CIS expert Sharon H. Greeson, R.Ph provided insight on CMS' expectation that states implement a new formula mandated under the PPACA that will significantly trim Medicaid reimbursement rates for generic drugs.
Compliance Implementation Services (CIS), a leading life sciences consulting firm, today announced that Sharon H. Greeson, R.Ph, Strategic Consultant, Government Pricing and Programs at CIS, was quoted in Modern Healthcare's recent article, "Reform Update: Pharmacists call for delay on new Medicaid generic reimbursement rates." Greeson commented on CMS' expectation that states implement a new formula mandated under the Patient Protection and Affordable Care Act that will significantly trim Medicaid reimbursement rates for generic drugs. She is quoted, "Beneficiary access could be an issue if implemented as is, as many providers could refuse to dispense medications where the reimbursement falls below their cost."
For the complete article, visit: http://www.modernhealthcare.com/article/20140415/NEWS/304159964/reform-update-pharmacists-call-for-delay-on-new-medicaid-generic. (Free registration to Modern Healthcare is required.)
Pharmacy stakeholders are trying to delay the move for a year to allow for time to come up with new dispensing fees and adopt the new formula under legislative and regulatory changes as needed. CIS' Chris Cobourn, Senior Vice President, Commercial Compliance, wrote an article for CIS' Blog entitled, "Multiple Stakeholders Send Letter to Secretary Sebelius Urging One-Year Transition Period for AMP- Based FULs," in which he says, "I would also agree with delaying Average Manufacturer Price (AMP)-based Federal Upper Limits (FULs) as CMS has not yet published the Final AMP Rule which will define how manufacturers must calculate AMP. Manufacturers have been operating without regulatory direction since the implementation of the Patient Protection and Affordable Care Act (PPACA) which redefined AMP in October 2010."
Modern Healthcare approached CIS to comment on this topic given our experts' extensive knowledge and commentary on CMS' AMP Final Rule and our insight into state Medicaid programs. CIS has developed relationships with state directors of pharmacy benefits and provides state Medicaid service offerings which help pharmaceutical manufacturers understand and plan for the expansion of Medicaid and Medicaid and Managed Care rebate liability.
About Compliance Implementation Services (CIS) CIS is a regulatory advisor and implementation firm that provides specialized consulting and operational services to life sciences companies. We offer a broad portfolio of services and solutions that expand deep into the clinical, manufacturing and commercial disciplines and that align with our clients' strategic priorities and business operations.
CIS continually provides leadership, global regulatory knowledge, deep industry experience and a problem-solving culture that responds to today's compliance and commercial challenges.
For more information, visit www.cis-partners.com.