As one of the nation’s most vital health care safety net programs, Medicaid provides health coverage for more than 72 million Americans. And all states cover optional outpatient prescription drugs. The Medicaid Drug Rebate program covers FDA-approved prescription drugs in exchange for rebates to states from manufacturers.

While curative drug treatments are an important part of the health care that individuals receive, rising costs and gaps in the process hinder state Medicaid programs’ ability to affordably access newer treatments. Federal pharmacy policies must consider the impact of these challenges on Medicaid programs and patients who need critical breakthrough drugs.

As the voice for state Medicaid directors in national policy discussions, NAMD is actively engaged in ongoing discussions with federal policymakers and stakeholders on these issues. NAMD also supports a group of pharmacy policy and technical experts to address critical priorities and gaps for Medicaid pharmacy programs.

NAMD has reviewed many Medicaid drug rebate and pharmacy-related proposals and released memos and letters to policymakers to on pharmaceutical issues including the role of genetic drugs, coordination between institutions like CMS and the FDA, and the voices of states and their Medicaid programs in the face of increasing drug and treatment prices.

NAMD Submits Comments on New Direction for CMMI

On November 20, NAMD submitted comments to a CMS Request for Information regarding future directions for the Center for Medicare and Medicaid Innovation (CMMI). NAMD calls for a stronger partnership between states and CMMI to promote further demonstration and alternative payment model alignment, and provides several specific issue areas where this partnership can be applied […]

NAMD Legislative and Regulatory Priorities for 2017

NAMD’s legislative and regulatory priority documents outline opportunities to modernize the federal rules governing Medicaid to ensure these comport with the realities and expectations for states to run high performing Medicaid programs. NAMD believes these modernizations – in federal statute and in federal regulation – can have a meaningful, positive impact for Medicaid enrollees. See […]

NAMD Memo on Impact of EpiPen Price Increases on the Medicaid Program

NAMD sent a memo to Congressional staff on the impact of EpiPen price increases on the Medicaid Program. Read full memo.

NAMD Submits Comments on Reopened 340B Ceiling Price Rule

On May 18, NAMD submitted comments to the Health Resources and Services Administration (HRSA) in response to reopened provisions of a proposed rule on the 340B drug discount program. NAMD called for HRSA to maintain its initially proposed “penny pricing” method for 340B drugs, for HRSA to align the 340B ceiling price for new drugs […]

NAMD Spring 2016 Federal Policy Update

NAMD staff prepared a memo for Directors outlining key federal regulatory and legislative priorities for the remainder of the year. It provides a snapshot of major priorities for HHS, including completion of the final Medicaid managed care rule, systems work, and value-based purchasing. It also provides an assessment of legislation which is likely to impact […]