The Centers for Medicare & Medicaid Services (CMS) is responsible for implementing laws passed by Congress related to Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program. To implement these programs, CMS issues various forms of guidance to explain how laws will be implemented and what states and others need to do to comply. In addition to regulations, CMS issues sub-regulatory guidance to address policy issues as well as operational updates and technical clarifications of existing guidance.
Federal Policy Guidance
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Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements (CMS 2482-P)
Date:
Topics:
- Prescription Drugs
- Eligibility
Type: Regulations
Best Practices for Avoiding 340B Duplicate Discounts in Medicaid
Date:
Topics:
- Prescription Drugs
Type: Informational Bulletin
Covered Outpatient Drug; Further Delay Of Inclusion Of Territories In Definitions Of State And United States (CMS–2345–IFC3) – Interim Final with Comment
Date:
Topics:
- Financing & Reimbursement
- Prescription Drugs
Type: Regulations
Medicaid Prescription Spread Pricing
Date:
Topics:
- Financing & Reimbursement
- Affordable Care Act (ACA)
- Prescription Drugs
Type: Informational Bulletin
Final Rule and Interim Final Rule with Comment Period: Medicaid Program; Covered Outpatient Drug; Finalization of Line Extension Definition; and Change to the Rebate Calculation for Line Extension Drugs (CMS-2345-F2 and 2345-IFC2)
Date:
Topics:
- Affordable Care Act (ACA)
- Financing & Reimbursement
- Prescription Drugs
Type:
National Medicaid Drug Rebate Agreement (CMS-2397-FN)
Date:
Topics:
- Affordable Care Act (ACA)
- Financing & Reimbursement
- Prescription Drugs
Type: Regulations
State Flexibility to Facilitate Timely Access to Drug Therapy by Expanding the Scope of Pharmacy Practice using Collaborative Practice Agreements, Standing Orders or Other Predetermined Protocols
Date:
Topics:
- Affordable Care Act (ACA)
- Financing & Reimbursement
- Prescription Drugs
Type: Informational Bulletin
Medicaid Program Covered Outpatient Drug Interim Final Rule (CMS 2345-IFC)
Date:
Topics:
- Financing & Reimbursement
- Prescription Drugs
- Affordable Care Act (ACA)
Type: Regulations
Medicaid Drug Rebate Program National Rebate Agreement
Date:
Topics:
- Affordable Care Act (ACA)
- Financing & Reimbursement
- Prescription Drugs
Type: Regulations
Covered Outpatient Drug Final Rule with Comment (CMS-2345-FC)
Date:
Topics:
- Affordable Care Act (ACA)
- Financing & Reimbursement
- Prescription Drugs
Type: Frequently Asked Questions