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Keeping you afloat amidst the rising sea of regulations

Alternative, Value Based Payment Models Reach Part B Drugs

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule on March 8, 2016 (published in the Federal Register on March 11, 2016) which could fundamentally change the way in which drugs administered in the physician office or hospital outpatient department settings (generally referred to here as Part B Drugs) are reimbursed by the Medicare program.

New Law Allows Texas State Board of Pharmacy to Scrutinize Compounding Pharmacies’ Relationships with Physicians

The federal government has focused on compounding pharmacies and pharmacists for fraud and abuse investigations in recent years, and now the great state of Texas has joined in.

A Closer Look at AMP and Other Regulations: The Impact on Generics

On Thursday, February 18, please join Arent Fox partner Stephanie Trunk and Deloitte Senior Manager Rick Moore for a webinar that will break down the provisions of the AMP final rule and other regulatory guidance with a special focus on the needs and considerations of generic manufacturers. Topics will include:

The Final AMP Rule: An Overview for Stakeholders

On January 21, 2016, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited Final Rule implementing changes to the Medicaid Drug Rebate Program (MDRP) under the Affordable Care Act (ACA).

Final Average Manufacturer Price (AMP) Rule Released!

On January 21, 2016, the Centers for Medicare & Medicaid Services released the Medicaid Covered Outpatient Drugs Final Rule (commonly referred to as the Final AMP Rule), which is available here. The rule is effective April 1, 2016, with a compliance date of April 1, 2017. The Arent Fox team will subsequently issue a comprehensive Client Alert. Stay tuned!

Final Average Manufacturer Price (AMP) Rule Released Once Again By Office of Management and Budget

On January 19, 2016, the Office of Management and Budget once again released the Medicaid Covered Outpatient Drugs Final Rule (commonly referred to as the Final AMP Rule) back to the Centers for Medicare & Medicaid Services (CMS). The precise time of the public release by CMS is anyone guess but it is expected to be imminent.

Final Average Manufacturer Price (AMP) Rule Back at Office of Management and Budget

On January 5, 2016, the Centers for Medicare & Medicaid Services (CMS) sent the Medicaid Covered Outpatient Drugs Final Rule (commonly referred to as the Final AMP Rule) to  the Office of Management and Budget for review.  The Final AMP Rule was originally reviewed and released by the OMB on December 11, 2015.   The return of the Final AMP Rule from CMS to OMB technically triggers another 90-day OMB review cycle.  However, it is unclear whether OMB will require a full 90 day review or whether the changes made by CMS were technical and can be reviewed more quickly.  As we previously note

OMB Clears Final Average Manufacturer Price (AMP) Rule

The Medicaid Covered Outpatient Drugs Final Rule completed review by the Office of Management and Budget late on Friday, December 11. It has been almost 4 years since publication of the 2012 Proposed AMP Rule aimed at implementing changes to the AMP calculation as set forth in the Affordable Care Act. The Arent Fox team will promptly post once the Final AMP Rule is release and subsequently issue a comprehensive Client Alert. Stay tuned!

Texas Medicaid Transitioning to National Average Drug Acquisition Cost (NADAC)-Based Pharmacy Reimbursement

The October 30, 2015 Texas Register contained a proposed regulation published by the Texas Health and Human Services Commission (HHSC) that would replace pharmacy reimbursement under the Texas fee-for-service Medicaid program, currently based on Estimated Acquisition Cost, with Acquisition Cost based on NADAC, Long Term Care Acquisition Cost and Specialty Pharmacy Acquisition Cost.  In addition, the proposed regulation would repeal burdensome price reporting requirements for drug manufacturers, and instead requir

CMS Reminds States of Coverage Obligations for Hepatitis C Drugs

On November 5, 2015, the Center for Medicaid and CHIP Services, a division of the Centers for Medicare & Medicaid Services (CMS), issued a Medicaid Drug Rebate Program notice (the Notice) to state Medicaid contacts emphasizing appropriate access to, and coverage of, direct-acting antiviral (DAA) drugs used to treat individuals with the hepatitis C virus (HCV).