The Medicaid and CHIP (Children’s Health Insurance Program) Payment and Access Commission (MACPAC) released its June 2021 Report to Congress on Medicaid and CHIP on June 15.
The June 2021 report contains a chapter addressing high-cost specialty drugs in the Medicaid program, in which the commission recommends that Congress “increase the minimum rebate percentage on drugs approved by the U.S. Food and Drug Administration (FDA) through the accelerated approval pathway until the manufacturer has verified the clinical benefit.”
The commission also recommends increasing the additional inflationary rebate on drugs that receive approval through the FDA’s accelerated approval pathway; the recommendation clarifies that the rebate would revert back to the standard amount upon the FDA granting traditional approval. The commission suggests these modifications would address state concerns over high drug prices while ensuring access for beneficiaries.
Moreover, the report includes a chapter on state strategies for integrating care for dual-eligible beneficiaries. While the chapter contains no recommendations, it reflects on ways state Medicaid programs can use their contracts with Medicare Advantage dual eligible special needs plans to promote enrollment in integrated plans.
- Washington Highlights