Bach Outlines ‘Gaping’ Loophole in Medicaid Proposal

July 15, 2020

A Centers for Medicare and Medicaid Services proposal includes a “gaping” loophole through which drugmakers could avoid selling drugs to Medicaid for the lowest possible price, Peter Bach writes in a Health Affairs Blog post.

The proposal, he writes, opens the door for drugmakers to exploit stipulations around value-based agreements.

“According to the proposal, a Medicaid program could only have access to the drug for that lower price if it agreed to the same value-based purchasing agreement that produced the low price in the first place,” Bach writes. “But there is no indication that drug companies would be required to even notify Medicaid programs of the existence of those agreements … .”

To read the full blog post, click here.

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