Question:

How does the government determine how to pay for drugs for Medicaid beneficiaries?

Answer:

State Medicaid programs and the federal government have been looking for new ways to determine payment for Medicaid-covered drugs. In the coming months, the Centers for Medicare & Medicaid Services (CMS) will be issuing a proposed rule to change the determination from an “estimated acquisition cost” to an “actual acquisition cost.” The goal is to more accurately reflect pharmacies’ purchase prices and, of course, to save money for the government.

Facebook
Twitter
LinkedIn
Email
Print

CPT® copyright 2021 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.