The Year in Medicaid 2024

The Year in Medicaid 2024

In this look back at the events of 2024, we recap significant events that shaped Medicaid pharmacy practice.

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 What the Medicaid Rebate Final Rule Means for Manufacturers

What the Medicaid Rebate Final Rule Means for Manufacturers

On November 19, 2024, the 2024 Medicaid Rebate Final Rule went into effect. The Final Rule establishes new oversight and enforcement measures for the Medicaid Drug Rebate Program (MDRP), primarily based on the changes introduced by the Medicaid Services Investment and Accountability Act of 2019 (MSIAA).

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 Register for Crossroads 2025

Register for Crossroads 2025

Registration for Crossroads 2025 is officially open. Crossroads will be held on August 25-27, 2025, in Nashville, Tennessee.

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 Changes to New York’s Rebate Programs

Changes to New York’s Rebate Programs

Manufacturers are often intimidated when directed by New York to participate in Medicaid, due to the uniqueness of their programs. We aim to eliminate confusion in navigating these processes to resolution. In this blog post, we’ll walk you through a summary of the most recent changes to the New York Medicaid programs.

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 State Medicaid Programs Retake Pharmacy Controls

State Medicaid Programs Retake Pharmacy Controls

State Medicaid programs’ relationships with managed care organizations that serve Medicaid recipients continue to evolve. Just when it appears that trends are slowing or stabilizing, a new method is introduced. The latest development could overlap existing state controls to bring even more pharmacy control back to state management.

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 Reimbursement Challenges with High-Cost Inpatient Drugs

Reimbursement Challenges with High-Cost Inpatient Drugs

The management and reimbursement of inpatient drug costs in Medicaid programs are pivotal topics, especially with the proliferation of high-cost therapies. The emergence of expensive inpatient drugs, such as cell and gene therapies, have challenged Diagnosis Related Groups (DRGs), the traditional bundled payment system used by hospitals.

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