Value-Based Contracting: CMS Final Rule Leaves ‘Multiple Best Price’ Questions Unresolved

The Centers for Medicare and Medicaid Services final rule addressing Medicaid value-based purchasing arrangements for drugs won’t move the needle much in the near term on advancing innovative purchasing arrangements for cell and gene therapy, an issue of increasing concern to Medicaid programs and other payers.

Published in the 31 December Federal Register, the final rule’s provisions aimed at supporting value-based payment arrangements are very similar to the proposed version. Importantly, the final rule acknowledges the concerns raised in stakeholder comments on implementing “multiple best price” reporting but puts off resolving them. The rule also addresses changes to Medicaid rebate requirements for line extensions