Medicaid Prescription Drugs: Pricing and Policy Issues


Sandra Olivia Barton (Editor)

Series: Health Care in Transition
BISAC: LAW093000

Medicaid is a federal-state entitlement program that pays for health care and related services on behalf of certain low-income individuals. Prescription drugs are an optional Medicaid benefit and all states cover outpatient drugs. States can create formularies, or lists of preferred drugs, but federal rules tend to result in comprehensive coverage, even for beneficiaries enrolled in Medicaid managed care plans.

Pharmaceutical manufacturers that voluntarily participate in Medicaid are required to pay rebates to states on covered outpatient drugs, which help Medicaid receive manufacturers’ lowest or best price. States then share the rebate they receive from pharmaceutical manufacturers with the federal government. This book discusses Medicaid prescription drug pricing and policies. (Imprint: Nova)

Table of Contents

Table of Contents


Chapter 1 – Medicaid Prescription Drug Pricing and Policy (pp. 1-80)
Cliff Binder

Chapter 2 – Medicaid Prescription Drugs: CMS Should Implement Revised Federal Upper Limits and Monitor Their Relationship to Retail Pharmacy Acquisition Costs (pp. 81-116)
United States Government Accountability Office

Index 117

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