Department of Health and Human Services Office of Inspector General: States' Collection of Rebates for Drugs Paid through Medicaid Managed Care Organizations.

摘要

In general, drug manufacturers must pay rebates for covered outpatient drugs reimbursed under Medicaid for a State to receive Federal matching funds. However, until the March 23, 2010, enactment of the ACA, P.L. 111-148, drugs dispensed by Medicaid MCOs were excluded from the rebate requirements Section 2501(c) of the ACA expanded the rebate requirements to include drugs dispensed to beneficiaries who receive care from MCOs if the organizations are responsible for coverage of such drugs, effective March 23, 2010. To facilitate rebate collection, States must include the utilization data collected from MCOs in their rebate invoices to manufacturers. The Congressional Budget Office (CBO) estimated that this provision will result in savings of $3.7 billion between 2010 and 2014.