Medicaid Managed Care

Medicaid VBPs for Patients Act (MVP Act)
Advocacy Issue

Medicaid VBPs for Patients Act (MVP Act)

Value-based payments (VBP) systems incentivize providers to improve patient outcomes, reduce costs, and improve the overall patient experience, making them a critical tool for promoting high-quality, affordable care. However, defining and measuring the value of a drug can be complex, especially when considering factors like clinical outcomes, patient characteristics, and population health. AMCP supports the Medicaid VBPs for Patients (MVP) Act to modernize the framework for value-based purchasing arrangements in Medicaid, ensuring that the proper channels exist to connect Medicaid patients with the therapies they need.
Legislation & Regulation, Medicaid Managed Care
Resource

AMCP Summary: Fraud and Abuse; Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain POS Reductions in Price on Prescription Pharmaceuticals

On January 31, 2019, HHS proposed sweeping changes to the current system for medication pricing and contracting by PBM companies in federal programs. This summary reviews OIG's proposal to eliminate the safe harbor protections for rebates that exist in the federal Anti-Kickback Statute (AKS) and replace these protections with proposed new safe harbors allowing for point-of-sale discounts to beneficiaries and for manufacturer-paid service fees to PBMs.
Medicaid Managed Care, Medicare Part D, Rebates, Legislation & Regulation