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Value-Based Contracts: Medicaid Best Price Concerns Could Be Eased With CMS Guidance

 
• By Cathy Kelly

Absent any legislative remedy, an administrative fix could provide manufacturers with confidence that value-based arrangements won’t trigger a new best price, Duke Margolis policy experts propose.

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The Centers for Medicare and Medicaid Services could use its existing statutory authority to issue guidance “clarifying” regulations governing the way manufacturers report pricing under the Medicaid drug rebate program to help enable values-based contracts, according to a policy brief developed by the Duke Margolis Center for Health Policy.

The issue of best price is one of the most frequently cited regulatory obstacles to value-based arrangements such as outcomes-based contracts

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