Medicaid Prescription Drug Programs
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.
11/27/2013 - Effective November 27, 2013, CMS began posting final NADAC files on the Survey of Retail Prices page.
11/26/2013 - The Federal Upper Limits (FUL) page has been updated to add the September 2013 AMP-based and 3MRA FUL files.
11/14/2013 - The list of products that are in the MDR program but are not listed with FDA has been updated on the Medicaid Drug Rebate Program Data page.
11/5/2013 - The Federal Upper Limits (FUL) page has been updated with the September 2013 monthly AMP Reported or Not Reported file.
11/5/2013 - The Medicaid Drug Rebate Program page has been updated with the 3rd quarter Drug Manufacturer Contact Information and State Contact Information.
11/5/2013 - The Medicaid Drug Rebate Program Data page has been updated with the 3rd quarter Rebate Product File & 3rd quarter AMP Reported or Not Reported file.