The House of Representatives has overwhelmingly approved H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act, which would finance extension of various Medicaid-related health programs by increasing manufacturer Medicaid drug rebate obligations. In terms of health programs, the legislation also would, among other things:
- Extend the "Money Follows The Person Rebalancing Demonstration" and the Medicaid demonstration program for certified community behavioral health clinics.
- Authorize state Medicaid fraud control units to review complaints of abuse or neglect involving patients in noninstitutional or other settings.
- Extend through March 31, 2024 the applicability of current Medicaid spousal impoverishment protections for recipients of home- and community-based services.
- Increase funding for the Medicaid Improvement Fund.
To offset the costs of these provisions, H.R. 3253 would make two changes to Medicaid drug rebate rules. First, the legislation would prohibit manufacturers from blending the average manufacturer price of a brand drug and any authorized generic of the drug for Medicaid drug rebate purposes. Second, the bill would exclude manufacturers from the definition of “wholesalers” for purposes of rebate calculations. The Congressional Budget Office (CBO) estimates that the Medicaid drug rebate provisions would save the federal government $1.17 billion over 5 years (FYs 2020-2024) and $3.08 billion over 10 years (FYs 2020-2029).
The legislation was passed on a bipartisan vote of 371 to 46. It now moves to the Senate.
This article is presented for informational purposes only and is not intended to constitute legal advice.
