To amend title XIX of the Social Security Act to exclude abuse-deterrent formulations of prescription drugs from the Medicaid additional rebate requirement for new formulations of prescription drugs, and for other purposes.
Summary
This bill amends title XIX (Medicaid) of the Social Security Act to exclude abuse-deterrent formulations of prescription drugs from the requirement that manufacturers of single-source or innovator drugs pay additional rebates to state Medicaid programs.
Under current law, the Centers for Medicare & Medicaid Services (CMS) must use predictive modeling and other analytic technologies to identify improper Medicaid claims. The bill prohibits a state agency from using or disclosing such technologies except for purposes of administering a state Medicaid program or Children's Health Insurance Program (CHIP). A state agency shall have in effect adequate data security and control policies to ensure that access to such information is restricted to authorized persons for authorized uses.
The bill places $5 million in the Medicaid Improvement Fund to be available beginning in FY2021.