Medicaid is a joint Federal-State program that pays for medical assistance for individuals and families with low incomes and relatively few assets. Although pharmacy coverage is an optional benefit under federal Medicaid law, all States currently provide coverage for outpatient prescription drugs to all categorically eligible individuals and most other enrollees within their Medicaid programs.
The Medicaid prescription drug programs include the management, development, and administration of systems and data collection necessary to operate the Medicaid Drug Rebate program, the Federal Upper Limit calculation for generic drugs, and the Drug Utilization Review program.
Additionally, the Medicaid prescription drugs section provides information related to State prescription drug resources on each State Medicaid program's prescription drug programs, information on the Medicaid Drug Rebate Dispute Resolution Program, and program releases issued by CMS on a regular basis.
To receive updates on the Medicaid prescription drug programs, please subscribe to our Medicaid Prescription Drug Policy & Reimbursement Updates Mailing List for notification on the latest information.
8/28/2014 - The Federal Upper Limits (FUL) page has been updated to add the June 2014 AMP-based and 3MRA FUL files.
08/15/2014 - The Medicaid Drug Rebate Program Data page has been updated with a new web file structure and data definitions for the drug product data file for 3Q2014 and later, which reflects the new data fields. The list of products that are in the MDR program but are not listed with FDA has also been updated.