The rebate program reduces net federal and state Medicaid spending on prescription drugs. In 2017, Medicaid spent $64 billion on drugs and got $34.9 billion in rebates from manufacturers. Net spending was $29.1 billion.
Managing the prescription drug benefit and expenditures is a perennial policy priority for state Medicaid programs, in part because policymakers remain concerned about spending growth. We explore key questions about states’ administration of this benefit.
The pending expiration of an ACA provision regarding Medicaid spousal impoverishment rules on Dec. 31 could tip the balance of financial incentives toward institutional long-term care and away from home and community-based services.
Funding is set to expire on Dec. 31. The program provides states with enhanced federal matching funds for services and supports needed to help seniors and people with disabilities transition from institutional care to community-based care.
Tennessee’s proposal to finance its Medicaid program through a “modified block grant” that allows for shared savings could create an incentive for the state to reduce optional eligibility or services for high-cost enrolees so that it can achieve savings.
Medicaid is a large source of federal and state spending. Recent audits and improper payment reports have brought program integrity issues to the forefront. We explain what program integrity is, CMS efforts to address it and current and emerging issues.
Most (63%) of the 23.5 million adults with Medicaid coverage in the U.S. who are not eligible for both Medicare and Medicaid, and who do not receive federal disability payments, are already working full- or part-time.
The ACA’s Medicaid expanion has increased health coverage, affordability and access to care while producing budget savings for states, according to a review of more than 300 studies and policy reports.