Mdrp dvd7/31/2023 ![]() States administer the benefit in different ways within federal guidelines regarding, for example, pricing, utilization management, and rebates. Though the pharmacy benefit is a state option, all states provide pharmacy benefit coverage. Medicaid provides health coverage for millions of Americans, including many with substantial health needs who rely on Medicaid drug coverage both for acute problems and for managing ongoing chronic or disabling conditions. As of March 2021, 14 states had introduced 17 bills that included provisions related to Medicaid prescription drug costs, and states are also pursuing a range of administrative actions in this area. While drug costs have been a focus for state Medicaid programs even before the COVID-19 fiscal crisis, there may be renewed state interest in examining policy options that would reduce Medicaid drug spending to address fiscal constraints and meet demands for other pandemic-related spending. In response to increased spending on high-cost specialty drugs, the Medicaid and CHIP Payment and Access Commission (MACPAC) recently adopted policy recommendations to Congress related to the Medicaid drug benefit. In addition, some Medicaid drug pricing policies could be included in upcoming legislation that aims to expand coverage, particularly if the policies provide spending offsets. Though attention in current federal actions is largely focused on Medicare drug prices, federal legislation also has been recently introduced or enacted that would affect Medicaid prescription drug policy. Prescription drug spending has again returned to the policy agenda, with Congress and the Administration developing proposals to target drug prices.
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