Michigan Medicaid Value-Based Prescription Drug Plan Approved

Posted on November 27, 2018

The Centers for Medicare & Medicaid Services recently approved a plan that allows the Michigan Department of Health and Human Services to enter into outcomes-based contracts with drug manufacturers for drugs provided to Medicaid patients.

The longstanding Medicaid Drug Rebate Program requires prescription drug manufacturers to pay a rebate to states and the federal government to offset the overall cost of their drugs that are paid under the Medicaid program. Under Michigan’s newly approved plan, drug manufacturers would be liable for higher supplemental rebate payments to the state if a medication does not result in agreed-upon patient outcomes. This demonstrates that the state is seeking opportunities for value initiatives that align with goals of the Quadruple Aim.

Michigan is the second state to receive federal approval of a value-based prescription drug payment program. Oklahoma’s program was approved earlier this year. Members with questions should contact Jason Jorkasky at the MHA.

Tags: Medicaid, CMS, prescription drugs, Medicaid drug rebate program

Posted in: Member News

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