New Medicaid Model for Treatment of Rare Diseases Introduced

The Centers for Medicare & Medicaid Services (CMS) announced the Cell and Gene Therapy (CGT) Access Model, an initiative that aims to improve the lives of people with Medicaid living with rare and severe diseases by increasing access to potentially transformative treatments. Initially the model will focus on increasing access to gene therapy treatment for sickle cell disease, a genetic blood disorder that disproportionately impacts Black Americans. CGT is a multi-year payment model with state Medicaid agencies and pharmaceutical companies acting as participants, with optional grant funding available for states to provide an increased level of support for patients receiving gene therapy. CMS expects to release a Request for Application (RFA) to manufacturers in early spring 2024 and an RFA and Notice of Funding Opportunity (NOFO) to states in summer 2024.

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