CMS recently finalized the rule, Medicaid Program: Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program. Find a corresponding fact sheet here. In the rule, CMS finalizes their proposals to: 1) address misclassification of drugs by manufacturers, 2) limit the time period for manufacturers to initiate disputes concerning utilization data to 12 quarters, 3) require that managed care contracts include new information on spread pricing, and 4) require that ingredient cost reimbursement and professional dispensing fee reimbursement be based on cost data and not market-based research. Notably, CMS did not finalize their proposal to create a Medicaid drug price verification survey.
