers for Medicare and Medicaid Services (CMS) has proposed a rule that would increase transparency in prescription drug costs for Medicaid beneficiaries. The rule would require manufacturers of high-cost drugs to submit detailed pricing information to CMS, including the cost of manufacturing and distributing the drugs. This information would be made public, which would allow states and beneficiaries to better understand the factors that drive drug prices.
The rule would also require states to disclose the amount they pay pharmacy benefit managers (PBMs) to administer drug benefits. PBMs are middlemen that negotiate drug prices on behalf of insurers and health plans. The lack of transparency around PBM payments has raised concerns that they are using spread pricing arrangements to increase their profits by charging insurers more for drugs than they pay pharmacies.
The proposed rule is part of the Biden-Harris Administration’s efforts to reduce prescription drug costs. The administration has also launched a program that requires drug companies to pay rebates to Medicare when their prescription drug prices rise faster than the rate of inflation.
The proposed rule is open for public comment until July 11, 2023. CMS will consider all comments received before finalizing the rule.
The proposed rule is a positive step towards increasing transparency in prescription drug costs. By making drug pricing information more accessible, this rule will help states and beneficiaries make better decisions about drug coverage.
