CMS Holds Back Medicaid Rebate Reporting Policy for Two Years

In a final rule, the Centers for Medicare and Medicaid Services (CMS) has pushed back implementation of a new policy that requires drugmakers to account for discounts that do not actually lower drug prices for patients.

The policy will require drugmakers to report discounts to CMS that do not help patients and instead lower costs for health insurers and pharmacy benefit managers (PBMs). It is intended to help ensure that patients see lower out-of-pocket costs through cost-sharing assistance, including copayment assistance cards provided by pharma companies.

CMS said that it is delaying the policy for two years (January 2023) to give manufacturers, insurance companies and PBMs time to make any necessary changes to the reporting systems used to offer discounts in patient assistance programs.