The Centers for Medicare & Medicaid Services (CMS) announced it is publishing the long awaited Covered Outpatient Drugs. The final rule includes reforms to the rebate and reimbursement systems for Medicaid prescription drugs:

    • Creates regulatory definition for AMP.
    • Updates FUL formula for payment of certain generic drugs.
    • Creates exception to FUL calculation.
    • Establishes AAC as basis for ingredient reimbursement and implements ‘professional dispensing fee.’
    According to CMS, the final rule will “save federal and state governments an estimated $2.7 billion over five years.” Comments will be accepted for 60 days after publication in the Federal Register on February 1, 2016. More information is available in a fact sheet, published by CMS.

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