Medicaid Drug Payments Linked to Patient Outcomes and Effectiveness.
This Act formally establishes Value-Based Purchasing (VBP) arrangements within Medicaid, linking drug payments to actual patient health outcomes. If an expensive drug fails to deliver the defined results, manufacturers must provide refunds or rebates, reducing financial risk for public health programs and potentially improving access to innovative treatments. The law also adjusts price reporting rules for both Medicaid and Medicare to accommodate these new payment models.
Key points
Value-Based Purchasing (VBP) Codified: Medicaid and Medicare payments for certain drugs are tied to whether the patient achieves specific health outcomes.
Financial Risk Reduction: States receive refunds from manufacturers if drugs do not perform as expected, ensuring taxpayer money is spent on effective treatments.
Improved Access: By lowering the financial risk for states, the bill aims to facilitate patient access to high-cost, transformative therapies, such as gene therapies.
Expired
Citizen Poll