Medicaid Prescription Drug Programs

Medicaid is a joint Federal-State program that pays for medical assistance for individuals and families with low incomes and relatively few assets.  Although pharmacy coverage is an optional benefit under federal Medicaid law, all States currently provide coverage for outpatient prescription drugs to all categorically eligible individuals and most other enrollees within their Medicaid programs.

The Medicaid prescription drug programs include the management, development, and administration of systems and data collection necessary to operate the Medicaid Drug Rebate program, the Federal Upper Limit calculation for generic drugs, and the Drug Utilization Review program.    

Additionally, the Medicaid prescription drugs section  provides information related to State prescription drug resources on each State Medicaid program’s prescription drug programs, information on the Medicaid Drug Rebate Dispute Resolution Program, and program releases issued by CMS on a regular basis.

If you have questions regarding Medicaid prescription drug programs, you may email your question(s) to the one of the appropriate resource mailboxes.

To receive updates on the Medicaid prescription drug programs, please subscribe to our Medicaid Prescription Drug Policy & Reimbursement Updates Mailing List to see the latest information.