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Covered Outpatient Drugs Policy

Affordable Care Act

Proposed Rule Published – On February 2, 2012 the Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking (NPRM) on Medicaid covered outpatient drugs [PDF] in the Federal Register.  This proposed rule would revise requirements pertaining to Medicaid reimbursement for covered outpatient drugs to implement provisions of the Patient Protection and Affordable Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act). This proposed rule would also revise other requirements related to covered outpatient drugs, including key aspects of Medicaid coverage, payment, and the drug rebate program.  The NPRM has a 60 day public comment period which will end on April 2, 2012.  

Guidance on List of Pediatric Drugs and Blood Clotting Factors [PDF]

Final Rule to Withdraw AMP and FUL - November 15, 2010 [PDF]

September 28, 2010 State Medicaid Director Letter on Medicaid Prescription Drug Rebates [PDF]

Proposed Rule to Withdraw AMP and FUL - September 3, 2010 [PDF]

April 22, 2010 State Medicaid Director Letter on Medicaid Prescription Drug Rebates [PDF]

 

Deficit Reduction Act (DRA)

Court Order to Vacate Preliminary Injunction - December 15, 2010 [PDF]

CMS-2238-F Medicaid Program: Multiple Source Drug Definition - Published October 7, 2008

CMS-2238-FC Medicaid Program: Prescription Drugs - Published July 17, 2007

 

Other Resources

Section 1927 of the Social Security Act

Program Releases